British long-distance runner Jake Smith was diagnosed with Relative Energy Deficiency in Sport (REDs) four years ago, after doctors warned his career could be over. Smith, who had signed a professional contract with Nike and represented Great Britain, experienced a relentless pattern of race, illness, and injury, returning from a running camp weighing just eight stone (51kg) at 5ft 5in (1.7m).
REDs is a syndrome that can affect anyone and, if left undiagnosed or untreated, can impact performance and cause serious, long-lasting health problems. While symptoms are better documented in women, men are just as susceptible, with stigma and a lack of obvious warning signs meaning the condition can go undetected for longer.
Dr. Nicky Keay, an expert in hormone health, explains that many symptoms stem from hormonal disruption due to insufficient energy intake. For men, this can manifest as reduced testosterone levels, leading to decreased libido and fatigue. A meta-analysis published last year in the Australian journal Sports Medicine indicated that 49.4% of male athletes and 44.2% of female athletes had low energy availability.
Olympic and world champion Jonny Brownlee, who recently retired, acknowledged that under-fuelling mistakes contributed to serious injuries in his triathlon career. He believes that while the culture around fuelling has changed, a stigma still surrounds REDs, particularly the perception that it is a "female issue."