RED-S and Female athlete health: A seminar with Chair of the IOC Expert Group

On Friday 10th 2014, High Performance New Zealand in association with the Sport Performance Research Institute of New Zealand (SPRINZ) and Sports Medicine New Zealand (SMNZ), hosted Dr Margo Mountjoy, a Canadian Sports Physician, Chair of the International Olympic Committee (IOC) Expert Group on Female Athlete Health and lead author of the recently published IOC Consensus Statement “Beyond the Female Athlete Triad – Relative Energy Deficiency in Sport”. Maria was fortunate to attend her seminar at the AUT Millennium Campus which focused on this paper. Particular points of interest were:

1)    Definition of the new and broader term RED’s [Relative Energy Deficiency Syndrome] compared to the Female Athlete Triad (as we discussed in one of our previous posts). That is, the Triad refers to the relationship between energy availability, menstrual function and bone health. Over a period of time, an athlete can move along a continuous spectrum ranging from the healthy athlete with optimal energy availability, regular menses and healthy bones to the opposite end of the spectrum characterised by amenorrhea, low energy availability and osteoporosis. According to Dr Mountjoy, RED-S is more encompassing and refers to impaired physiological function including, but not limited to, metabolic rate, menstrual function, bone health, immunity, protein synthesis, cardiovascular health caused by relative energy deficiency.

2)    Dr Mountjoy explained that psychological consequences (e.g. disordered eating, eating disorders, depression and mood disorders) can either precede or be the result of RED-S.

3)    She discussed the effects of low energy availability on exercise training and sport performance and how consolidated research on this topic is required as it is likely to be a key driver encourainge female athletes to adhere to prevention and management protocols for Triad related issues.

4)    There is a need to broaden research to address the risk of male athletes, athletes with a disability and athletes of non-Caucasian ethnicity.

5)    She offered interesting case studies that had utilised the newly proposed Sport Risk Assessment and Return to Play model that outlines classification criteria for the designation of the athlete with RED-S into one of three categories:  “High Risk – Red Light”, “Moderate Risk – Yellow Light” or “Low Risk – Green Light”.  Sports participation based on the athlete classification is recommended, ranging from “No Start” in the Red Light category to Full Participation for athletes classified in the Green Light category.