It has been five years since I wrote my first book, Finding Your Sweet Spot: How to Avoid RED-S, to shed light on a complex condition in an understandable way. In 2014, the International Olympic Committee (IOC) expanded the female athlete triad to Relative Energy Deficiency in Sport (REDs) as we learned that the effects of low energy availability impact more than just females and much more than just bone density and the menstrual cycle. Finding Your Sweet Spot: How to Avoid RED-S was the first book written exclusively on the topic.
What is REDs and Why It Matters
In the last five years, awareness of REDs has risen exponentially – so much so that one paper has even begun questioning its existence. (You can hear more of my thoughts in this article here). While REDs is a diagnosis of exclusion, so too is Irritable Bowel Syndrome (IBS), Bell’s Palsy, and Schizophrenia, to name a few. Their symptoms aren’t any less real whether the syndrome “exists” or not. Reports of the prevalence of low energy availability (LEA) / REDs in females ranges from 23%- 79.5% across various sports. Whether the real prevalence is 1% or 100%, it is a syndrome affecting athletes that I see almost daily. I acknowledge that there is a place for statistical risk; however, for athletes themselves, or those that care for athletes, it honestly doesn’t matter. No level of underfueling is insignificant.
The Athlete Experience: When REDs Symptoms Are Overlooked
Like many of us that go on to create a career within this realm, it is because we have our own story. A story of what it was like to have so many puzzle pieces being looked at in isolation and never put together to see the big picture. The horrible GI health and repeated trips to the doctor for Irritable Bowel Syndrome (IBS). Being denied the ability to donate blood because I was anemic. My irregular menstrual cycle and missing periods not being flagged because menstrual cycles were never talked about. Injuries not healing, excessive fatigue, dreading practice, mood changes, and so much more. It was all connected. This is what led me to go back to school as I realized there is power in nutrition, yet there is also power in the misinformation that we are fed each and every day.
Raising REDs Awareness Through Shared Stories
My first book on REDs raised a lot of awareness and I received countless stories from athletes detailing how they finally felt heard and could relate to the stories of other athletes in the book. This newfound awareness helped athletes learn the cause of all their seemingly unrelated problems and helped athlete providers learn how to identify, treat, and assess REDs. Awareness of the problem is the first step towards finding a solution.
After watching the 2024 summer Olympics, my passion for expanding this discussion only grew stronger. Ilona Maher, USA Rugby sevens Olympic bronze medalist, who has posted several videos promoting adequate fueling and appreciating what our bodies do rather than what they look like. Henrik Christiansen, a three time Olympic swimmer for Norway, started the Olympic village chocolate muffin craze, igniting numerous other olympic athletes to post their own reviews of the infamous muffin. Not to mention athletes like Simone Biles, the most decorated gymnast in history, using her platform to speak on the importance of mental health.
These are just a few of what seemed to be significantly more stories of athletes prioritizing fueling, physical health, and mental health at the 2024 summer Olympics more than any of the prior Olympics. These athletes are changing the narrative that you do not get to the highest stage in the world in spite of poor mental and physical wellbeing, but because of prioritizing mental and physical wellbeing. I hope and dream that we may just see the first generation of well-fueled athletes. Athletes that prosper at sport and most importantly – LIFE.
What We’ve Learned In The Past Five Years
These past five years have furthered our understanding of what REDs is and how it negatively impacts athletes’ health and performance. The continued challenge is that knowledge can only take us so far. Despite an increase in research showing that underfueling is counterintuitive, and despite brave athletes sharing their stories to raise awareness, we continue to see athletes struggling with REDs.
Why REDs Awareness Alone Isn’t Enough
After devoting years to treating athletes, I have noticed a common theme. Somewhere along the way a trusted person in their life led them to believe they were the exception. They led them to believe that underfueling would not harm them. That underfueling was what they needed to do to succeed. That underfueling was what everyone else was doing. The list of origin stories go on and on, but the outcome is always the same. At some point resiliency wavers.
From Awareness To REDsolution
While I have seen countless athletes struggle with REDs, I have seen just as many recover and become healthier, happier, stronger, faster, more durable, etc. It’s time to do more than create awareness, it’s time to find a resolution – or rather, a REDsolution.
If you’re a player, parent, or coach looking for a resolution, visit my website and learn more about my services for athletes.
Craving more information on REDs? Check out my interview on the Eat for Endurance video and audio podcast. We had a great conversation about REDs and the many different health and performance issues, including some not as commonly talked about (e.g. high cholesterol may be a result of chronic underfueling).