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the shizzle => diet, training and injuries => Topic started by: shark on October 21, 2019, 10:01:53 am

Title: Relative Energy Deficiency in Sport (RED-S)
Post by: shark on October 21, 2019, 10:01:53 am
Article by Mina on UKC

https://www.ukclimbing.com/articles/features/relative_energy_deficiency_in_sport_-_a_cautionary_tale-12345


Not heard of RED-S before.

From the article

Quote
So, low energy availability is the villain here and lack of periods is just one of many problems associated with RED-S. Essentially, when the body doesn't receive enough energy (specifically carbohydrate) relative to demand, it will prioritise fuelling movement and down-regulate other physiological processes in order to conserve energy. Over-exercising, relative under-fuelling (intentional or unintentional), psychological stress or any combination of the three can lead to low energy availability.

RED-S can result in a multitude of dysfunctions with signs and symptoms including frequent illness and injury, lack of or irregular menstruation, fatigue, decreased performance and training response, impaired concentration, stress fractures, cold intolerance, mood swings, weight loss, delayed puberty and decreased morning erections in men.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Doylo on October 21, 2019, 10:38:14 am
I can’t imagine training as hard as that no matter what I’m eating. Don’t know how people do it double sessions 5/6 days a week. Not surprised doing it for years along with underfueling causes problems. Hope she makes a quick recovery. I’m sure she will now she knows what’s going on.
 
and decreased morning erections in men.
I put this down to self loathing.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Mr E S Capegoat on October 21, 2019, 11:27:47 am
‘Red-S’ sounds like a combination of overtraining and restrictive eating patterns which seem quite common in climbing. Other factors associated include obsessional behaviour, perfectionism, singular goal driven behaviour  lots of repetition, despite downwards spiral, failing to see the wood for the trees etc. Wander round Malham catwalk any given weekend and it’s all going on. Sardines and salad etc. Other non sports related but physiologically related ideas include neuro fatigue, central fatigue, ME, chronic fatigue, depression, post viral syndrome etc. I think this might be often reported in sport, did Steve Ovett suffer this in the late 80’s?
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: mrjonathanr on October 21, 2019, 11:46:36 am
Seb Coe  struggled to recover from virus,  not uncommon with overtraining
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: nick63 on October 21, 2019, 12:47:31 pm
There's lots of info on RED-S on the British Journal of Sports Medicine site. It's a big problem and used to be thought only a female issue, however the latest evidence suggests it's both female and male.

There's good podcast, again on the BJSM site, about RED-S. We all know climbing is a power to weight ratio sport but not eating enough will probably cause more problems in the long run; increased risk of injury, poor recovery from injury or illness, sudden drop in performance. Stress fractures are a common and again fail to heal or re-fracture with little stress.

Is it better to get strong at a healthy weight (whatever that is) or calorie restrict and risk the consequences of RED-S?
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: cheque on October 21, 2019, 01:19:05 pm
I'm pretty sure RED-S used to sponsor Crawley Town a few years ago.

Takes a lot of guts to altruistically write an article like this, particularly all the periods stuff. If nothing else it's an absolute goldmine for those of us who might want a resource of excuses for only training once a week and eating Jaffa Cakes at the crag.  ;)
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: shark on October 21, 2019, 02:09:06 pm
Is it better to get strong at a healthy weight (whatever that is) or calorie restrict and risk the consequences of RED-S?

Or tactically and temporarily drop the weight for when you need to perform
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Paul B on October 21, 2019, 02:39:27 pm
That's a really well written piece. I'm glad to see people writing (and publishing) such things rather than the Insta/FB "only the good bits".

Quote
but I realise now there was also an element of compulsive behaviour and using exercise as an emotional management tool.

 :guilty:  :-[
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Nibile on October 21, 2019, 02:51:30 pm
Excellent piece of writing on a crucial subject.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Mr E S Capegoat on October 21, 2019, 03:06:50 pm
Branding as ‘Red-s’ gives an opportunity for an industry to pop up around what appears to be already well recognised psychologically mediated sets of symptoms e.g disordered eating and compulsive / obsessional training. They’ll be some Red-s experts out there I’m sure. Life coaches in the wholistic sense.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: abarro81 on October 21, 2019, 03:51:11 pm
Branding as ‘Red-s’ gives an opportunity for an industry to pop up around what appears to be already well recognised psychologically mediated sets of symptoms e.g disordered eating and compulsive / obsessional training. They’ll be some Red-s experts out there I’m sure. Life coaches in the wholistic sense.

Surely the "symptoms" you describe are causes, not symptoms, of the physiological symptoms of RED-S (hormonal dysfunction, bone density getting messed up etc)?
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Stu Littlefair on October 21, 2019, 04:16:07 pm
I think Dan's point is that there can be a psychological component to much of this. In general eating too little/training too much could be the immediate cause of similar issues but in many cases (not necessarily Mina's) the root cause of eating too little/training too much may be psychological.

And then there's the possibility that the psychological issues and stress are the more immediate cause of similar issues...
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Mr E S Capegoat on October 21, 2019, 06:04:05 pm
Sure it would be too dualistic to suggest one without the other. The name RED-S is dualistic in that it reads as a physical illness, a collection of signs and symptoms. Obsessionality, compulsive behaviour, rigid thinking, perfectionism, emotional numbing, distorted body image all come along with a chronic calorie deficit and in turn become part of what keeps a person there. Reduced bone density, risk of cardiac event, halted periods, fatigue are signs of a body struggling to cope with the demands of the training and diet regime.
These regimes are often continued as they provide rewards. Feelings of euphoria, control, emotional numbing, sometimes they act as punishment or self harm which has its own returns. This stuff is closely linked to self esteem and body image / sporting performance culture. Calling it RED-S is a little confusing in a sense because what it’s describing is-
1. Calorie deficit
2. Compulsive over exercise
However you contextualise it. 
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: mrjonathanr on October 21, 2019, 06:40:55 pm
The name RED-S is dualistic in that it reads as a physical illness, a collection of signs and symptoms.

