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KIN 428 > REDS - pt. 1+2 > Flashcards

REDS - pt. 1+2 Flashcards

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1
Q

Imbalance between intake and energy expenditure is most prevalent in what sports?

A

in bodyweight sensitive or aesthetic sports

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2
Q

Is REDs more prevalent in males or females?

A

females

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3
Q

What is energy availability?

A

defined as the amount of energy remaining after energy requirements for exercise training is removed

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4
Q

How do you calculate energy availability?

A

EA = energy intake - exercise energy expenditure

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5
Q

Chronic low EA can lead to what?

A

hormone disruption/menstrual disturbances (hypoestrogenemia)

suppressed bone formation

suppressed metabolic function

increased bone resorption

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6
Q

Recall how to determine energy intake?

A

24hr recall
FFQ
3-5 day food journal/records
Diet history
self-reported eating routine

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7
Q

Can weight maintenance be achieved with chronic low EA?

A

yes, that’s why it can be difficult to assess

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8
Q

What are overt signs of low EA?

What if bodyweight is not low?

A

BMI <17.5kg/m2 or <85% of expected BW for adolescents

If bodyweight is not low, look at current patterns of food intake compared to current level of physical training

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9
Q

How is EEE measured?

A

HR monitors
activity monitors
indirect equations

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10
Q

How is fat-free mass determined?

A

skinfolds, DEXA, underwater weighing

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11
Q

What are errors with diet recalls and assessing energy intakes?

A

labor intensive
time consuming
food knowledge
different people performing the tests

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12
Q

How does a balanced EA support health and performance?

A

hormones
bone
GI
cellular maintenance
circulation
thermoregulation
immunity
mental health

muscle strength
lean mass
concentration
coordination
glycogen storage
recovery
adaptation
aerobic performance
injury protection

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13
Q

What is LEA?

A

Low Energy Availability:
mismatch between dietary energy intake and energy expended in exercise that leaves the body’s total energy needs unmet, that is, there is inadequate energy to support the functions required by the body to maintain optimal health and performance.

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14
Q

What is the difference between adaptable LEA and problematic LEA?

A

adaptable LEA: typically a short-term experience with minimal or no impact on long-term health, well-being or performance.

problematic LEA: exposure to LEA that is associated with greater and potentially persistent disruption of various body systems, often presenting with signs and/or symptoms, and represents a maladaptive response. Characteristics may vary according to the body system and individual.

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15
Q

What are moderating factors for LEA?

A

may offer protection or additional risks in the progression from LEA exposure to the expression of disturbances to health, well-being or performance

ex. characteristics of ind. athletes
environment or behaviour activities
gender
age
genetics
duration/intensity

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16
Q

What are the 2 types of determinants of food consumption?

A

person-related factors (ex. nutrition knowledge, taste and food preferences, appetite, influences, psychological, biological, medical)

environmental-related factors (ex. time/schedule, economic stability, cultural background, culture of sport, cooking skills, access to food, cooking equipment)

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17
Q

What is REDs?

A

syndrome of impaired physiological and/or psychological functioning experienced by female and male athletes that is caused by exposure to problematic (prolonged) LEA

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18
Q

What are the detrimental outcomes of REDs?

A

include - not limited to - decreases in energy metabolism, reproductive function, musculoskeletal health, immunity, glycogen synthesis, cardiovascular and hematological health

all can individually and synergistically lead to impaired well-being, increased injury risk and decreased sports performance

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19
Q

What is the difference between disordered eating and eating disorders?

A

disordered eating: abnormal eating behaviours
(restrictive eating, irregular or inflexible eating patterns, excessive exercise beyond assigned training to compensate for dietary intake, and use of purgatives) - doesn’t meet clinical criteria for an eating disorder

eating disorders:
mental illnesses clinically diagnosed by meeting defined criteria characterized by abnormal eating behaviours

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20
Q

If female athlete triad still a thing?

A

yes, part of REDs

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21
Q

What are the 3 components of the female athlete triad?

A

low energy availability (with or without ED)

amenorrhea / menstrual dysfunction

low bone mineral density (osteoporosis)

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22
Q

Explain the how the female athlete triad is a spectrum.

