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BY Amity Warme, MS; Sport Nutrition
Underfueling prohibits you from meeting your potential. It limits your physical and mental capacity to work, to train, and to perform. As athletes, we strive for peak performance and flawless physique. In many sports, carrying extra weight is a disadvantage. The problem arises, however, when athletes mistakenly prioritize low body weight and leanness while neglecting the role of food as fuel for optimal performance, growth and development, and long-term health.
• Train hard but fail to see results commensurate with your effort?
• Experience chronic fatigue or difficulty completing intended workouts?
• Get sick often?
• Struggle with recurring or frequent injuries?
• Have difficulty building strength or gaining muscle?
• Feel like you recover slowly after training, climbing, skiing, running?
• Miss menstrual cycles or have decreased sex drive?
• Have a negative or complicated relationship with food?
Read on to learn more about the detrimental effects of underfueling and how to recognize RED-S and the corresponding impact on your health and performance.
What is Relative Energy Deficiency in Sport (RED-S)?
RED-S refers to the impairment of physiological functioning and athletic performance caused by low energy availability (LEA). It is a fundamental mismatch between the amount of energy consumed relative to the amount of energy expended through physical activity. RED-S is most prevalent in athletes participating in weight sensitive sports such as climbing and distance running. Both males and females can experience RED-S through either intentional under-eating or an inadvertent calorie deficit.
Energy Output > Energy Intake => Low Energy Availability
How does RED-S develop?
Your body requires energy for everything it does – breathing, normal cell turnover, regulating body temperature, circulating blood, etc. Simply existing requires energy (calories) from food intake. Your basal metabolic rate (BMR) refers to the baseline number of calories your body needs to maintain functioning if you were lying in bed completely still all day. Activities of daily living – walking, cooking, cleaning, talking, thinking, digesting – require additional energy.* Engaging in exercise – climbing, running, skiing, hiking, etc. – further increases your body’s energy needs. Subtracting the energy used in exercise from your total energy intake gives us your energy availability (EA).*
The exact EA needed to maintain health and performance varies widely from one individual to another depending on body composition, age, gender, and metabolism. If EA falls below the minimum amount, your body enters a state of low energy availability. At this point your body goes into energy saving mode. Picture a cell phone with low battery that turns off background apps to conserve energy. The problem? These background functions (hormone levels, immunity, bone density, and more) are essential to your long-term health.
Signs, symptoms, and performance consequences of RED-S:
RED-S may manifest in different ways for each individual and one can easily fall into a vicious cycle. An athlete may restrict food intake to lose weight, but over time their metabolism slows down to conserve energy. Weight loss and body composition changes stagnate. The athlete may interpret this as not restricting enough or not training hard enough and double down on their efforts, thus perpetuating the issue. An athlete struggling with RED-S may have trouble objectively assessing their condition, so it is important to be aware of the following signs, symptoms, and performance consequences in yourself and those around you.
Signs and Symptoms Performance consequences
• Recurring illness and infections
• Low bone density
• Depression, irritability, and mood swings
• Irregular menstrual cycles
• Decreased sex drive
• Excessive weight loss
• Gastrointestinal upset
• Disordered eating patterns or thoughts
• Sleep disturbances
• Decreased growth in adolescents • Low energy
• Decreased muscle strength
• Decreased endurance capacity
• Increased risk of injury – bone and tendon
• Decreased glycogen stores
• Decreased coordination and concentration
• Inability to build muscle or strength
• Slowed metabolism
• Loss of training time due to injury or illness
• Lack of energy to complete intended workout
• Inability to recover after training
We all want to find the silver bullet that leads to improved sport performance. It is easy to get caught up in the mentality that simply losing weight is the answer. It may even seem to work for a short time. Eventually, however, the consequences associated with chronic underfueling will play out and both your health and performance will suffer.