That’s basically a textbook definition of a syndrome, which seems fair enough. As it’s behaviourally induced, ipso facto, there’s some psychological component.

Still seems valid to represent the range of physical signs and symptoms as such though (at least to me, a layman).
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Mr E S Capegoat on October 21, 2019, 06:52:38 pm
The textbook is wrong RED-S is a nonsense diagnosis. Most likely made up by some sport scientist / coach collaboration who don’t want to call it what it is so they can still keep hammering the same old shit.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: webbo on October 21, 2019, 07:00:20 pm
Careful Dan you are starting to make sense. :o
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: abarro81 on October 21, 2019, 07:01:05 pm
Is that 1 and 2 or 1 or 2 Dan? (Would quote but on phone and it's a faff..)

It would be interesting to know how many people have it undiagnosed. I have an instinctive aversion to your post, which I think is this (on the presumption that your answer to the above is 1 AND 2):
I can imagine that years of hard training and cyclical dieting could lead my body to a place where it gets screwed up, confused and, for example, decides to mess up my testosterone or something. But I can't identify with your number 2..
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: webbo on October 21, 2019, 07:09:14 pm
You could speculate that continued training or exercising whilst suffering from some sort of injury would be compulsive over exercising.
Which would include about 99% of climbers.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Mr E S Capegoat on October 21, 2019, 07:45:56 pm
It’s only dysfunctional if it causes dysfunction.

Low body weight is associated with a number a physical and psychological symptoms of which obsessional rigid thinking and compulsive behaviour is one of them.
Low body weight also generates interpersonal difficulties for some / most people.
When you’re ‘stuck’ in a cycle of intense diet and exercise it is possible to tread water at a low BMI say 16.5 and still function pretty well. This situation tends to bring a fair few pro’s which keep it going. 
A significant majority of people existing at this won’t recognise it as a problem.
Intensive exercise in whatever form often driven by conscious and unconscious needs and desire to control. E.g physical, emotional, psychological systems is part of this.
Rigid structures and protocols in diet and exercise feed into this.  Which is all fantastic if it’s working for you.
Our psychological and physical ‘systems’ aren’t separable in this way. The concept of ‘mental’ and ‘physical’ health is a false dichotomy stemming from a dualist culture in medicine. The RED-S  diagnosis is a  socially acceptable branding of a more complex  set of difficulties which are individually variable.
One person does it to numb and forget, another to ‘perform’, another to  self punish, another to control, another to conform and be accepted. The destination is usually the same or similar.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Mr E S Capegoat on October 21, 2019, 07:47:48 pm
Careful Dan you are starting to make sense. :o

Sorry I’ll stop it now
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: abarro81 on October 21, 2019, 09:57:32 pm
Apparently cordial discussions of this on UKC are now a banning offense. Looks like the Mick Ryan censorship program lives on...
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Mr E S Capegoat on October 21, 2019, 10:13:32 pm
What happened Alex?

*seemed like a reasonable thread to me all sides getting along, apart from that ged bloke seeing his arse about mental health / eating disorders.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: TobyD on October 21, 2019, 11:54:25 pm
The textbook is wrong RED-S is a nonsense diagnosis. Most likely made up by some sport scientist / coach collaboration who don’t want to call it what it is so they can still keep hammering the same old shit.

In much the same way as many blanket diagnoses that attempt to cover a range of actual symptoms. The problem is that  people seem to want diagnoses. There's a rather broader point about these encouragingly healthcare behaviour, dependence and over medicalisation. Essentially I'm saying I think you've got a good point Dan.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: abarro81 on October 22, 2019, 07:26:05 am
I take it back.. jumped to conclusions too fast.. apparently it was their anti-spam not erroneously flagging me! Sorry ukc
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Stu Littlefair on October 22, 2019, 08:08:35 am
Quite a good thread that. It would have been wierd if you’d been banned for it!

My impression from reading the document alicia linked and some surrounding medical research on hypothalamus function and functional hypothalamic amenorrhea (FHA) is that the idea of RED S is useful, but suffers from too narrow a focus on energy deficit.

FHA is also strongly linked to emotional stress, for example, and occurs in sedentary women with normal diets too.

It’s not too much of a stretch to imagine nutrition beyond calories plays a role, and there’s some evidence that, e.g. vitamin D is important (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6265788/)

If Mina’s excellent article strikes a chord with someone reading it, then some self care (eat well, reduce stress, engage in activities that are simply fun) might yield more benefit than just eating more.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: abarro81 on October 22, 2019, 10:07:13 am
Good post, except we all know that doing things that are fun is for losers. Start down that road and you'll end up like mr scapegoat, pontificating about the Freudian implications of spending too much time aerocapping on jugs shaped like dongs
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Mr E S Capegoat on October 22, 2019, 10:41:04 am
You clearly need to read Kuntworthy’s latest schematic Alex. Overcoming Kleinian envy which developed through witnessing parental coitus. The energy systems pathway is clear and yes it does involve the budding ‘energy system acolyte’ hanging off a big yellow cock for 15 minutes before continuing to traverse in circles for 10. While an onlooking crowd of angry Self serious ukbers call for justice.

