TY - JOUR T1 - Relative energy deficiency in sport (RED-S) JF - British Journal of General Practice JO - Br J Gen Pract SP - 295 LP - 297 DO - 10.3399/bjgp22X719777 VL - 72 IS - 719 AU - Emily Todd AU - Niall Elliott AU - Nicky Keay Y1 - 2022/06/01 UR - http://bjgp.org/content/72/719/295.abstract N2 - Relative energy deficiency in sport (RED-S) is a condition of low energy availability that has serious long-term consequences on health and sporting performance.1 Whether intentional or unintentional, the impact of chronic low energy availability was previously described as the ‘female athlete triad’: low energy availability, amenorrhoea, and low bone density. Oestrogen plays an important role in calcium absorption, hence the link between amenorrhoea and low bone density. However, in 2014, the term RED-S was introduced by the International Olympic Committee (IOC) to reflect research that found much wider consequences across bodily systems, and that the condition affects both male and female athletes. In fact, exercisers of any activity, age group, or level of competition are susceptible to RED-S.Personal experience of this condition can be harrowing. Bobby Clay is an example of a promising young athlete left with osteoporotic fractures aged 19.2,3 Given that GPs will often be the first medical professional involved in these athletes/dancers’ care, and many sports physicians have a general practice background, it is imperative to raise awareness of RED-S in primary care.Case 1Athlete A presents with frequent coughs and colds, and persistent fatigue. He is applying for a scholarship to an international ballet school. He was told he would need to lose 2–3 kg. His mother reports that he has lost 7 kg so far, has become obsessive about his calorific intake, and has excluded both wheat and dairy from his diet. He has recently suffered increasing anxiety if he cannot attend ballet practice.Case 2Athlete B recently started university, having been a good club-level athlete at school. She has increased her training volume, is cooking her own meals for the first time, and cycles 4 miles to and … ER -