Relative Energy Deficiency in sport (REDs) : Endocrine manifestations, pathophysiology and treatments

© Published by Oxford University Press on behalf of the Endocrine Society 2024..

Research on lean, energy-deficient athletic and military cohorts has broadened the concept of the Female Athlete Triad into the Relative Energy Deficiency in Sport (REDs) syndrome. REDs represents a spectrum of abnormalities induced by low energy availability (LEA), which serves as the underlying cause of all symptoms described within the REDs concept, affecting exercising populations of either biological sex. Both short- and long-term LEA, in conjunction with other moderating factors, may produce a multitude of maladaptive changes that impair various physiological systems and adversely affect health, well-being, and sport performance. Consequently, the comprehensive definition of REDs encompasses a broad spectrum of physiological sequelae and adverse clinical outcomes related to LEA, such as neuroendocrine, bone, immune, and hematological effects, ultimately resulting in compromised health and performance. In this review, we discuss the pathophysiology of REDs and associated disorders. We briefly examine current treatment recommendations for REDs, primarily focusing on non-pharmacological, behavioral, and lifestyle modifications that target its underlying cause - energy deficit. We also discuss treatment approaches aimed at managing symptoms, such as menstrual dysfunction and bone stress injuries, and explore potential novel treatments that target the underlying physiology, emphasizing the roles of leptin and the activin-follistatin-inhibin axis, the roles of which remain to be fully elucidated, in the pathophysiology and management of REDs. In the near future, novel therapies leveraging our emerging understanding of molecules and physiological axes underlying energy availability or lack thereof may restore LEA-related abnormalities, thus preventing and/or treating REDs-related health complications, such as stress fractures, and improving performance.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - year:2024

Enthalten in:

Endocrine reviews - (2024) vom: 15. März

Sprache:

Englisch

Beteiligte Personen:

Angelidi, Angeliki M [VerfasserIn]
Stefanakis, Konstantinos [VerfasserIn]
Chou, Sharon H [VerfasserIn]
Valenzuela-Vallejo, Laura [VerfasserIn]
Dipla, Konstantina [VerfasserIn]
Boutari, Chrysoula [VerfasserIn]
Ntoskas, Konstantinos [VerfasserIn]
Tokmakidis, Panagiotis [VerfasserIn]
Kokkinos, Alexander [VerfasserIn]
Goulis, Dimitrios G [VerfasserIn]
Papadaki, Helen A [VerfasserIn]
Mantzoros, Christos S [VerfasserIn]

Links:

Volltext

Themen:

Endocrinological disorders
Female Athlete Triad
Journal Article
Low Energy Availability
Pathophysiology
Relative Energy Deficiency in sport
Therapeutic approaches

Anmerkungen:

Date Revised 15.03.2024

published: Print-Electronic

Citation Status Publisher

doi:

10.1210/endrev/bnae011

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM369782550