What’s the big deal about the Triad and RED-S?

I am so excited that the winter Olympics has begun! It is always inspiring to see so many talented individuals excelling in the sport they love. With so much talk about the athlete’s performance and fueling, I thought it was appropriate to discuss the concepts of the Female Athlete Triad (Triad) and Relative Energy Deficiency in Sport (RED-S). As athletes training intensity and duration increases, they are at a higher risk of developing these conditions.

So what is the Traid? The Triad consists of three conditions, a low level of available energy, irregular menstrual cycle and bone loss. This condition is common in athletes where aesthetics and weight are extremely important for success. In extreme cases, when the Triad is experienced over a long period of time, female athletes can suffer from amenorrhea, infertility, stress fractures and develop osteoporosis. As you can tell, if an athlete is dealing with any of the symptoms of the Triad, their performance will suffer and they SHOULD reach out for help.

Further research assessed that the underlying factor that impact all aspects of the Triad begins with a low level of energy intake when compared to the energy expended. Obviously, this concept does not only affect women; men are also subject to low energy availability. After further assessment, the International Olympic Committee (IOC) termed the overall syndrome, which effects men and women, Relative Energy Deficiency in Sport (RED-S). In the cited consensus statement, “RED-S refers to impaired physiological function including, but not limited to, metabolic rate, menstrual function, bone health, immunity, protein synthesis, cardiovascular health caused by relative energy deficiency.”

So what is the big deal? Long term effects of RED-S could lead to nutrient deficiencies, mood changes, eating disorders, chronic fatigue and increased immune vulnerability. Medical and physiological damage can occur to the cardiovascular, endocrine, skeletal, renal, gastrointestinal, reproductive and central nervous systems. Basically, all our important systems in the body become at risk if we do nothing and continue to be in an unhealthy energy deficiency! Putting yourself into an extreme energy deficiency and maintaining a high level of training is very dangerous and will not give you the results you are looking for.

This is a HUGE deal!! I work with athletes all the time who want to drop weight and cut calories. On a weekly basis, I see individuals who have succumb to an extreme energy deficiency and are now having to deal with those consequences. Often times, they are extremely fatigued, testosterone is low, lacking a regular menstrual period, experiencing dizziness often, feeling like food is the enemy, struggling with recovery and are going down the path of disordered eating. None of those symptoms I just listed will help you achieve your goals.

Any athlete reading this should take a moment to assess how their energy intake has compared to energy expenditure. As training volume goes up, your needs go up. Therefore your energy consumption should change depending on goals and whether you are in season or off-season. If weight loss is your goal, I highly recommend you focus on that during off-season or during the very first part of your training when volume is lower. Adequate energy intake and a focus on nutrition are extremely important in order to train and perform at your best.

Remember, thin does not mean healthy no matter what sport you are in. Choosing to make healthy changes to your physique, if needed, with proper education is very important. Changes take time, so seek assistance and be patient. Don’t let urgency of weight loss or the pressure of fitting into a “perfect” physique ruin your athletic abilities, health or dreams!

Read Allie Kieffer and Adam Rippon stories to learn about their struggles with body image, proper fueling and performance. I hope this blog has hit home to yall and maybe helps you think a little more about your nutrition and performance!

Please feel free to leave comments or questions below regarding energy needs, nutrition for performance or any other nutrition related topic, I would be happy to help!

Consensus Statement


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