I am so excited to introduce to you the award winning blogger; Kirstin Kadé, from the Taste & See blog. She is a South African currently completing her MSc degree (human nutrition) at the University of Surrey in the UK. Kirstin has a passion for wholesome and nourishing food, and has an interest in learning more about how the food we eat can impact our long-term health and how our relationship with food can impact our overall wellbeing. I found this article that she wrote for the Art of Body so relevant and feel that it is something that every active (and non-active) individual should read and apply to their lives on a daily basis.
Finding joyful forms of movement, in whatever shape, form, and intensity we might love, is beneficial for our long-term health and wellbeing. Regular physical activity helps us build and maintain bone and muscle strength, is associated with a reduction in cholesterol levels and blood pressure and is known to have a positive effect on anxiety and depression symptoms.
Unfortunately, with the rise of #fitspo culture and the pressure to fit into a narrow, socially acceptable body shape, size, and composition, more and more of us (females in particular) are combining strenuous exercise with restrictive and insufficient food intake, to the detriment of our health. Although our intentions are most often good, when we start new exercise regimes, we often forget that this will place new nutritional demands on the body that need to be met in order to keep our bodies strong and healthy. Proper nutrition is key to:
· Good athletic performance
· Increased energy production
· Injury and illness prevention
· Improved recovery from illness and injury
So, it’s no wonder then that our health can be impacted negatively when we under-fuel and over-exert our bodies simultaneously.
Relative Energy Deficiency in Sport (RED-S)?
RED-S is the result of insufficient caloric intake and/or excessive energy expenditure that can affect both men and women, and both individuals who identify as athletes and those who do not identify as athletes (performance artists, dancers, and those who are just very active) [1,2]. The negative consequences of this condition can impact many important physiological systems, including normal metabolism, menstrual function, bone health, immunity, protein synthesis, as well as cardiovascular health . This can lead to:
· Menstrual dysfunction and fertility issues in women
· Decreased muscle mass and strength
· Fatigue and poor athletic performance
· Low bone mineral density
· Increased risk of stress fractures and sports injuries
· Poor recovery from illness and injury
· Long-term bone and heart problems
Disordered eating and inadequate calorie intake
When you are active, whether you are a sportsperson or just someone who does quite a bit of exercise, your body needs more energy in the form of calories (which you get from food) than if you were not active . When disordered eating and inadequate calorie intake is coupled with excess activity, there will generally be insufficient energy available for the body to carry out normal functions such as growth, development, and reproduction . It may seem really simple, but one of the most important factors to prevent RED-S is ensuring that enough calories are consumed to meet exercise needs and normal bodily processes.
One of the key signs of RED-S is menstrual dysfunction. This can range from having longer than normal cycles (less frequent periods, known as oligomenorrhoea) to missing periods completely (known as amenorrhoea) . Now it may not seem like such a big deal, but the low oestrogen levels associated with amenorrhoea can adversely affect muscle function, cholesterol levels, and reproductive health . Not only that, but prolonged low oestrogen levels can also negatively affect bone health in the long-term .
Low bone density is one of the key concerns related to RED-S. Often athletes and active individuals with the condition will have bone density that is lower than expected for their age and is often low enough to be considered osteopenic or osteoporotic . This, coupled with low energy availability and menstrual dysfunction, mean that those with RED-S are at an increased risk of experiencing stress fractures . The consequences of this aren’t only concerning in the short-term, but are also devastating in the long-term as bone mineral density cannot be regained once lost.
