Are You Fuelling For Your Best Results? 

No matter what age, many people are very focused on how they look with a quest to be thin.  In the media - magazines, advertisements, social media - there are so many different diets and exercise programs to try to achieve the ultimate goal of thinness. 

Though men do not escape this cultural pressure and narrative, it seems to be particularly aimed at and focused on women, telling them at every turn that thin is the thing to be, and basing value on looks and size. 


The quest for thinness is not only driven by aesthetics. Tied to this quest for thinness is messaging that tells us that being thin is synonomous with being healthy. 

As women approach perimenopause and menopause, the hormonal changes that occur have an impact on body composition.  Many women notice that all of a sudden they are gaining weight despite following the same exercise routine and nutrition habits. 

This change in body composition combined with pressure to be thin leads many women to exercising more and eating less to try to lose weight.  Does this sound familiar? And when the results aren't coming fast enough, the typical response is further increasing exercise, and further caloric restriction. 

This all leads to frustration when the results still aren't coming despite all the efforts put into restricting and burning calories. The weight isn't coming off, performance and energy start to suffer and instead of feeling energized after exercise, fatigue and brain fog  take over. 

That's the problem with increasing exercise and significantly restricting intake  - it will not get you the results you're looking for and it's only a matter of time before it starts to hinder your progress as well as day to day function and can lead to LEA and REDS.

Low Energy Availability (LEA) is a state in which the body does not have enough energy available to support all physiological functions to maintain optimal health. According to the 2023 IOC Concensus Statement on LEA & REDS,  “LEA is any mismatch between dietary intake and energy expended in exercise that leaves the body’s total energy needs unmet.” 

When LEA is prolonged or severe it can lead to Relative Energy Deficiency in Sport (REDs).  REDs is “a syndrome of physiological and/or psychological functioning caused by exposure to problematic (prolonged and/or severe) LEA.  The detrimental outcomes include, but are not limited to, decreases in energy metabolism, reproductive health, musculoskeletal health, immunity, glycogen synthesis, and cardiovascular and hematological health, which can all individually and synergistically lead to impaired well being, increased injury risk and decreased sports performance” (Mountjoy M, Ackerman KE, Bailey DM, et al2023 International Olympic Committee™ (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs)British Journal of Sports Medicine 2023;57:1073-1098. )

In 2023 the International Olympic Committee released a consensus statement on LEA and REDs which includes a review of the latest research on the topic.  While the research primarily focused on athletes, the information and key take aways can be applied more braodly.  While the average person may not be competing at an elite level, many people are testing their fitness limits. Whether the reason is for the pursuit of thinness, health or sport performance  consideration of energy availability is just as important for the average person as it is for the high level athlete.  

The consensus statement outlines the potential impacts on health due to problematic LEA and REDs. 

These include;

• Impaired reproductive function
• Impaired bone health
• Impaired GI function
• Impaired energy metabolism/regulation
• Impaired haemotological status (low iron)
• Urinary incontinence
• Impaired glucose and fat metabolism
• Mental health issues (depression, disordered eating behaviors, exercise dependency/addiction)
• Impaired neurocognitive function (impaired memory, decision making, spatial awareness, cognitive flexibility and executive function)
• Sleep disturbances
• Impaired cardiovascular function
• Reduced skeletal muscle function
• Impaired growth and development
• Reduced immunity

The consensus statement also outlines the impact of LEA and REDs on performance outcomes. 

These include;

• Increased illness and injury
• Decreased training response
• Decreased recovery
• Decreased cognitive performance/skill development
• Decreased muscle strength
• Decreased endurance performance
• Decreased power performance

The research reviewed identified that the physiological impacts were more related to poor energy intake rather than excessive exercise.

(Mountjoy M, Ackerman KE, Bailey DM, et al2023 International Olympic Committee™ (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs)British Journal of Sports Medicine 2023;57:1073-1098.)

When reviewing these above lists there are similarities to some of the symptoms that might be experienced by women in perimenopause and post menopause which include, but are not limited to:

• Brain fog
• Irregular menstrual cycles
• Sleep disturbance
• Mood disturbance and irritability
• Pool mental and physical performance
• Lack of motivation

It can be easy to write these symptoms off as a normal result of the hormonal fluctuations that come with perimenopause and post menopause, and while that may be an underlying factor, how you are fuelling your body must also be considered. 

Our bodies need adequate energy to produce and regulate hormones regardless of  life stage. During times of fluctuation, like perimenopause and post menopause, proper nutrition and fuelling can become even more crucial to help to manage symptoms and support the body through these changes. 

In addition to proper nutrition, exercise is also crucial during the menopause transition. Not only for managing symptoms, but for maintaining bone health, cardivascular health and maintaining muscle mass which can all be impacted by hormonal changes. 

The trouble comes when doing too much, eating too little, and looking to the scale as the only measure of progress. 
For women who are looking to lose weight, or change their body composition, especially those in the menopause transition, significant restriction and over exercising is just not the way to go. 

Finding a combination of exercise, nutrition and recovery is a better road for getting lasting results without impacting performance and day to day function.
  

Physiotherapists Wendy Hancock and Miriam Mulkewich have a special interest in working with women going through the menopause transition, an use exercise, movement, and education to support their clients through the changes they are experiencing, while working them towards their goals. 

How do I Know if I’m Experiencing LEA or REDS? 

Most people won't identify that they're not eating enough, partially because we're often being told that we're all eating too much (maybe you remember the sayings "a moment on the lips, a lifetime on the hips" or "nothing tastes as good as skinny feels")! So how can someone know if they're at risk or are experiencing LEA or REDS? 

If you answer YES to any of the below questions, it’s time to consider how you’re fuelling your body:

Answering YES to these questions doesn't automatically mean you're experiencing LEA or REDS, but it can indicate that something is going on that needs to be addressed. Working with professionals who understand human physiology, movement and nutrition is a great place to start. 

Don’t rely on the information you read on social media! There is no one size fits all strategy for exercise, training and nutrition. Your needs will depend on many factors including your level of activity, goals, and health history. 

Our Physiotherapists and Kinesiologist can help you adjust or develop a training program that finds the sweet spot of doing enough to reach your goals without over doing it. Our Registered Dietitian will help you develp a nutrition strategy that will support your level of activity while taking into consideration performance and weight related goals. 

It's common to think that symptoms related to energy intake and over training only affect elite athletes, but the truth is that LEA & REDS can affect anyone who is doing purposeful exercise and activity. Although the pressure to lose weight and stay thin is often directed at women, men also have pressure placed upon them to look a certain way and can experience issues related to food restriction and over training. 

It's worthwhile for anyone who is exercising purposefully to consider how they are fuelling their body. Our bodies require energy to function and perform our daily tasks, to participate in sports and recreation, and keep us feeling our best. When our bodies are not getting the energy and nutrients they need, function, performance and how we feel all start to suffer. 

Instead of guessing your way through adjustments to your exercise and nutrition, work with our team to develop a plan that will support you in your day to day and in feeling your best while you reach your goals! 

Book an appointment here or call us at 905-333-3488 and we'll get you on your way to feeling your best! 

P.S. If you have young active persons and athletes in your life, they also need to be fuelling properly! If you think your young person could use some guidance, our team is here to help them too. 


Find the IOC 2023 Concensus Statement on REDS & LEA here