What all people who work out need to know about RED-S

We’ve all had days when we’ve overdone it at the gym and ended up exhausted, or not eaten enough for whatever reason and unleashed a torrent of hanger on those all around us.

But regularly exercising hard and not eating enough to refuel can lead to serious ill health, thanks to a condition called RED-S.

 RED-S stands for Relative Energy Deficiency in Sport.

 It was once known as the Female Athlete Triad, a syndrome found in young sporty women who had symptoms of disordered eating, stopped periods and bone loss.

 However, it has recently been renamed to include a number of other symptoms and to take the experience of men into account.

 Dietitian Renee McGregor launched the TRAIN BRAVE campaign along with athlete and recovered eating disorder sufferer Tom Fairbrother.

 The project aims to raise awareness of RED-S and to change the fitness culture of overtraining and underfuelling.

Renee tells Metro.co.uk: ‘When we exercise, we use energy in order to fuel and power the activities we are performing.

 It is essential that sufficient energy is put into our bodies to meet the demands we place upon it, otherwise there will be an energy deficit.

‘Low energy availability arises if nutritional intake isn’t sufficient to cover the energy demands of both training and resting metabolic processes.

Where there is a prolonged period of low energy availability, this is known as RED-S.’

Whether you’re actively restricting your food intake or not, you can still develop RED-s.

 Renee explains: ‘In some cases the athletes just do not realise that they are underfuelling, for example those that are training but also commute by bike to and from work.

‘While they know to fuel their training, they don’t appreciate the additional demand of their cycling.’

 People who participate in endurance sports such as running, swimming, cycling and triathlon can be at particular risk of RED-S.

‘These require great energy demands over a long period of time,’ says Tom Fairbrother.

‘Gravitational sports, where individuals are required to lift or propel themselves upwards are also particularly at risk, as it be can be perceived that being lighter gives you an advantage.

These activities include gymnastics, climbing and cycling.’ But it’s not just competitive athletes who are in danger.

‘The rise of clean eating fads and social media influencers and bloggers who may not be qualified to provide nutritional advice is a major risk, as individuals may begin to restrict or reduce energy consumption without considering the impact this will have on energy availability,’ Tom tells us.

 While it’s totally normal to enjoy keeping fit and eating a balanced diet, there are certain symptoms that can be a sign your healthy lifestyle is becoming something sinister.

Finding it hard to deviate from your workout routine or diet, feeling cold even when it’s warm outside and having regular injuries are all symptoms of RED-s.

Left untreated, these can eventually lead to serious issues. Renee says: ‘If RED-S goes untreated, the main concern is that it can lead to long term health problems such as infertility, poor bone health; depressed immune system and then also mental health issues around anxiety, social isolation and disordered eating.’ Luckily, RED-s is totally treatable.

‘If any of these symptoms sound familiar, or you have experience some of the physical issues outlined above, it is essential to increase energy availability and restore a positive energy balance,’ Renee explains.

 ‘This effectively means increasing food intake and/or reducing training volume.

‘However, these two things can often be harder than they sound, so professional advice and help can be needed.

‘We encourage you to seek professional help – go to your GP as it is always useful to get blood tests to ascertain the degree of physical damage that is going on, which will then determine what the appropriate path to restoration and recovery is.’

 And if you’re worried about a friend? Renee suggests: ‘Opening up a dialogue is the first step.

Maybe pick up on the fact that you have noticed that they are choosing to miss out on social occasions and wondered if there was something wrong? You could see if they will admit to some of the symptoms mentioned above.

 ‘Help them to identify the opportunities they are missing by pursuing their gruelling training and eating regimen.

Encourage them to talk to you about why they feel the need to push so hard.

Help them to understand that their behaviour is probably a response to stress and anxiety and that they would really benefit from getting some professional support – don’t try to help them without clinical guidance.’