Recovering from RED-S:
Eating enough calories to match your energy demands is critical. If you think you may be experiencing RED-S, work with a sports dietitian to determine the underlying cause of your underfueling. Disordered eating and intentional food restriction commonly lead to RED-S but many athletes under-eat inadvertently. Maybe you are too busy, too tired, don’t feel hungry, want to lose weight, want to look a certain way, or want to perform better, but underfueling your body can have serious consequences. Instead of subscribing to the idea that being a better athlete requires commitment to dieting, chronic calorie restriction, and continual weight loss, let’s think of food as fuel. Don’t limit yourself by not fueling properly. Adequate energy empowers you to pursue the activities you love, maximize your potential, and perform at your peak.
*Total Daily Energy Expenditure (TDEE) includes:
Exercise Varies by: intensity, duration, body weight, genetics
Non-exercise activity thermogenesis (NEAT) Includes: activities of daily living (cooking, cleaning, gardening), fidgeting, etc.
Thermic effect of food (TEF) Varies by: amount and composition of food consumed
Basal metabolic rate (BMR) Varies by: weight, age, gender, body composition, hormones
*Energy availability reflects the number of calories remaining after subtracting calories burned in exercise from total calorie intake and is expressed in terms of kcal/kg of lean body mass.
My story navigating RED-S:
I love trying my absolute hardest. I love digging deep, tapping the last reserves, and emptying the tank as I push myself physically and mentally on the rock. In 2017 I committed more fully to the adventure life and threw myself whole-heartedly into climbing – seeking continual improvement and dedicating days on end at the crag. I started consciously restricting the type and amount of food I ate in order to become leaner, lighter, and, in my mind, a ‘real climber.’ Rest days weren’t allowed as I strove to constantly perform at my peak. I deeply enjoyed this high energy output and dedication to craft – I still do – but for a time, it came at the expense of my long-term health.
In 2019, a DXA scan showed that both my body fat percentage and bone mineral density were extremely low. Short-term, I was increasing my risk for stress fractures, illness, anemia, and fatigue. Long-term, I was increasing my risk for more severe complications, including osteoporosis, infertility, and more. I had fallen prey to the idea that I needed to lose weight in order to perform better. I restricted my food intake, telling myself I was just eating “healthy” while I continued to increase time in the gym and on the rock. Admittedly, however, I was tired all the time, slightly irritable, rigid in my routine, and lacking the pep in my step that was characteristic of my chronically over-stoked personality. Despite my relentless effort to improve performance, I failed to see commensurate results.
The truth of the matter, put simply – I was chronically underfueling my body. Many of my symptoms were characteristic of RED-S. I didn’t understand that the mismatch between my energy intake and output was harming my health and hindering my performance. As my nutrition awareness grew, I began making changes to my dietary habits. These days I ensure that my food intake matches my energy output. And I pay attention to warning signs that I may be underfueling:
• Lack of psych to train or climb
• Feeling exhausted after training or climbing
• Overall low energy or fatigue over several days
• Feeling impatient or irritable
• Constantly thinking about food
• Slow recovery
A 2021 DXA scan showed that both my body fat percentage and bone density had increased. I am still on the lower end of bone density for my age, but no longer dangerously so. I am still in the midst of the process, but I am consciously working to shift my perspective. Rather than viewing calories in a negative light, I see food as the fuel that empowers me to accomplish my goals. I am intentional to:
• Eat a wide variety of foods that meet my nutrient needs
• Consume protein throughout the day to support muscle growth and repair
• Fuel with carbohydrate rich foods before, during, and after exercise
• Enjoy the social aspect of eating without taking myself too seriously
Without proper fueling I couldn’t have sent Freerider and Golden Gate this spring. I wouldn’t have had the juice to tackle alpine objectives in Rocky Mountain National Park and my days in Indian Creek wouldn’t be packed with pitches. Now, instead of worrying about micromanaging my diet, I focus my energy on exploring the limits of my capabilities and giving it my all.
Connect with me:
If you have questions or comments, please feel free to reach out to me at [email protected] or on Instagram @amity.warme. I would be happy to answer questions or point you toward additional resources.
Powerful stories of other climbers dealing with and recovering from RED-S:
• Mina Leslie-Wujastyk
• Jasna Hodžić, PhD
• Delaney Miller
• Light Documentary featuring Emily Harrington, Angie Payne, Kai Lightner, and others
Last updated 12 October 2018. Effective immediately.