That one’s on you btw

Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: SA Chris on October 28, 2019, 01:44:59 pm
Can we get Jim'll Paint it to do that on the new T Shirt?
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: T_B on November 07, 2019, 01:36:47 pm
This is both shocking and sad. I really hope that climbing can avoid going this way

https://www.nytimes.com/2019/11/07/opinion/nike-running-mary-cain.html

Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Mr E S Capegoat on November 08, 2019, 10:03:37 am
It seems shocking because it’s quite explicit and brought into public consciousness. A direct example of a brand ‘owning’ a person. I’m in two minds about the Red-s name. On one hand it raises awareness to sports people and navigates the potential shame of an anorexia or restrictive eating disorder diagnosis, possibly enabling ‘athletes’ to feel safer in accessing help on the other hand it’s absolutely not different on any level to an eating disorder diagnosis. Maybe it could be renamed red-L or relative energy deficiency in Life
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: T_B on November 08, 2019, 10:46:53 am
It's the level of abuse from Salazar that I find shocking and the fact that this culture remains so prevalent/accepted. There are other female Nike athletes now going public basically saying "yeah we knew this abuse was going on, sorry we didn't say anything".

But yes, as you say, Nike owns them.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Mr E S Capegoat on November 08, 2019, 11:28:43 am
It’s definitely interesting that a company at the end point of the capitalist system like Nike would employ a narcissist to do their dirty work. It’s similar to the point I was making in the other thread. The desire for perfection based on a sense of self that’s ‘held’ by others is a common theme in restrictive eating disorders. In this way the behaviour might not even have been recognised as abuse and coercive control, just ‘normal’. I’d argue you could expand this out quickly to the controlling culture as a whole and is fully present within climbing.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Stu Littlefair on November 08, 2019, 12:14:52 pm
The desire for perfection based on a sense of self that’s ‘held’ by others is a common theme in restrictive eating disorders.

It's the human condition. As you say higher up the page it's only dysfunctional if it causes dysfunction. When held in check it also drives most human endeavour, including exploration, adventure and arguably charity.

It's easy to pile onto Salazar and Nike, and their behaviour is clearly horrible. BUT, in another context, society might view this kind of pressure and perfectionism as an ideal to strive for (e.g the Apollo programme). I think this makes the issue a bit harder to react to than just an "oh, isn't this awful" response.

To drag back onto RED-S I think it's power in helping athletes deal with disorder eating without stigma makes it a worthwhile concept. But it's also the weakness of a diagnosis, since it doesn't encourage the athlete to think about other areas of live that are putting their bodies under stress.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Mr E S Capegoat on November 08, 2019, 03:00:31 pm
In this sense Salazar, Nike and society are one in the same. Under the illusion of free will the ‘athlete’ embraces their approach supported by the crowds desire to see performance and therefore experience themselves in this individual. Honnold and free solo is a good example of this in climbing, a bewildered man acting on motivations beyond his control for difficult to fully articulate reasons, held aloft by a community and idolised in this way. We all experienced a bit of what it was like to be him in the cinema. Some level of insight into this can offer a sense of freedom and opportunity to be more ‘yourself’. It’s clear many ‘great’ performances and endeavours have been undertaken in this way, smashey and nicey for example. I’d hazard that in the end the more driven and owned by the ‘other’ real person or abstraction (money, grades and it’s symbolism) the results are inevitably problematic for some if not all the people involved. Perfectionism exists because others make it so. This is a paradox in restrictive eating disorders and many other things, the society / government which is working so hard to ‘cure’ them is the very thing creating them e.g the education system
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: T_B on November 08, 2019, 03:09:28 pm
Dan. Get yersel to a ParkRun ;D
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Mr E S Capegoat on November 08, 2019, 03:18:21 pm
You’re taking the piss right Tom? 🤣
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: webbo on November 08, 2019, 03:29:49 pm
In this sense Salazar, Nike and society are one in the same. Under the illusion of free will the ‘athlete’ embraces their approach supported by the crowds desire to see performance and therefore experience themselves in this individual. Honnold and free solo is a good example of this in climbing, a bewildered man acting on motivations beyond his control for difficult to fully articulate reasons, held aloft by a community and idolised in this way. We all experienced a bit of what it was like to be him in the cinema. Some level of insight into this can offer a sense of freedom and opportunity to be more ‘yourself’. It’s clear many ‘great’ performances and endeavours have been undertaken in this way, smashey and nicey for example. I’d hazard that in the end the more driven and owned by the ‘other’ real person or abstraction (money, grades and it’s symbolism) the results are inevitably problematic for some if not all the people involved. Perfectionism exists because others make it so. This is a paradox in restrictive eating disorders and many other things, the society / government which is working so hard to ‘cure’ them is the very thing creating them e.g the education system
I was of the belief that systems tended to be a causative factor in eating disorders, often the family system.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Mr E S Capegoat on November 08, 2019, 04:20:21 pm
I think so. Family, educational, broader informing or governing, societal / cultural. Anything that ‘has’ or influences part of a person in that way. I guess trans-diagnostically it could work for lots of problems. Neurotic being ‘alienated’ from the inside world or self and ‘psychotic’ being alienated from the outside world or ‘other’ fully immersed inside your own head. Ps I don’t fully follow that broad idea and of course it’s a heuristic / oversimplification of the bio-psycho-social systems and their relative complex interactions.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: webbo on November 08, 2019, 04:36:17 pm
I don’t think I ever came across an individual with eating issues who wasn’t or had been part of a dysfunctional family.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Mr E S Capegoat on November 08, 2019, 04:59:40 pm
We’re agreeing then? ✌️💗 please say yes.....
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: webbo on November 08, 2019, 06:05:22 pm
Did you say the same, I would have never have guessed.
Do you speak like that in real life. :-\
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Mr E S Capegoat on November 08, 2019, 06:39:01 pm
The old ukb lose-lose. To say any one system is to blame is overly simplistic without taking into consideration ideas like the nature of consciousness and the illusion of free will, predetermination, individual and broader cultural forces. Values, belief systems etc. So are the ‘family’ to blame? Only in that they represent the broader fucking mess in their dysfunctional behaviour. Is it the government / society / culture to blame? well we live in a performance orientated world where winning or getting your ‘medal’  whatever that might mean, is held paramount. Is genetics to blame, well in some part of course people can be more obsessional or ‘driven’ whatever. So are there a significant amount of climbers out there operating in this ‘system’ of course. And to be honest, so what? Every time somebody posts their weekly report including weight etc in power club, the whole thing is so predictable because it is a predetermined set of behaviours which have been instigated by all these driving factors and assimilated in the unconscious before they’ve even happened.
Jeez webbo I thought we could become solid pals there for a minute
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: webbo on November 08, 2019, 06:51:56 pm
Well I suppose I could be become pals with someone as well balanced as your good self.
Well balanced as in a chip on either shoulder. ;)
Fuck me Dan you need to lighten up. I have climbed for about 47 years if you can call it climbing. These days I spend most of my time pissing about on a piece of overhanging plywood in the garage believing I’m training to get better or futility not any worse.
I would love to be doing what Jimmy Webb or Daniel Wood are doing not because they are the driven to be the best in the world by a society which thrives on elitism.
Because those moves they do just look fantastic and being able to do them must be out of this world.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Mr E S Capegoat on November 08, 2019, 07:31:07 pm
Cheers for the advice. Although I’m not sure ‘Webb n Woods’ are real people? A bit like that ‘Shultez’ bloke. Figments of their own imagination.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Mr E S Capegoat on November 09, 2019, 07:51:55 am
Actually one thing about this -
When I responded to Tom’s post about ‘shocking and sad news’ with a well thought out and in depth reply to the best of my ability I get told to lighten up etc when it isn’t in-line with peoples thinking. Here’s the alternate response

