5. Nutrition against RED-S: How to optimally cover your energy needs
RED-S arises from an imbalance between energy intake and energy expenditure, which often goes unnoticed, especially in endurance sports. The most important measure against RED-S is therefore to increase energy availability – through a targeted and balanced diet. In this article, you'll learn how to calculate your energy requirements and counteract RED-S with smart nutritional tips.
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#### Understanding and calculating energy availability
Energy availability (EA) is a key parameter: it represents the energy available to your body after deducting energy expenditure during exercise, based on kg of fat-free mass (FFM). The recommended value is at least 45 kcal per kg FFM per day to optimally support all bodily functions. Below 30 kcal/kg FFM, the risk of RED syndrome increases dramatically.
Example calculation for a 70 kg endurance athlete with approximately 15% body fat:
- FFM = 59.5 kg
- Energy requirement without training = 2,200 kcal
- Training consumption e.g. B. 600 kcal
- To maintain energy availability, energy intake should be chosen so that EA ≥ 45 kcal/kg FFM remains [6][5].
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#### Dietary tips against RED-S
- **Increase calorie intake:** Supplement your diet with an additional 300-600 kcal daily, ideally from complex carbohydrates, high-quality proteins and healthy fats.
- **Distribution throughout the day:** Small snacks between meals help to keep blood sugar levels stable and support energy metabolism.
- **Protein sources:** Protein supports muscle building and regeneration (fish, chicken, legumes, dairy products).
- **Carbohydrates:** Essential for endurance athletes as their main energy source (oatmeal, wholemeal bread, potatoes).
- **Fats:** Important for hormone production and cell health; healthy sources include nuts, seeds, avocado, and olive oil.
- **Micronutrients:** Ensure you get enough calcium, vitamin D, iron, and magnesium to support bones and muscles. Supplements can be beneficial, but should be discussed with your doctor.
- **Hydration:** Adequate fluid intake is equally crucial for performance and recovery [1][6][5].
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#### When to seek professional support?
Especially if you suffer from RED-S syndrome or notice symptoms, specialized nutritional counseling is recommended. Many health insurance companies cover the costs partially or fully. If eating disorders or psychological stress are present, psychological support is an important part of the therapy. A multidisciplinary team of sports medicine specialists, nutritionists, and psychologists is ideal [1][6].
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**Conclusion:**
Only a targeted adjustment of your diet with sufficient energy intake will help you prevent and overcome RED-S. The combination of optimized food choices, calorie distribution throughout the day, and control of energy requirements are fundamental for healthy performance in endurance sports [1][6].
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Sources
[1] RED-S syndrome - Menstrual disorders in female athletes https://sportsandmedicine.com/de/2024/02/red-s-syndrom-menstruationstoerungen-bei-sportlerinnen/
[2] RED-S in athletes and runners https://kraftrunners.de/health/physio-red-s-syndrom
[3] Young, sporty – and sick https://www.doccheck.com/de/detail/articles/43323-jung-sportlich-und-krank
[4] RED-S: Relative energy deficiency in sports due to too much ... https://oped.de/blog/red-s-im-sport-zu-viel-training-und-zu-wenig-kalorien
[5] RED-S Syndrome: A Guide to Relative Energy Deficit ... https://blackroll.com/de/artikel/red-s-syndrom
[6] RED-S syndrome in runners: causes and treatment https://www.runnersworld.de/verletzungen-vorbeugung/red-s-syndrom-bei-laeufern-ursachen-und-behandlung/
[7] RED-S https://sportaerztezeitung.com/rubriken/ernaehrung/13482/red-s/
[8] RED-S consultation | University Hospital Tübingen https://www.medizin.uni-tuebingen.de/de/das-klinikum/einrichtungen/kliniken/medizinische-klinik/sportmedizin/sprechstunde-red-s
[9] From RED-S to eating disorders in athletes https://www.universimed.com/ch/article/psychiatrie/red-s-essstoerungen-athleten-499459