The updated position statement from the International Olympic Committee (IOC) on Relative Energy Deficiency in Sport (REDs) was recently published in the British Journal of Sports Medicine following a preview at the Female Athlete Conference last June here in Boston. The last REDs consensus statement was published in 2018 so this new statement reflects a significant amount of new research (178 new studies!!), primarily on women (80% of study participants!!) (Montjoy et al, 2023). Below is a summary of my key takeaways from the update.

Summary

• Low Energy Availability (LEA) is the underlying cause of REDs. LEA is defined as “any mismatch between dietary energy intake and energy expended in exercise that leaves the body’s total energy needs unmet, that is, there is inadequate energy to support the functions required by the body to maintain optimal health and performance” (Montjoy et al, 2023).
• LEA is classified as “Adaptable” or “Problematic”. Adapatable LEA is “typically a short-term exposure to a reduction in energy availability with minimal (or no) impact on long-term health, well-being or performance” (Montjoy et al, 2023). Problematic LEA is “exposure to LEA that is associated with greater and potentially persistent disruption of various body systems, often presenting with signs and/or symptoms, and represents a maladaptive response” (Montjoy et al, 2023).
• The definition of REDs was updated to reflect the expanded impacts of problematic LEA on health and performance. REDs is “a syndrome of impaired physiological and/or psychological functioning experienced by female and male athletes that is caused by exposure to problematic (prolonged and/or severe) low energy availability. The detrimental outcomes include, but are not limited to, decreases in energy metabolism, reproductive function, musculoskeletal health, immunity, glycogen synthesis, and cardiovascular and hematological health, which can all individually and synergistically lead to impaired well-being, increased injury risk, and decreased sports performance”(Montjoy et al, 2023).
• Not eating enough carbohydrates, known as Low Carbohydrate Availability (LCA), may accelerate the onset of REDs, and can potentially occur without LEA, though more research is needed (Montjoy et al, 2023).

What does this mean for you?

Not eating enough is like putting regular gas in a high-end sports car that requires premium fuel. While you can get from point A to point B, your engine might sputter and slow, and will start to accumulate damage over time with repeated exposure, and eventually need to be replaced. Except your engine is irreplaceable! And new research suggests damage may occur, even if overall energy intake is sufficient but carbohydrate intake is insufficient (i.e. low carbohydrate availability). Nutrify can help. Invest in a comprehensive nutrition assessment and receive a 3-day meal plan and coaching support you need to help you meet your health & performance goals. Schedule a complimentary introduction call to learn more.

Sources

Mountjoy M, Ackerman KE, Bailey DM, et al 2023 International Olympic Committee’s (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs) British Journal of Sports Medicine 2023;57:1073-1097.