‘Ooooo yes balsalsa fellah, shocking yes very terrible. Nike should give him the sack. How did some one like him ever get that job. Our young athletes need proper training to win medals. Ooooo terribly sad etc... I blame the parents and possibly teachers cos they’re all rubbish these days....’ ‘now that Jimmy Webb and Danny woods are the real thing, they’re not even aware of climbing as a ‘thing’ just turned up to a rock one day and celebrated getting to the top... amazing I’d like to be like them etc... true role models and they drink beer and eat macdonalds.... proper climbers’

Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Ged on November 17, 2019, 08:51:26 pm
What happened Alex?

*seemed like a reasonable thread to me all sides getting along, apart from that ged bloke seeing his arse about mental health / eating disorders.

You seem to get quite angry quite quickly.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: moose on November 26, 2019, 09:14:54 am
This latest Ross Tucker "The Science of Sport Podcast" might be of interest.  I've not listened myself but the preceding ones in the series - on talent development, cheating / doping, and the evolution and effectiveness of the Nike Vaporfly were excellent.

https://play.acast.com/s/realscienceofsport/4676edf0-7f8a-4208-8464-0b929be25d66 (https://play.acast.com/s/realscienceofsport/4676edf0-7f8a-4208-8464-0b929be25d66)

https://player.fm/series/the-real-science-of-sport-podcast/mary-cain-challenging-the-culture-of-fat-shaming-and-elite-performance (https://player.fm/series/the-real-science-of-sport-podcast/mary-cain-challenging-the-culture-of-fat-shaming-and-elite-performance)

https://podcasts.apple.com/us/podcast/mary-cain-challenging-culture-fat-shaming-elite-performance/id1461719225?i=1000457810935 (https://podcasts.apple.com/us/podcast/mary-cain-challenging-culture-fat-shaming-elite-performance/id1461719225?i=1000457810935)
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Fiend on March 19, 2020, 10:22:00 pm
(https://www.rockfax.com/wp-content/uploads/pdfs/girls.jpg)

Plus ca change, plus c'est la meme chose  :-\
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Johnny Brown on March 20, 2020, 01:56:30 pm
Who's playing Gill's role nowadays?
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Duma on July 06, 2023, 08:54:56 am
As mentioned on the current comps thread, Volker Schöffl has resigned from IFSC Medical Commission in protest at inaction on RED-S

https://www.instagram.com/p/CuUH0oIt1Ve/ (https://www.instagram.com/p/CuUH0oIt1Ve/)

Quote
As a consequence of the non-action of the IFSC I resign with immediate effect from my voluntary position in the IFSC Medical Commission.
Hereby I am drawing the same consequence as our MedCom president. We share the opinion that as medical doctors we can no longer accept the non-action of the IFSC concerning the RED-S problems of our athletes.

I have been a #MedCom member since the inauguration of the IFSC in 2009. During that time frame we achieved many goals for the well-being of our athletes. However, the current politics with regards to RED-S cannot be accepted. We have worked for more than 10 years on the topic. We have collected numerous data, have measured BMI/MI at every WorldCup last year and have developed very profound plans how to detect and help athletes with such problems. We have spent many hours in meetings and on the desk establishing a new and better system of monitoring and decision making. As a consequence, we now have the most profound data on this matter of all sport disciplines. We have pointed out the problem and possible solutions to the sports director and board continuously and repeatedly. However, the only acknowledgement we have received has consisted of defamation and discouragement. In short, the IFSC may not be willing at all to undertake further action regarding this important health issue of its athletes and is acitvely delaying and slowing down any decisions that could lead to much needed action.

As medical doctors we cannot accept this any longer.

Sport climbing has a RED-S problem.
Possible solutions to detect, evaluate and help critical athletes were developed through the Medical Commission.
These solutions have been and are being ignored. No further action is taken by the IFSC.

For the wellbeeing of our athletes and the development of this sport, I cannot take any responsibility on this matter and am forced to resign.

Many thanks to my long-time colleagues and friends in the Medical Commission for their work and efforts, especially to our president Dr.Eugen Burtscher.