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14. DISCLAIMER OF WARRANTIES AND LIMITATION OF LIABILITY: WEBSITES. Your use of the SCARPA Websites is at your own risk. If you are dissatisfied with any of the Content or other contents of the SCARPA Websites or with these Terms, your sole remedy is to discontinue use of the SCARPA Websites. THE WEBSITES AND ALL INFORMATION, CONTENT, MATERIALS, SOFTWARE, AND SERVICES INCLUDED ON OR OTHERWISE MADE AVAILABLE TO YOU THROUGH THE WEBSITES ARE PROVIDED BY SCARPA ON AN "AS IS" AND "AS AVAILABLE" BASIS, UNLESS OTHERWISE SPECIFIED IN WRITING. SCARPA MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, AS TO THE OPERATION OF THE WEBSITES OR THE INFORMATION, CONTENT, MATERIALS, SOFTWARE, OR SERVICES INCLUDED ON OR OTHERWISE MADE AVAILABLE TO YOU THROUGH THE WEBSITES, UNLESS OTHERWISE SPECIFIED IN WRITING SIGNED BY AN AUTHORIZED SCARPA REPRESENTATIVE. YOU EXPRESSLY AGREE THAT YOUR USE OF THE WEBSITES IS AT YOUR SOLE RISK. TO THE FULL EXTENT PERMISSIBLE BY APPLICABLE LAW, SCARPA DISCLAIMS ALL WARRANTIES, EXPRESS OR IMPLIED, INCLUDING, BUT NOT LIMITED TO, IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. ALTHOUGH SCARPA TAKES COMMERCIALLY REASONABLE MEASURES TO PROTECT ITS CUSTOMERS PERSONAL INFORMATION, SCARPA DOES NOT WARRANT THAT (1) THE WEBSITES, (2) INFORMATION, CONTENT, MATERIALS, SOFTWARE, OR SERVICES INCLUDED ON OR OTHERWISE MADE AVAILABLE TO YOU THROUGH THE WEBSITES, (3) THE WEBSITES’ SERVERS, OR (4) E-MAIL ARE FREE OF VIRUSES OR OTHER HARMFUL COMPONENTS. EXCLUDING SCARPA’S INTENTIONAL MISCONDUCT, SCARPA EXPLICITLY DISCLAIMS AND WILL NOT BE LIABLE FOR ANY DAMAGES OF ANY KIND, ARISING FROM OR RELATED TO YOUR USE OF THE WEBSITES OR FROM ANY INFORMATION, CONTENT, MATERIALS, SOFTWARE, OR SERVICES INCLUDED ON OR OTHERWISE MADE AVAILABLE TO YOU THROUGH THE WEBSITES, UNLESS OTHERWISE SPECIFIED IN WRITING SIGNED BY AN AUTHORIZED SCARPA REPRESENTATIVE. This provision may be unenforceable or inapplicable within the State of New Jersey.
15. LIMITED WARRANTY: PRODUCTS. SCARPA products are warranted to the original retail purchaser to be free from defects in materials and workmanship for one year from the original date of purchase. Warranties for non-SCARPA products, that is products sold by SCARPA but manufactured by other manufacturers (by way of example, products manufactured by Koflach or Rottefella), may be different. Check the materials that come with the non-SCARPA products and that manufacturer’s website for information about their warranties. If you purchase a SCARPA product from any SCARPA Websites that you believe is defective, return the product to us pursuant to the SCARPA Return Policy and include your receipt and proof of purchase showing the purchase date. SCARPA will repair or replace the product at our sole discretion. If SCARPA determines that there is no warranty issue with the returned product, the product will be returned to you with a note of explanation. SCARPA’S LIABILITY UNDER THIS LIMITED WARRANTY IS EXPLICITLY LIMITED SOLELY TO SUCH REPAIR OR REPLACEMENT. UPON EXPIRATION OF THE WARRANTY PERIOD, SCARPA SHALL HAVE NO LIABILITY UNDER THIS LIMITED WARRANTY OR OTHERWISE. THE FOLLOWING ARE EXPLICITLY EXCLUDED AND NOT COVERED BY THIS LIMITED WARRANTY: (1) DAMAGES DUE TO NORMAL USE AND WEAR; (2) DAMAGES DUE TO ABUSE OR ACCIDENTS; (3) SCARPA PRODUCTS THAT HAVE BEEN RESOLED OR IN ANY WAY MODIFIED; AND (4) THE FIT OF ANY SCARPA PRODUCT. THIS LIMITED WARRANTY IS IN LIEU OF ALL OTHER WARRANTIES, EXPRESS OR IMPLIED, and except as otherwise specified above, SCARPA MAKES NO WARRANTY OF ANY KIND, EXPRESSED OR IMPLIED, INCLUDING WITHOUT LIMITATION ANY WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE, OR ANY WARRANTY AS TO THE DESIGN, CONDITION OR QUALITY OF MATERIALS AND WORKMANSHIP TO THE PURCHASER OF THE GOODS AND/OR ANY OTHER PERSON WHATSOEVER. NOTHING CONTAINED IN THE FOREGOING SENTENCE IS INTENDED TO RELEASE THE SELLER FROM LIABILITY FOR ORDINARY DAMAGES FOR PROVEN PRODUCT LIABILITY CLAIMS.