A
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23
Q

What is the difference between primary and secondary amenorrhea?

A

primary: delay in onset of puberty & menarche @ 15 yrs

secondary: disruption in normal menstrual cycle, missing period for >3 months (consecutive or not, within a year)

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24
Q

What is the hormonal cause of amenorrhea?

A

low estrogen, progesterone, and testosterone levels

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25
Is amenorrhea related to infertility?
can be, along with may other long term health problems
26
Discuss the impact and causes of low BMD and female athlete triad.
decreased estrogen from ovaries --> estrogen increases uptake of calcium into blood and deposit into bone/skeleton reduced intake of important nutrients for bone health (protein, calcium, Vit D.) increased risk of stress fractures peak bone mass occurs around 19 yrs for females and 20.5 yrs for males
27
Is bone loss always reversible?
no, not always
28
When is peak bone mass for males and females?
19yrs for females 20.5yrs for males
29
What is the process for the treatment of the triad?
1) recovery of energy status (days-weeks) 2) recovery of menstrual status (months) 3) recovery of BMD (years)
30
What are some of the warning signs of LEA or REDs?
inconsistent training poor training response <9menstrual cycles per 12 months (females) low libido >2 bone injuries high levels of fatigue poor sleep quality - increased hrs sleeping poor sleep quality decreased performance at training and competitions low ferritin not responding to proper supplementation restrictive eating habits GI problems weight loss or consistent BW drops in muscle mass and strength change in mood/irritable
31
What is the issue with the warning signs of LEA or REDs?
they are pretty generic symptoms, makes the diagnosis difficult; have to work with and understand the athlete
32
What are other factors that may impact fatigue?
dehydration, poor sleep quality, underfueling, doing workouts fasted, stress, low CHO intake, illness, poor planning with school/work and training, low iron stores, caffeine withdrawal
33
What is a major impact with LEA in the development of REDs?
low carbohydrate availability
34
How does overtraining syndrome relate to REDs?
there is a lot of overlap
35
What is included in the REDs health conceptual model? (13)
- impaired reproductive function - impaired bone health - impaired GI function - impaired energy metabolism/regulation - urinary incontinence - impaired glucose & lipid metabolism - mental health issues - impaired neurocognitive function - sleep disturbances - impaired CV function - reduced skeletal muscle function - impaired growth & development - reduced immunity
36
What is included in the REDs performance conceptual model? (8)
-decreased athlete availability - decreased training response - decreased recovery - decreased cognitive performance/skill - decreased motivation - decreased muscle strength - decreased endurance performance - decreased power performance
37
What are the many aspects that need to be considered when assessing EA?
health performance moderating factors exposure the individual
38
What is the #1 cause of REDs in sport?
LEA
39
Who is at risk for REDs?
any athlete or active individual can suffer from REDs particular risks for: female athletes weight class sports aesthetically judged sports where low BW is an advantage sports with high energy expenditure
40
In the REDs health conceptual model, what factor is a 2-way street with LEA and REDs?
mental health issues Neurodivergent thinker or mental health issue - can lead them into LEA as well. They affect each other.
41
In the IOC consensus statement, what is the CAT2 3-step protocol?
1) (screening) population-specific questionnaires or clinical interview 2) REDs severity/risk assessment 3) REDs clinical diagnosis and treatment
42
Does everyone with an LEA have an eating disorder?
no
43
Are eating disorders and disordered eating a common cause of LEA in athletes?
yes
44
The DSM-5 recognizes what EDs?
- anorexia nervosa - bulimia nervosa - binge eating disorder - OSFED: other specified feeding and eating disorders - avoidant/restrictive food intake disorder - other
45
Is amenorrhea a requirement for diagnosis of anorexia nervosa?
no, not anymore
46
What is the diagnostic criteria for anorexia nervosa?
restriction of energy intake relative to requirements, causing low BW intense fear of gaining weight or becoming fat, or persistent behaviour that interferes with weight gain disturbed by body's weight or shape, self-worth influenced by bodyweight or shape, or persistent lack of recognition of seriousness of low bodyweight
47
Is taste fatigue a diagnosable thing?
no, but could lead to anorexia where athlete is refusing that product even though it would benefit their performance
48
