Young athletes who consistently burn more energy than they consume can develop a condition that affects growth, bone health, hormones, recovery and athletic performance, according to guidance from University of Rochester Medicine.
Relative Energy Deficiency in Sport, or RED-S, can affect athletes of any gender and in any sport. Warning signs can include persistent fatigue, dizziness, frequent injuries, stress fractures, feeling cold, slower recovery and declining strength or performance.
Dr. Susan Wiener, an assistant professor of adolescent medicine at UR Medicine Golisano Children's Hospital, said puberty is among the most metabolically active periods of life. Intense training can significantly increase an adolescent's nutritional needs during that growth.
Under-fueling is often unintentional, according to the guidance. Young athletes may underestimate how much food they need to support school, daily activities, physical development and training.
Athletes in endurance sports, appearance-focused sports and sports with weight classes may face greater risk because of high energy demands or pressure involving body size and weight.
Chronic under-fueling can also affect cardiovascular and immune function. Delayed puberty, slowed growth or changes in menstrual cycles can indicate that the body lacks enough energy for normal development.
Bone health is a particular concern during adolescence, when the body builds density that affects lifelong skeletal health. Wiener said athletes who do not adequately support bone development as teenagers may face a higher risk of osteoporosis and major orthopedic procedures later in life.
UR Medicine recommends regular meals and snacks, attention to nutrition and hydration after activity, and annual sports physicals that monitor growth and development.
Parents should contact a pediatrician when a young athlete has unexplained weight loss, persistent fatigue, recurring injuries, missed menstrual periods or declining performance, the guidance said. Early evaluation and treatment can help prevent more serious health problems.
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