Please note that certain state laws do not allow limitations on implied warranties or the exclusion or limitation of certain damages. If you are a resident of such a state and these laws apply to you, some or all of the above disclaimers, exclusions, or limitations may not apply to you, and you may have additional rights.
16. Reserved Rights. SCARPA reserves the right to do any of the following, for any reason, at any time, without notice: (1) to modify, suspend or terminate operation of or access to the Websites, or any portion of the Websites; (2) to modify or change the Websites, or any portion of the Websites, and any applicable policies or terms; (3) to interrupt the operation of the Websites, or any portion of the Websites, as necessary to perform routine or non-routine maintenance, error correction, or other changes; and (4) discontinue or restrict your use of the Websites.
17. WARNING: SKIING, CLIMBING, MOUNTAINEERING, TRAIL RUNNING, HIKING, WALKING, AND RELATED ACTIVITIES, ARE POTENTIALLY LIFE THREATENING, HAZARDOUS, AND DANGEROUS. By purchasing or using any SCARPA equipment in any manner, you agree that you are: (1) personally and solely responsible for: (a) learning and knowing the limits and capabilities of the equipment and yourself, (b) the proper use of and techniques for such equipment, (c) making responsible, sound decisions in changing situations, and (2) assuming all risks and accepting full and complete responsibility for any and all damages and injury of any kind to yourself or others, including death, paralysis, and serious injury, which may result from or is related to your use of any equipment manufactured by or purchased through SCARPA, its partners, Websites, or retailers. In addition, YOU AGREE TO ASSUME ALL RISKS AND ACCEPT FULL AND COMPLETE RESPONSIBILITY FOR ANY AND ALL DAMAGES AND INJURY OF ANY KIND, INCLUDING DEATH, PARALYSIS, AND SERIOUS INJURY, WHICH MAY RESULT FROM OR IS RELATED TO YOUR USE OF OR RELIANCE UPON ANY MATERIALS OR INFORMATION PRODUCED BY SCARPA, ITS PARTNERS, AND/OR THAT IS CONTAINED IN ANY SCARPA WEBSITES, CATALOGS, PUBLICATIONS, OR OTHER SCARPA MATERIALS. Resources like the SCARPA Websites and publications can provide useful information and tips, but they are no substitute for good decision making, safe and appropriate use of equipment, or professional instruction for the numerous hazardous situations in which you may choose to use SCARPA products.
18. Disclosure of Your Information. You agree and SCARPA reserves the right at all times and without further notice to disclose any information that SCARPA deems necessary to comply with any applicable law, regulation, administrative or legal process or governmental request. SCARPA also may disclose your information when SCARPA determines that applicable law requires or permits such disclosure, including exchanging information with other companies and organizations for fraud protection purposes. You agree that SCARPA may disclose any information we have about you (including your identity) if SCARPA determines that such disclosure is necessary in connection with any investigation or complaint regarding your use of the Websites, or to identify, contact or bring legal action against someone who may be causing injury to or interference with, either intentionally or unintentionally, the Websites, SCARPA’s rights or property, or the rights or property of the Websites’ users, including SCARPA’s customers. You acknowledge and agree that SCARPA may preserve any transmittal or communication by you, including emails, through the Websites or any service offered on or through the Websites, and may also disclose such data if required to do so by law or SCARPA determines that such preservation or disclosure is reasonably necessary to (1) comply with legal process, (2) enforce these Terms, (3) respond to claims that any such data violates the rights of others, and/or (4) protect the rights, property or personal safety of SCARPA, its employees, users of or visitors to the Websites, and the public.
