Relative energy deficiency in sport (REDs) as a stress-induced disruption of energy flow

The diagnosis of Relative Energy Deficiency in Sport (REDs), a model attributing a wide range of negative health and performance effects, is becoming highly prevalent among athletes. Through the lens of a complex dynamic systems perspective, this paper aims to: (a) address and clarify key conceptual controversies surrounding the current REDs model, (b) explain the energy deficiency in athletes as a disruption of energy flow within physiological networks rather than merely a consequence of caloric insufficiency or excessive physical workload, (c) identify the relatedness of socio-behavioral and psychobiological constraints limiting energy flow, and (d) recommend integrated assessment systems to detect early signs of REDs. By relying on the energy resistance principle, REDs is being conceptualized as a disruption of energy flow driven by the interplay of socio-behavioral and psychobiological stressor constraints. Semi structured in-depth interviews are proposed to identify individual interactions among sources of stress, and prevent REDs.