I hope this step may help the cause and our athletes but I know it won‘t.

Volker Schöffl – climbing doctor
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Fiend on July 06, 2023, 10:10:49 am
Mmmmm some vintage baiting / attention-seeking Gapescrote on this thread! I do tend to agree with one implied point though, can we just call it what it is i.e. anorexia - within the context of a sport that rewards a certain level of power-to-weight enhancing eating disorder.

Fair play for Volker taking a public stance and a pity his efforts haven't come to anything yet. I wonder if it's callous to say "just let them get on with it", acknowledge that minimal body fat is one key component to performance and the athletes can choose to do that and take the risks in return for greater comp success.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Wellsy on July 06, 2023, 10:51:57 am
It is up to them but also these are often young people surrounded by other people highly invested in their success but not necessarily in their wellbeing beyond that.

Lots of athletes have said there is a big problem and now we have a highly respected doctor saying he cannot continue as a medical professional in his role. I think that safeguarding is very important and that climbers at all levels can be vulnerable to eating disorders.

It wouldn't be right to say "let em make their own choice and bear the consequences" imo and it seems that the most qualified opinions seem to agree, or at least feel that not nearly enough is being done to keep athletes safe.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Dexter on July 06, 2023, 11:07:54 am
I agree that it shouldn't just be ignored and up to them. To me this has some parallels to some countries use of steroids in Olympics. Where athletes are told to do something by a coach (take pills, or some diet) without truly understanding the implications and trusting the coach. Both examples have serious health implications but one illegal one isn't.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Duncan campbell on July 06, 2023, 11:35:39 am
I’d agree, adding in that in my (personal) opinion and experience, often people who are highly successful and/or obsessed/motivated often have underlying mental health issues or traumas that drive them. Not always in a totally unhealthy way and obviously not always the case.

 
But I think the “let them make their own decisions” tact leaves a lot of room for people who are more vulnerable to put performance ahead of well-being at risk.

Plus it kind of says “athletic performance is more valuable than well-being” because those who are unwilling to sacrifice well-being to gain ultimate power-weight are penalised.

Obviously there is an element to this already but within the boundaries of what is healthy for an athlete.

Well-being should always be more valuable than athletic performance.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: yetix on July 06, 2023, 11:37:50 am
+1 on what Duncan said. It also sounds like volker felt he had tried to do everything he could but the ifsc were just dragging their heels. Will be interested to see what happens from this as it can't exactly make them look good and surely will need a response?
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Baron on July 06, 2023, 12:41:18 pm
Slightly on a tangent.
Interesting comment from Mark Cavendish the other day about how landing a pro team cycling contract is no longer about victories, but more about your basic numbers (your engine, if you like). Made me wonder if pro climbing will head that way (hence tenuous link to weight control in this thread). I mean, it kinda happens already in a slightly different way with social media reach trumping ascent palmares.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: sirlockoff on July 06, 2023, 03:55:10 pm

the IFSC has been working on new regulations such that people with low BMI (<=18) will have to undergo bunch of medical screenings (Alanna's IG)

the doctor(s) / athletes also want a RED-S testing to every athlete, which to my understanding is not synonym with disordered eating, so what we consider 'healthy looking athlete' could indeed have RED-S, and that seems quite a black box

Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Muenchener on July 06, 2023, 04:06:07 pm
I wonder if it's callous to say "just let them get on with it", acknowledge that minimal body fat is one key component to performance and the athletes can choose to do that and take the risks in return for greater comp success.

According to this interview with Dr Schöffl (unfortunately only in German) (https://binwegbouldern.de/dr-volker-schoeffl-ueber-essstoerungen-im-klettersport/) the athletes almost certainly aren't aware of the real risks. It's not just a case of a temporary compromise for a few competitive years. Anorexia, he says, is the #1 cause of death in young women, and he himself has had patients die or be permanently disabled by it.

Also, many of the athletes concerned are adolescents who should not be expected to make life-risking choices entirely on their own initiative, and whose coaches are to a certain degree in loco parentis and should (he said, naïvely) be concerned about their wellbeing and not just their competitive success.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: SA Chris on July 06, 2023, 04:08:11 pm
Quote
We have developed very profound plans how to detect and help athletes with such problems. We have spent many hours in meetings and on the desk establishing a new and better system of monitoring and decision making. As a consequence, we now have the most profound data on this matter of all sport disciplines. We have pointed out the problem and possible solutions

From reading this, it looks like different options have been presented rather than just "testing for low BMI"; other testing options are probably available. Looks like all are being ignored though.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Muenchener on July 06, 2023, 08:18:53 pm
From reading this, it looks like different options have been presented rather than just "testing for low BMI"; other testing options are probably available. Looks like all are being ignored though.

Schöffl says in the interview that he'd prefer a bodyfat percentage to a BMI limit, but that there's no currently available cheap, convenient test for bodyfat that gives consistently repeatable results. He says there's some promising research in that direction currently ongoing. Meanwhile he regards a BMI limit as much better than nothing, for all BMI's limitations. But apparently BMI limit warnings/recommendations that are sent out to national federations & coaches are simply being ignored.

I suspect the IFSC's reluctance or inability to do anything more serious about enforcement is what's led to the resignations.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: SA Chris on July 06, 2023, 09:58:24 pm
I suspect the IFSC's reluctance or inability to do anything more serious about enforcement is what's led to the resignations.

Absolutely no doubt.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: steveri on July 06, 2023, 10:15:19 pm
Re: just let them get on with it, I can attest that some folk with eating disorders make some pretty poor decisions.