19. Indemnity. YOU AGREE TO DEFEND, INDEMNIFY AND HOLD SCARPA, ITS SUCCESSORS, AND ASSIGNS, AND ITS AND THEIR DIRECTORS, OFFICERS, EMPLOYEES, AGENTS, CO-BRANDERS OR OTHER PARTNERS, HARMLESS FROM ANY DEMANDS, DAMAGES, LOSS, LIABILITY, CLAIMS OR EXPENSES (INCLUDING ATTORNEYS’ FEES AND JUDGMENTS OF ANY KIND OR NATURE), MADE AGAINST OR INCURRED BY SCARPA BY YOU, ANY PERSON OR ENTITY ACTING ON YOUR BEHALF, AND/OR ANY THIRD PARTY RELATED TO, ARISING OUT OF OR IN CONNECTION WITH YOUR IMPROPER USE OF THE WEBSITES, YOUR BREACH OF ANY OF THESE TERMS, AND/OR ANY OTHER VIOLATION BY YOU THAT CREATES LIABILITY FOR SCARPA. This provision may be unenforceable or inapplicable within the State of New Jersey.
20. Applicable Law; Dispute Resolution; Arbitration; Class Action Waiver; Miscellaneous Provisions. By visiting or using any SCARPA Websites, you agree that:
(1) All matters relating to these Terms, and/or your access to or use of the Websites, including all disputes, will be governed by the laws of the United States and by the laws of the State of Colorado without regard to its conflicts of laws provisions.
(2) In the event of any controversy or dispute between SCARPA and you arising out of or in connection with these Terms and/or your use of the Websites, SCARPA and you shall attempt, promptly and in good faith, to resolve any such dispute. If we are unable to resolve any such dispute within thirty (30) days, then either party may request that such controversy or dispute be mediated. The mediation may be conducted in person, through the submission of documents, by phone or online. If conducted in person, the mediation shall take place in Boulder, Colorado. If the dispute is not resolved through mediation within a reasonable time (not to exceed sixty (60) days from the mediation request), then the parties shall be free to pursue any right or remedy available to them under applicable law through binding arbitration as described below.
(3) BINDING ARBITRATION: In the event of any dispute arising under or relating to these Terms your access to or use of the Websites (including products or services sold or distributed by SCARPA through SCARPA Websites), such dispute will be finally and exclusively resolved by binding arbitration. NEITHER YOU NOR WE SHALL HAVE THE RIGHT TO LITIGATE ANY CLAIM IN COURT OR TO HAVE THE CLAIM DECIDED BY A JUDGE OR JURY. DISCOVERY RIGHTS, SUCH AS EACH PARTY'S RIGHT TO THE EXCHANGE OF PREHEARING INFORMATION OR PREHEARING TAKING OF SWORN TESTIMONY, MAY ALSO BE LIMITED IN ARBITRATION. All disputes will be resolved before a neutral arbitrator, whose decision will be final except for a limited right of appeal under the Federal Arbitration Act. The arbitration shall be commenced and conducted under the Commercial Arbitration Rules of the American Arbitration Association (AAA) and, where appropriate, the AAA’s Consumer Arbitration Rules, both of which are available at the AAA website www.adr.org. The arbitration may be conducted in person, through the submission of documents, by phone or online. If conducted in person, the arbitration shall take place in Boulder, Colorado. The parties may litigate in court to compel arbitration, to stay proceeding pending arbitration, or to confirm, modify, vacate or enter judgment on the award entered by the arbitrator. The Federal Arbitration Act and federal arbitration law apply to these Terms.