What is the diagnostic criteria for bulimia nervosa?
recurrent episodes of binge eating, as characterized by both: 1) eating, within a 2-hr period, an amount of food that is definitively larger than what most individuals would eat in a similar period of time under similar circumstances 2) a feeling that one cannot stop eating or control what or how much one is eating recurrent inappropriate compensatory behaviours in order to prevent weight gain such as self-induced vomiting, misuse of laxative, diuretics, or other medications; fasting or excessive exercise binge eating and inappropriate compensatory behav. occurring at least once per week for 3 months self-eval is unjustifiably influenced by body shape and weight disturbance not exclusively during episodes of anorexia nervosa
49
Bulimia nervosa is seen in what % of general population?
~2-3%
50
What are some additional negative physiological effects of bulimia nervosa?
tooth decay, tears in esophagus, aspiration pneumonia, electrolyte imbalances, heart failure
51
What are the NCAA warning signs for AN?
dramatic weight loss; preoccupation with food, calories, weight; wearing baggy or layered clothing; relentless, excessive exercise; mood swings; avoiding food-related social activities
52
What are the NCAA warning signs for BN?
noticeable weight loss or gain; excessive concern about weight; bathroom visits after meals; depressive moods; strict dieting followed by eating binges; increasing criticism of one's body
53
What is binge eating disorder?
eat an unusually large amount of food and feel out of control during binge eat more quickly than usual, until uncomfortably full, when not hungry, alone due to embarrassment, disgusted, depressed, or guilty after eating
54
How is binge eating different from bulimia nervosa?
not followed by compensatory period
55
What is OSFED? give example
does not meting criteria for AN and BN exhibit some but not all of the characteristics associated with clinical eating disorders ex. all of criteria for AN are met except despite significant weight loss, current weight is in the normal range
56
Night eating syndrome is an example of what type of eating disorder?
OSFED
57
What is anorexia athletica?
type of disordered eating that impacts athletes take in a limited number of calories despite a high level of physical activity become overly concerned with weight, exhibit some of diagnostic criteria associated with AN & BN
58
What are the 5 criteria for anorexia athletica?
excessive fear of becoming obese restriction of kcal intake weight loss no medical disorder to explain leanness/weight loss GI complaints
59
What is avoidant/restrictive food intake disorder?
symptoms of this usually appear in childhood - avoids foods with certain textures and colours, traumatic experience involving food - can result in fear of eating Does not include experiences of body dissatisfaction in the way body weight or shape are perceived but can develop into AN or BN later in adulthood
60
What is orthorexia nervosa?
unhealthful fixation about eating 'healthful foods' may lead to elimination of entire food groups, later eliminating another group of food, and another - in quest for a "perfect" and "clean eating" diet can lead to malnourishment quality instead of quantity of food is severely restricted
61
Is orthorexia nervosa recognized in the APA diagnostics manual?
no, not yet anyways
62
What is the 4-level tiering system of performance indicators?
traffic light system: green, yellow, orange, red want athletes to ideally be in green zone ideally thresholds are provided when possible
63
What is the treatment plan for someone with REDs?
depends on severity and risk requires an interdisciplinary team: medical, mental health, sport dietician support increase energy availability via increased intake or decreased output - increase current EI by 300-600 kcal/day and focus on energy intake timing around training sessions
64
What is the critical foundation of the training diet?
energy intake!
65
What about supplementation in treatment?
may be indicated with medical support maybe for calcium, B12, iron is indicated, vitamin D assessment piece needed
66
What are outcomes measures for treatment from REDs?
reversal of recent weight loss return to normal bodyweight with normal menses weight gain to achieve a BMI>18.5 or >90% predicted bodyweight energy intake at 2000kcal per day+ for training demands
67
At what point is return to play after REDs?
back at green ideally
68
Explain how prevention is key, who should look out for indicators, and for what?
coaches and other support staff
69
What are prevention strategies from NCAA coach handbook?
de-emphasize weight recognize individual differences in athletes coach supported education - awareness is first step in any behaviour involvement by sport governing bodies

KIN 428 (12 decks)

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