Nutritional aspects of energy availability and relative energy deficiency in sport

The relative energy deficiency in sport (REDs) is a complex state of low energy availability in the athletes’ body. Signs and symptoms comprise not only a low bone mineral density and a menstrual dysfunction as initially thought but also a metabolic and hormonal imbalance together with cardiovascular and mental issues. This leads to an increased risk for injury and illness and decreases performance over a longterm. In this review the complexity of the issue together with some suggestions for underlying causes are summarized. Furthermore, some aspects on nutritional interventions in the case of low energy availability are suggested. Some proposition how to work in an interdisciplinary team together with the athlete and the social environment were pointed out. In the future, distinct protocols are needed for the correct diagnosis of this health-issue. Furthermore, prevention strategies are desperately required to prevent as many athletes as possible from low energy availability.