What is RED-S, why is it important, and is your athlete experiencing it? 

Since meeting you over a month ago, I have been working with several of you in our athlete overhaul program. Some commonalities among the crew were from food aversions to less-than-expected growth to significant mood swings. Working alongside their families and creating a decent weekly nutrition structure has been extremely rewarding. 

RED-S: Relative Energy Deficiency in Sports describes a cluster of symptoms all experienced when the nutrition intake does not meet an athlete's bodily requirements, energy output and recovery. I wanted to share some common signs and symptoms that your young athlete may be undernourished. 

The emotion, oh, the emotion! 

 Guys, whether we are 43 or 13, if we are using our body as the primary fuel source, our brain uses anything to get us to change our behaviour and eat! Unfortunately, with school life, social pressures and a whole host of other environmental and genetic factors, your young athlete may not experience the feeling of hunger coming from their stomach. Then it eventually happens: the irrational, completely over-the-top reaction to something completely random and minor. Your beloved sweet child, whom everyone else compliments you about, is now imitating the wicked witch from the west melting in front of you because their sister looked at them weirdly. Ok, I may be projecting from my own house now, but the truth is, we get it when our son or daughter isn't themselves; in all of the young athletes I've worked with in the last month, they have all reported improved emotional regulation, "I'm able to focus more", "things don't bother me as much" and all parents have said they have noticed a change. 

Give me the energy!

The second change I noticed has been energy; I can do more, I feel way better, and their training has been at higher intensities. It sounds simple, but if any athlete wants to be more, do more and achieve more, they will need more energy. Being able to push themselves harder consistently for the entirety of the session builds greater conditioning and confidence in our athletes' ability. One young man has seen a dramatic improvement in this space, often experiencing lightheadedness and weakness on the court, with a schedule of 6-7 matches in a week. This was impacting his experience of the sport. A little nervous as a result; it was just easier not to eat but starting with fluid and now building to a lighter high GI snack before training and game time, he doesn't feel that way anymore. 

More than what it looks like...

Aesthetic concerns. This is from my experience with another athlete in the last month. After returning home from a scholarship experience abroad, the talented young lady, unfortunately, needed to be admitted to the hospital. Unfortunately, the new found independence mixed with their environment had a bias toward a particular aesthetic, and the more undernourished the athlete becomes, the more that perception of deficit creation is normalised. Often, without the guiding hand of those of you reading this, this can become a slippery slope, and this young person lost close to 30% of their body weight and, required hospitalisation to ensure medical stability and will require some significant time away from the sport. In this scenario, there were some warning signs a little earlier, several months ago, a soft tissue injury occurred from overtraining, and recovery took a long time due to overtraining through the rehab phase. Unfortunately, you only get to connect these dots after the fact, but for this young lady, it means a fair time on the sideline. 

Why have I shared these experiences with you? Well, it is in an attempt to help you identify some common signs and symptoms of your son or daughter experiencing relative energy deficiency. 

1. Emotional regulation - teenagers are not expected to be rational 100% of the time, but are we seeing them go long periods without food, and are we giving them the best chance to regulate that emotion? '

2. Energy - how tired is your athlete? Yes, it's hard to get out of bed. We expect that, but is there any time of the day when they are enthused and excited? Is it hard to get them to basketball? Is their tiredness impacting their quality of life? (quick double click on this one: in all our athletes, we had a focus on bedtime habits, again focussing on improvement rather than perfection).  

3. Growth? When I did my undergrad training in Australia, one of my lecturers was famous for saying, "NO CHILD IN AUSTRALIA SHOULD LOSE WEIGHT!" We have since moved away from some general statements, but the idea is that our young people may grow out before they grow up or vice versa. We would ideally like their height to catch up to their weight rather than them losing weight. If you notice your young athlete is particularly concerned about their aesthetics and reducing their intake as a result, This might be a red flag to open some dialogue or reach out. 

4. Injury - are we getting persistent injuries that aren't healing like we would hope? Is it because we're under fuelling? 

There are countless examples I could bore you with on this topic, but thanks for your attention; I hope this has helped you with some signs and symptoms that might be happening in your house. 

Regards

Sean Cornish

Spartans Dietitian