Re: Duncan’s point, almost by definition to get to the very top you have to be uniquely obsessed. Which is why we’re generally won over by people who seem genuinely nice people with no edge… that are still utterly, utterly brilliant at what they do.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Duncan campbell on July 07, 2023, 08:26:13 am
So, what is it your saying exactly...?
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Fiend on July 07, 2023, 10:30:29 am
Plus it kind of says “athletic performance is more valuable than well-being” because those who are unwilling to sacrifice well-being to gain ultimate power-weight are penalised.

Isn't that the truth though?? Or the natural extrapolation of performance-chasing??
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: IanP on July 07, 2023, 11:07:58 am
Plus it kind of says “athletic performance is more valuable than well-being” because those who are unwilling to sacrifice well-being to gain ultimate power-weight are penalised.

Isn't that the truth though?? Or the natural extrapolation of performance-chasing??

I'd it really though?  Who are the incredible athletic performers who sacrificed their well being?  Tennis big 3, Usain Bolt, Serena Williams, Messi,  Fraser-Pryce ?  The ultimate athletic performance should mean managing your well being alongside the competing stresses of pushing your body to its limits.

I wonder whether there is a risk with these lower profile sports like climbing (gymnastics similarly?) to in some ways treat the athletes as replaceable objects to be pushed to or past there limits and swapped out if they break.  Compared to major sports like tennis or football where the value of the athlete is such that most people involved have a buy in to keeping them healthy and performing to their potential for the longer term.

Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Dac on July 07, 2023, 11:53:59 am
I think the "athletic performance is more valuable than well-being” issue is an interesting one.

As a whole people do put a high value on athletic performance and are certainly willing for our top athletes to be highly obsessive if it results in wins/trophies/medals. For example I can remember reading that Daily Thompson used to train on Christmas Day, as his competitors would be spending the day with their families, do he was getting an extra days training over them. And I recall a commentator during a Mo Farah race mentioning that his wife was due to give birth, but if she went into labour before the race, would not be telling Mo, do he was not distracted from his run.
 Can you imagine another profession of hobby where such behaviour would be tolerated, never mind lauded? "Look love don't tell me if the baby comes, I'm really close on this 8B, and conditions look really good today."
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: abarro81 on July 07, 2023, 11:57:39 am
Being really good at a sport is surely never going to be healthy, neither mentally or physically. That doesn't mean that some limits shouldn't be in place though to protect athletes though, whether that's around drugs or around issues like RED-S
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: T_B on July 07, 2023, 12:04:31 pm
What an odd thing to say. There are loads of really good athletes who are no doubt on balance healthy. Injury is par for the course for pros, but you can say the same for amateurs in many sports (eg running, climbing).

Maybe Ondra would be better off sat on the sofa??
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Bradders on July 07, 2023, 12:28:10 pm
Being really good at a sport is surely never going to be healthy, neither mentally or physically. That doesn't mean that some limits shouldn't be in place though to protect athletes though, whether that's around drugs or around issues like RED-S

If that is the case, and I don't think it is but anyway, then isn't that the whole point of this? I.e. basically saying that's not how it should be so let's take steps to stop it in future.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: abarro81 on July 07, 2023, 12:31:47 pm
Maybe I'm phrasing badly, I guess I don't mean that it's impossible to be an elite athlete and be "healthy", but that being an elite athlete is inherently likely to be "unhealthy" in some way. A bit like smoking is unhealthy, but you might still smoke and live until 90 or not smoke and die of lung cancer at 50.

A few examples:

https://www.skysports.com/rugby-union/news/12321/12711929/study-finds-higher-neurodegenerative-disease-risk-for-international-rugby-players-dementia-motor-neurone-disease-more-likely

https://bjsm.bmj.com/content/57/1/33

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7520548/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8870309/


isn't that the whole point of this? I.e. basically saying that's not how it should be so let's take steps to stop it in future.
Yes. Same with banning PEDs - it's a way to protect athletes from themselves (or the worst parts of themselves, or pressure to do things that are very bad for them, or however you want to frame it).
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Liamhutch89 on July 07, 2023, 12:34:31 pm
"Look love don't tell me if the baby comes, I'm really close on this 8B, and conditions look really good today."

Too fucking right! The kid can wait.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Gritter on July 07, 2023, 05:01:42 pm
Why not let them get on with it in a supportive and affirming manner? Coaches could facilitate the process by using regular weight checks, body fat ratios and measurements of the upper arm and thigh circumference. I for one stand by my body dysmorphic and anorexic brothers and sisters, worried parents can be reassured that 'the science' backs up a 100% affirmative approach to extreme weight loss. It will be important for all coaches to remember that questioning or challenging the beliefs of any individual identifying a 5 stone underweight gluten intolerant fat person, will be frowned upon.

Wasn't it Daley Thompson not Daily?  :coffee:
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Wellsy on July 07, 2023, 05:13:55 pm
We're having a pretty good discussion here, or at least we were until you had to come in with an axe to grind, on account of everyone ignoring you and leaving you to have a tantrum in the last thread you frequented
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: SA Chris on July 07, 2023, 05:28:19 pm
Quite.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Fiend on July 08, 2023, 09:00:10 am
Isn't that the truth though?? Or the natural extrapolation of performance-chasing??

I'd it really though?  Who are the incredible athletic performers who sacrificed their well being?  Tennis big 3, Usain Bolt, Serena Williams, Messi,  Fraser-Pryce ?  The ultimate athletic performance should mean managing your well being alongside the competing stresses of pushing your body to its limits.

I wonder whether there is a risk with these lower profile sports like climbing (gymnastics similarly?) to in some ways treat the athletes as replaceable objects to be pushed to or past there limits and swapped out if they break.  Compared to major sports like tennis or football where the value of the athlete is such that most people involved have a buy in to keeping them healthy and performing to their potential for the longer term.
I meant for climbing in particular, so yes the examples you give for more established, not-necessarily-power-to-weight-driven sports will be different.

