Relative energy deficiency in sport

Dr Megan Ogilvie discusses how to screen for Relative Energy Deficiency in Sport (RED-S), a clinical syndrome comprising low energy availability (LEA) as a result of over-training and a negative calorific balance. She talks about how to investigate and manage these patients that are often overlooked in our community.

Topics

Intro
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The term RED-s
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What is the underlying mechanism underpinning RED-s?
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Does RED-S only affect female athletes?
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Patient screening
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Common clinical features
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Physical examination and history
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Investigations, what should we order?
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What is the diagnostic criteria?
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The multidisciplinary team
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What is the outcome for these athletes?
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Prevention messages in our communities
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Junior athletes
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Para athletes
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Transgender athletes
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Take home messsages
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Take home messages

Energy deficiency is an extremely common and often missed diagnosis – don’t exclude just because BMI is normal
These patients need ongoing preferably multidisciplinary support for recovery
Aims – liberalising food groups and nutrition, enough nutrition, don’t overdo the exercise and manage the stress and anxiety
The medical lead must continue to follow and support as well as co-ordinating care from the others in the multidisciplinary team

Resources

Relative Energy Deficiency in Sport High Performance Sport NZ
Relative Energy Deficiency in Sport (RED-S) – a Narrative Review and Perspectives from the UK. Dtsch Z Sportmed. (2020)
RED-S CAT BrJ Sports Med (2015)
2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad BrJ Sports Med (2014)
Mary Cain & RED-S: When Weight Loss Affects Performance The real Science of Sport podcast

Patient Resources

Presenter

Megan Ogilvie

General and reproductive endocrinologist

Megan is a general and reproductive endocrinologist with particular interests in energy deficiency in the athlete, menopause, polycystic ovarian syndrome and gonadal dysgenesis. She works at Fertility Associates and the Auckland District Health Board. Megan has been part of WHISPA , a High Performance Sport NZ medial advisory board since 2017.