"Relative Energy Deficiency in Sports", REDs for short, is a complex syndrome that results from an energy intake that is too low in relation to training. An eating disorder can be just one of many symptoms; hormonal disorders, listlessness or even depression are also conceivable consequences.
Prof. Dr. Karsten Köhler, head of the Assistant Professorship of Exercise, Nutrition and Health, is involved in research on the interaction of nutrition and sport to optimize physical performance and health. He has also been scientifically involved with the topic of REDs for years. Despite increasing research activities and also increasing attention in practice, the syndrome is still too little known.
For this reason, Prof. Köhler, together with a group of researchers from Europe and North America, has now published a review study that deals with strategies for primary, secondary and tertiary prevention of REDs. It recommends best practice prevention guidelines for athletes' health and performance teams, the athletes' environment (e.g. coaches, parents, managers) and sports organizations. The paper entitled "Primary, secondary and tertiary prevention of Relative Energy Deficiency in Sport (REDs): a narrative review by a subgroup of the IOC consensus on REDs" has now been published in the "British Journal of Sports Medicine". The journal has an impact factor of 18.4.
"We have now revisited the REDs model with new scientific evidence some ten years after the term was first coined," explains Prof Köhler. "The problem until now was that it was unclear which clinical indicators doctors could use to diagnose the syndrome. We therefore wanted to create a framework to get a grip on REDs both in prevention and in treatment."
Three levels of prevention were identified. Primary prevention should be used to prevent a disease before it even occurs. This should be applied to risk groups. In particular, athletes in weight-sensitive and slimming sports as well as female and adolescent athletes need special attention.
"I was primarily involved in developing the strategies for primary prevention," says Prof. Köhler. "In particular, we wanted to give a comprehensive overview of the factors involved in the development of REDs. There are individual sports, such as ski jumping or currently climbing, in which dealing with a low body weight is already an issue. In many other sports where low weight or physical appearance play a role, there are no rules on this. In this respect, we need a certain culture here to prevent REDs."
Secondary prevention should involve early detection of REDs signs or symptoms to enable early treatment to prevent the development of more serious consequences such as osteoporosis. Strategies such as self-assessment tools, individual health surveys and objective assessment of REDs markers are particularly suitable for this purpose.
Tertiary prevention, or clinical treatment, is used to prevent or at least limit the short-term or long-term serious health consequences of REDs. It is essential to identify and treat the cause of low energy availability. If a condition is already present, the focus should be on increasing energy intake, reducing energy expenditure during physical activity, or a combination of both.
Media consumption can also promote the REDs syndrome, Prof. Köhler knows: "We need to reduce risk factors for disordered eating behaviour based on weight or appearance. Social media also play a certain role here, because one's own behaviour can also be confirmed or triggered by certain content. In this respect, we have to contribute to normalizing the topic to some extent." Therefore, Prof. Köhler welcomes the fact that more and more athletes talk about REDs on their own social media channels and contribute to de-tabooising the syndrome.
According to the scientists, the best approach to prevent REDs is primary prevention. Furthermore, early detection in athletes at risk is crucial to prevent the progression of REDs. Therefore, a multidisciplinary approach is recommended, targeting the athlete's health and performance team, coaches and sport organizations, focusing on a supportive and safe sport environment.
To the publication „Primary, secondary and tertiarty prevention of Relative Energy Deficiency in Sport (REDs): a narrative review by a subgroup of the IOC consensus on REDs“ in the „British Journal of Sports Medicine“
To the homepage of the Associate Professorship of Exercise, Nutrition and Health
Contact:
Prof. Dr. Karsten Köhler
Associate Professorship of Exercise Nutrition and Health
Georg-Brauchle-Ring 60/62
80992 München
phone: 089 289 24488
e-mail: karsten.koehler(at)tum.de
Text: Romy Schwaiger
Photos: “British Journal of Sports Medicine”/private