Defined by the International Olympic Committee, REDS (‘relative energy deficiency in sport’) is a complex syndrome entailing ‘impaired physiological function including metabolic rate, menstrual function, bone health, immunity, protein synthesis, and cardiovascular health caused by relative energy deficiency’.

This was previously termed the ‘female athlete triad’, referring to a tripartite mix of disordered or otherwise insufficient eating, a lack of menstrual periods, and osteopenia/osteoporosis. Today ‘REDS’ is the preferred term as this encompasses the potential involvement of non-menstruating athletes as well as the holistic physiological implications of an energy deficit.

The REDS syndrome highlights the importance of adequate fuelling and management of stress, both physiological and psychological. Not only will an imbalance between these factors have a severely detrimental impact on athletic performance, but this can also lead to a wide range of long-term health conditions such as osteoporosis, infertility/increased risk of complications in pregnancy, and cardiovascular disease.

Case Studies:

Further information:

Prevention, recovery and management: