Protecting an Athlete’s Health: IOC Focuses on Energy Deficiency

The primary goal of the International Olympic Committee’s (IOC) sports medicine team is to protect the health of the athlete. The Committee addressed the widespread incidence of eating disorders and it’s effect on the menstrual cycle and bone health in a 2005 Consensus Statement on The Female Athlete Triad.1 They have recently followed this up with a new paper, “Beyond the Female Athlete Triad: Relative Energy Deficiency in Sport (RED-S),” in recognition of the widespread consequences of failing to meet the energy needs of training with adequate food intake.2 The new designation RED-S broadens our focus to both males and females who fail to make up for the energy cost of their sport with an adequate increase in calories.

This new consensus statement acknowledges the widespread consequences of under-eating even without loss of the menstrual cycle, and recognizes that male under-eating has consequences as well. While major athletic groups including the National Collegiate Athletic Association (NCAA), American College of Sports Medicine (ACSM) and the IOC have stepped up efforts to increase awareness of the Female Athlete Triad among athletes, coaches, and trainers, under-eating female athletes who do not present with the entire Triad and male athletes who don’t eat enough have historically received far less attention.

Eating too little affects the bone health of both males and females. This is disturbing as weak bones can result in stress fractures and bones which will remain under-mineralized throughout the lifespan, but that is not all. Protein synthesis, metabolic rate, immune function, and cardiovascular function will all be compromised as well. The result? Decreased muscle strength and performance, decreased endurance performance, and an increased risk of injury and illness.

Failure to meet energy needs may be deliberate as an athlete tries to lose weight, or unconscious as athletes struggle to ingest enough food to compensate for calories used each day in the hours spent training for their sport.

The expert work group who developed the consensus statement recommends that a multi-disciplinary support system including sports physician, sports nutritionist, psychologist, physiotherapist and physiologist be identified, and that athletes and all who work with them be educated as to how to prevent, recognize and treat this syndrome.
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1IOC Consensus Statement http://www.olympic.org/content/news/media-resources/manual-news/1999-2009/2005/11/09/ioc-consensus-statement-on-the-female-athlete-triad/

2Mountjoy M et al The IOC consensus statement: beyond the Female Athlete Triad-Relative Energy Deficiency in Sport (RED-S). British Journal of Sports Medicine 2014;48:491-497.

 

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