Tips for proper nourishment when active
1. Adequate fuel. As an active individual, it is important to ensure that energy intake is sufficient to support the type and intensity of the activities that you are doing. This means consuming enough total calories, including fats and carbohydrates, that will allow your body to remain strong and healthy, and help you maintain a weight that is healthy for your body.If you are struggling with this and are able to, try to schedule a session with a qualified dietitian or sports nutritionist who can help you with this.
a. Carbohydrates – These are the main sources of energy for the body. They are also needed for brain function and energy storage as glycogen. You can find carbohydrates in wholegrains (like oats, millet, quinoa, spelt, and brown rice), legumes, fruits, and veggies.
b. Protein –This is important for muscle growth, repair, and recovery (particularly in athletes and active individuals), and as an alternate source of energy for endurance activities. Additional protein will always be needed during times of injury. You can find protein in lean meats, eggs, legumes, soy products, fish, nuts, and seeds.
c. Fat– Fats are necessary for building and repairing body cells, controlling inflammation, providing lubrication for joints, hormone production, and for energy stores. Great sources of healthy fatsinclude nuts and seeds, fatty fish (herring, mackerel, halibut, salmon), soybeans, and olive oil.
2. Focus on nutrients. Eat a nutrient-rich, varied, well balanced diet.In general, an activeperson’s diet should consist of a wide variety of whole, fresh foods to ensure that sufficient vitamins and minerals are consumed each day. Why? Well different vitamins and minerals are important for a wide variety of bodily functions including regulation of hormones and metabolic processes, muscle contractions, nerve impulses, and help in the building of strong bones, ligaments and tendons.
3. Eat frequently enough. It is important to eat frequently enough, and to honour our body’s hunger cues. When we have been ignoring our hunger cues due to things like dieting and chronic food restriction, it can often be difficult to tune into when our body actually needs food. It is often normal to not feel hungry at all after an intense training session, but this is a time where it is really important to provide your body with the energy it needs. Here is a really good blogpost [Link https://www.positive-nutrition.com/single-post/2016/04/13/How-to-Recognize-Hunger-and-Fullness] that I would encourage you to read through if this is something that you recognise that you struggle with.
4. Rest. Our bodies need rest days, and by this, I mean proper rest days, not just days where we choose to go for a slow jog instead of a sprinting session. We need to give our bodies time to rest in order to allow for proper recovery. This might be difficult for you if you are an athlete as you might be under pressure from coaches, teammates, and other sources to just keep going (#noexcuses right?). But in the long-term, your health and wellbeing will benefit from designated periods where you allow your body to recuperate. It is important to take a look at your exercise and activity patterns, and notice if you are going overboard and are putting your body under strain – remember our bodies can benefit from movement even in moderate amounts.
5. Mental health. If you can relate to anything shared in this blogpost but don’t know where to start, I would love to encourage you to seek help from a psychologist or counsellor who can journey alongside you to work through these things. It doesn’t help to have a fit, strong body if your mental wellbeing is not in a healthy space.
Useful nutrition resources for athletes and those who are active
Dietitian Without Borders (http://dietitianwithoutborders.com/blog/
Heather Caplan’s blog (http://heathercaplan.com/realtalk/)
- When it might be time to gently (re)introduce nutrition (http://heathercaplan.com/nutrition/intuitive-eating-nutrition-session/)
- Real Talk: I think Sport Specific Orthorexia is a thing (http://heathercaplan.com/nutrition/sport-specific-orthorexia/)
Sports nutrition podcast
 Statuta SM, Asif IM, Drezner JA. Relative energy deficiency in sport (RED-S). Br J Sports Med. Nov 2017;51(21):1570-1. Available from: https://bjsm.bmj.com/content/early/2017/07/03/bjsports-2017-097700
 Mountjoy MJ, Burke LM, Stellingwerff T, Sundgot- Borgen J. Relative Energy Deficiency in Sport: The Tip of an Iceberg. Int J Sport NutrExercMetab. 2018;28:313-15. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29972091
 Weiss-Kelly A. The Female Athlete Triad [factsheet]. American Orthopaedic Society for Sports Medicine. 2011. Available from: https://www.sportsmed.org/aossmimis/stop/downloads/FemaleAthleteTriad.pdf
 Hobart JA, Smucker DR. The Female Athlete Triad. Am Fam Physician. Jun 2000;61(11):3357-64. Available from:https://www.aafp.org/afp/2000/0601/p3357.html