Risk factors for developing low energy availability
- Early sport specialisation with high training loads and energy demand at a young age
- Young athletes can be at particular risk in sports/dance where the emphasis is on being a slim physique for performance and/or aesthetic advantages. However there is no doubt that some of these skill-based sports/dance do require acquisition of specific techniques from an early age. Therefore training focused on neuromuscular skills, rather than training intensity may to some extent mitigate low energy availability. Nevertheless, a young athlete aiming to achieve a slim physique, can result in intentional restrictive nutrition practices.
- Adolescence can be challenging psychologically and physically with changes in body proportions and composition, especially if this means changes that do not conform to favourable physique for a particular sport. The timing of these changes associated with puberty vary from individual to individual, even within the same sport/dance. Comments, corrections and approach from coaches /teachers can be misinterpreted by young athletes, to be directed at physical appearance, rather than technique.
- The situation can be further complicated if the young athlete/dancer moves to train at a boarding school where it is difficult for parents to monitor behaviour and nutrition intake. Peer pressure can have a big effect: either positive or negative.
Download the Clinical Assessment Tool for Risk Stratification of RED-S
Discussion with your son/daughter or friend and about any concerns regarding training load, nutrition and behaviour. Discussion coach/teacher and with welfare officer of team or school as necessary.
Supporting and encouraging appropriate nutrition, in terms of quantity, quality and timing around training. Clinical dieticians are trained to treat eating disorders.
In girls periods not starting by age 16 years, requires medical review. Or in women in whom periods have stared, periods that stop >6 months need medical review to exclude underlying medical conditions. Delayed puberty and/or deceleration in expected height and weight gains may require medical review. Ask GP to refer to Dr Roger Wolman NHS clinic at RNOH, London for specialist medical review.
“In full time training away from home, it is difficult to appreciate what is being eaten and the challenges in this closed environment. Apart from overcoming internal conflict, peer pressure to eat less were difficult factors to negotiate. With attentive, informed and integrated support, the motivation to overcome RED-S has come with the realisation that eating well means becoming a fitter, stronger, leaner, more resilient and robust ballerina”
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