(4) CLASS ACTION WAIVER: Any arbitration or proceeding shall be limited to the dispute between us and you individually. To the full extent permitted by law, (a) no arbitration or proceeding shall be joined with any other; (b) there shall be no right or authority for any dispute to be arbitrated or resolved on a class action-basis or to utilize class action procedures; and (c) there shall be no right or authority for any dispute to be brought in a purported representative capacity on behalf of the general public or any other persons. YOU AGREE THAT YOU MAY BRING CLAIMS AGAINST US ONLY IN YOUR INDIVIDUAL CAPACITY, AND NOT AS A PLAINTIFF OR CLASS MEMBER IN ANY PURPORTED CLASS OR REPRESENTATIVE PROCEEDING.
(5) You hereby irrevocably waive, to the fullest extent permitted by law, (a) any objection that you may now or hereafter have to such jurisdiction and venue and (b) any claim that any such arbitration proceeding has been brought in an inconvenient forum. Note that the preceding provision regarding venue may not apply if you are a consumer based in the European Union, however, in all cases, the United Nations Convention on Contracts for the International Sale of Goods shall not apply in any dispute arising out of or related to these Terms;
(6) Any and all claims arising out of or related to these Terms must be brought by you within one (1) year after the cause of action arises, or such claim or cause of action is forever and irrevocably barred. Claims made under the separate terms and conditions of purchase for goods and services are not subject to this limitation.
(7) No recovery may be sought or received by you against SCARPA for damages other than your out-of-pocket expenses, excluding attorney fees.
(8) A printed version of these Terms and of any notice given in electronic form shall be admissible in any mediation or arbitration proceeding based upon or relating to these Terms to the same extent and subject to the same conditions as other business documents and records originally generated and maintained in printed form. All headings in these Terms are for convenience or reference only and shall be ignored in construing these Terms.
(9) SCARPA’s failure to enforce all or any part of these Terms or respond to a breach thereof by you or any other party shall not in any way be construed as a waiver or a relinquishment of any right granted SCARPA hereunder of the future performance of all or any part of these Terms, and your obligations set forth in these Terms shall continue in full force and effect.
(10) If any provision in these Terms is held invalid or unenforceable under applicable law, the invalid or unenforceable provision will be modified to the minimum extent necessary and deemed superseded by a valid, enforceable provision that most closely matches the intent of the original provision and the remaining provisions of these Terms will continue in full force and effect.
(11) These Terms contain the entire and final agreement regarding SCARPA Websites and their Content, and supersede any prior or contemporaneous communications between you and SCARPA regarding the Websites.
(12) Any offer for any feature, product or service made on the Websites is void where prohibited. If you choose to access the Websites from outside the U.S., you are solely responsible for complying with applicable U.S. and local laws. Although the Websites may be accessible worldwide, not all products or features provided or offered through the Websites are available in all geographic locations, or available (legally or otherwise) for use outside of the U.S. SCARPA reserves the right to limit, in its sole discretion, the provision and quantity of any product or feature shown on the Websites to any person or geographic area.
(13) All rights not explicitly granted in these Terms are hereby reserved by SCARPA.
(14) By continuing to use the SCARPA Websites, you hereby agree and intend to be bound by these Terms.
SCARPA North America, Inc. (“SCARPA”) appreciates the difficulties that individuals with disabilities face and has supported disabled athletes and groups for many years. SCARPA strives to comply with all applicable laws and guidelines so that our website is accessible to individuals with disabilities, including W3C’s WCAG 2.1 (Web Content Accessibility Guidelines) accessibility standards up to Level AA.
SCARPA has taken and continues to take a variety of steps to ensure the accessibility of our website. The site is built to comply with WCAG 2.1 accessibility guidelines, including media content tagged with titles, alternative text, and descriptive information, and font sizing is supported and may be controlled through the browser.
If you experience any difficulty using or accessing any part of this website, please call us at 303.998.2895 or email us at [email protected] and we will work with you to ensure that you have full access to the information in which you are interested and which is available to the public on our site, and can purchase our products, if desired.
Please contact us at 303.998.2895 or [email protected] if you have any feedback to share about the accessibility of this website.