I am partly playing devil's advocate here of course. But then who are we to deny people their ultimate climbing performance...

"Look love don't tell me if the baby comes, I'm really close on this 8B 9A, and conditions look really good today."
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: mrjonathanr on July 08, 2023, 09:38:40 am
Coaches could facilitate the process by using regular weight checks, body fat ratios and measurements of the upper arm and thigh circumference.


Have you the slightest idea how problematical this is in relation to young people, especially girls? :wall:

If you have nothing worthwhile to contribute, don’t.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: moose on July 08, 2023, 10:35:11 am
The latest Science of Sport podcast reported that a few sporting bodies (UK Swimming etc) have banned that kind of monitoring as it can trigger disordered eating - athletes starving themselves during the days prior to measurement day. 
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Gritter on July 08, 2023, 11:35:54 am
Coaches could facilitate the process by using regular weight checks, body fat ratios and measurements of the upper arm and thigh circumference.


Have you the slightest idea how problematical this is in relation to young people, especially girls? :wall:

If you have nothing worthwhile to contribute, don’t.

It was a joke ffs
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: IanP on July 08, 2023, 02:55:12 pm

I meant for climbing in particular, so yes the examples you give for more established, not-necessarily-power-to-weight-driven sports will be different.

I am partly playing devil's advocate here of course. But then who are we to deny people their ultimate climbing performance...


I picked more mainstream sports since it's probably significantly more difficult to reach / stay at the top for those than a niche sport like climbing. 

However to answer your point, Ondra and Garnbret seem to have managed to balance ultimate performance and health over an extended period.

Understand that there's an element of devil's advocate but as others have pointed even if there was any merit in this argument it would have to be considered in the light of how much you really believe athletes (particularly young and up and coming) can make rational informed decisions to cause themselves harm unaffected by external factors.

Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Gritter on July 08, 2023, 08:41:21 pm
The Gillick competence seems to have pretty broad boundaries these days, at what BMI does a 16 or 17 year old be deemed to be making poor and irrational choices? 13.5 seems around the mark.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: edshakey on July 27, 2023, 07:59:16 pm
Quote from: Janja Garnbret on Facebook/Instagram
Do we want to raise the next generation of skeletons?

Brittle hair, dull expressions, trying to show everyone you are ok but are you really?

Eating disorders are poorly understood, probably more so inside sports than in the general public. Under-eating is not something to be proud of or emblematic of success. Being light does not mean being strong. I can’t count how many times I have heard someone say that they hated their body or that they wanted to be skinnier. It breaks my heart hearing young girls say that if they lost a few kilos they could be just as strong as the other girl is. It hurts to see so many examples in the climbing community.

We all have the power to change the culture of eating disorders in sports. It starts with the way we talk about food, our bodies and how we define being fit. I encourage coaches to hire dietitians or other professionals to speak about nutrition to their athletes and train coaches on eating disorders in sport. RED-S screenings should be mandatory for all World Cup and Continental Cup participants. And yes, I believe that sanctions from competitions are needed if thresholds set by experts are not met. This being said, I‘m skeptical towards putting national federations in charge of this as for understandable reasons there can be too much personal closeness to see the truth or dependency on an athlete’s success to actually make the necessary calls.

I said it before and I'll say it again. Malnutrition and RED-S in climbing needs to be tackled asap. Preventing athletes and our sport in general from further damage should be in all of our interest and on top of the @ifsclimbing agenda.

Let’s not look away and make sure competitive climbing doesn’t become a failing environment no-one can truly win in!
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: abarro81 on July 27, 2023, 08:31:05 pm
Are there any other sports that have BMI limits or similar? Watching TDF some of those guys must presumably be running prettying unhealthy body fat % for periods of the year?
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Paul B on July 27, 2023, 08:46:16 pm
There's a GCN+ video called "the Weight of the Peloton" and Zwift are seemingly still giving away free memberships for the TdF Femmes.

I've not watched it yet. Don't forget legs are heavy.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: jwi on July 27, 2023, 09:44:14 pm
Are there any other sports that have BMI limits or similar? Watching TDF some of those guys must presumably be running prettying unhealthy body fat % for periods of the year?

If a ski jumper is below 18.5 kg/m2, or 20 fully equipped, they must use shorter skis.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: stone on July 31, 2023, 09:52:42 pm
What if, for competitions, everyone had to climb with a weight belt that took them up to a certain weight for their height -perhaps set a bit heavier than fairly hefty?
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Fiend on August 05, 2023, 11:50:55 am
 :agree:
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Muenchener on August 05, 2023, 09:45:26 pm
Volker Schöffl actually argued in favour of that idea in this (German language) interview: https://binwegbouldern.de/dr-volker-schoeffl-ueber-essstoerungen-im-klettersport/
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: cheque on August 05, 2023, 10:12:15 pm
Brilliant, give ‘em all a trad rack. :lol: “You’ve weighed in a bit low, here’s a Friend 6 and another 4 quickdraws”
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: stone on August 06, 2023, 06:46:42 pm
Volker Schöffl actually argued in favour of that idea in this (German language) interview: https://binwegbouldern.de/dr-volker-schoeffl-ueber-essstoerungen-im-klettersport/
Wow, I was worried it was a really stupid idea but the I failed to make a compelling self-rebuttal to myself- but that's also often the case with stupid stuff I've said!
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: moose on August 06, 2023, 07:45:24 pm
Brilliant, give ‘em all a trad rack. :lol: “You’ve weighed in a bit low, here’s a Friend 6 and another 4 quickdraws”

Or, they can climb without added weight, but have to cope with increasing numbers of holds that fall off and angry fulmers.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: jwi on August 07, 2023, 10:09:55 am
I do not understand at all what enforced weight wests would achieve. In the world cup, BMI is not correlated with results. Body-fat percentage is, even when controlling for training load.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: remus on August 07, 2023, 11:00:10 am
I do not understand at all what enforced weight wests would achieve. In the world cup, BMI is not correlated with results. Body-fat percentage is, even when controlling for training load.

