Relative Energy Deficiency in Sport (RED-S)

RED-S is becoming a more talked about issue in sports and especially in rock climbing. It is a condition that can affect anyone that participates in sports, especially at a competitive level.

When RED-S is present, an individual is not eating enough to provide the amount of energy needed to support the range of body functions involved in optimal health and performance. RED-S is present when Low energy availability (LEA) occurs. LEA is when a reduction in energy intake ie food and/or increased exercise, causes negative adjustments to body systems. This will cause negative consequences to performance and health.

RED-S is a condition that affects many aspects of physiological function including;

· metabolic rate

· bone health

· immunity

· protein synthesis

· menstrual function

· cardiovascular health

· psychological health

It is important that RED-S is identified and managed as early as possible. Some of the common symptoms of RED-S are;

· mood changes, poor concentration

· failure to improve in sport or under-performance

· recurrent injuries

· low energy levels

· loss of enjoyment of sports

· altered or absent menstruation

RED-S can be difficult to diagnose, and it may have multiple causes. Where RED-S is suspected, a medical doctor should be consulted.

An info sheet from High Performance Sport New Zealand (HPSNZ) on RED-S can be found here.

The Australian Institute of Sport has produced an education module on LEA (low energy availability) and RED-S. Much of the information in the module is relevant to all genders.

The International Federation of Sport Climbing (IFSC) responded to the issue of athlete health and wellbeing through several statements including this one (July 2023). Read the full IFSC statement here The IFSC Medical Commission is developing a plan to move the IFSC towards a more robust policy relating to RED-S in 2024.   Read more here

Many thanks to Karen Carmichael for this comprehensive explanation of RED-S, symptoms and effects.