A British Medical Journal paper co-authored by Lauren Fleshman, Trent Stellingwerff, Mary Cain and Kara Goucher (among others) is calling national sports bodies to formulate policies on RED-S. These policies would include RED-S prevention, diagnosis and treatment protocols targeting athletes, coaches and their families.
In their publication titled, “#REDS (Relative Energy Deficiency in Sport): time for a revolution in sports culture and systems to improve athlete health and performance“, the authors outline what needs to be done in the sport of running to fix its eating disorder culture and promote healthy habits and healthy runners. They’re closely following the work in sport concussion from the early 2010s. National sporting policies ensure that comprehensive and standardized sport-related guidelines are followed when an athlete is in need.
The authors broke the paper down into prevention, diagnosis and treatment. In the treatment section, it was outlined that it’s crucial for all runners to have access to a network of RED-S and eating disorder experts, including sport and exercise physicians, registered sport dietitians and sport psychologists in their own country. It’s surprising that in 2020 this level of protection isn’t already offered to runners, but it isn’t.
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Jennifer Sygo is a registered dietitian and sports nutritionist who works with Athletics Canada, among other sporting organizations. She says that across endurance sport there’s a 30 to 50 per cent rate of signs and symptoms of RED-S in athletes. “These are things like menstrual disruptions, disordered thoughts and stress fractures. This all exists in non-endurance sport as well, but it’s certainly more common in sports like distance running.”
Sygo mentions that there’s been a lot of improvement with regard to athlete resources over the past few years, but that there’s still a long way to go. “Not all Canadian universities have a dedicated dietitian on staff. I still see runners in my practice who were referred to me by a sports medicine doctor because their school didn’t have these resources.”
Her advice to coaches is two-fold: one, that talking about an athlete’s menstrual cycle shouldn’t be taboo. And two, that a coach shouldn’t be responsible for every level of an athlete’s care, but they are responsible for providing them with the tools to keep them healthy. Above all else, Sygo and the authors want to be able to empower athletes to identify and protect themselves from the toxic cultures that can be associated with running, and to understand that food and appropriate energy levels are paramount to good health and strong performance.