I think the idea is to remove the immediate advantage from being underweight. Say there is a minimum weight of 50kg for a given climber, if the option is to weigh 45kg and carry a 5kg weight belt or to put on 5kg of muscle, then if you want to perform well the 5kg of muscle is a better option. As you say, I struggle to see how it would help with issues of unhealthily low bf percentage.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Liamhutch89 on August 07, 2023, 11:13:25 am
I do not understand at all what enforced weight wests would achieve. In the world cup, BMI is not correlated with results. Body-fat percentage is, even when controlling for training load.

Is there any data on that? Most affordable body fat tests are notoriously unreliable.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Muenchener on August 07, 2023, 02:04:13 pm
Is there any data on that? Most affordable body fat tests are notoriously unreliable.

I keep going back to the interview with Dr Schöffl that I liked to above. Only in German unfortunately, and no transcipt/translation available.

He agrees that bodyfat % would be a far better measure than BMI, but also says calliper tests are not sufficiently consistent/repeatable and would lead to endless appeals. He says there's research ongoing into better methods using ultrasound - portable and relatively cheap / available - that looks promising but isn't ready yet.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: jwi on August 07, 2023, 02:33:07 pm
I do not understand at all what enforced weight wests would achieve. In the world cup, BMI is not correlated with results. Body-fat percentage is, even when controlling for training load.

Is there any data on that? Most affordable body fat tests are notoriously unreliable.

Yeah. Furthermore, thanks to the central limit theorem, it does not much matter that caliper tests have somewhat high variance since they are unbiased.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Liamhutch89 on August 07, 2023, 02:58:44 pm
I do not understand at all what enforced weight wests would achieve. In the world cup, BMI is not correlated with results. Body-fat percentage is, even when controlling for training load.

Is there any data on that? Most affordable body fat tests are notoriously unreliable.

Yeah. Furthermore, thanks to the central limit theorem, it does not much matter that caliper tests have somewhat high variance since they are unbiased.

Where is this data, i'm just curious? My expectation is that every male competitor is somewhere between 6% and 12%, with most being sub 10%, and perhaps Megos being the one exception who occasionally turns up at bodybuilder-like sub 6% levels (AKA near death).
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Wellsy on August 07, 2023, 03:25:09 pm
Are we really thinking that arbitrarily bringing people to the same weight makes sporting sense?
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Liamhutch89 on August 07, 2023, 03:30:17 pm
Are we really thinking that arbitrarily bringing people to the same weight makes sporting sense?

That's exactly what happens in boxing. E.g. 147lbs is an arbitrary value, but every fighter in the division is killing themselves to make weight for it.

But to answer your question; probably not.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Wellsy on August 07, 2023, 03:38:33 pm
Sure, but in fight sports we have weight classes, as with lifting sports. These fit the culture and challenges of those. I don't think weight classes are appropriate for climbing comps, but I don't think arbitrarily adjusting people's weight to a standard is either. I doubt anyone in this thread would seriously want either of them too!

Ultimately being strong and light helps, which is unfair on weaker, heavier people. Being more talented helps too, as does having started earlier with better coaching, not getting injured... sport isn't fair, I don't think we need to change these weight considerations for performance, we just need to be thinking about ensuring there are checks on athlete health
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Liamhutch89 on August 07, 2023, 03:58:02 pm
Sure, but in fight sports we have weight classes, as with lifting sports. These fit the culture and challenges of those. I don't think weight classes are appropriate for climbing comps, but I don't think arbitrarily adjusting people's weight to a standard is either. I doubt anyone in this thread would seriously want either of them too!

Ultimately being strong and light helps, which is unfair on weaker, heavier people. Being more talented helps too, as does having started earlier with better coaching, not getting injured... sport isn't fair, I don't think we need to change these weight considerations for performance, we just need to be thinking about ensuring there are checks on athlete health

Weight classes in climbing is an interesting thought experiment at least. Let's say the males have categories for over 50kg, over 60kg, over 70kg and over 80kg. A climber of around 63kg might still try to reduce their weight a little bit, but not too much or they'd be in the next weight class down. Psychologically (and possibly objectively) going down a division would mean they are losing their advantage. At the other end of the scale, a climber of around 67kg might actually choose to bulk up a little bit so they can compete in the next class up and potentially feel they are at an advantage.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: stone on August 07, 2023, 04:51:57 pm
If everyone was weighted down to a certain (fairly high) BMI wouldn't it be expected that %bodyfat of competition climbers would become more like that of athletes in sports where low %bodyfat provided no advantage (eg swimming I guess)? That's the aim isn't it?

I agree that it would be unfair in making competition climbing no longer an ideal sport for those of slight build. But if it is medically harmful to have the %bodyfat of many current competitors, then that's a price worth paying isn't it?

Malcom Smith did hard board problems with a weight vest didn't he?

Is the counter-argument that competitors would just build lots of muscle to get them up to any set BMI and still starve themselves and still suffer RED-S/eating-disorders etc?

Is measuring hormone levels another option? That seems very intrusive though and unlikely to meet the ideal of creating a situation where competitors were carefree about their %bodyfat.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: wasbeen on August 07, 2023, 05:00:17 pm
There seems to be fewer super skinny boulderers than lead. Hopefully, putting more emphasis on the combined lead and bouldering may help promote getting better through getting stronger than getting lighter. Lead routes could also be made more burley and dynamic. However, reading the IFSC press re-release, it seems they are still somewhat in denial. It reminds me a bit of the IAAF with regards to doping, where they have repeatedly avoided short-term pain in order to protect the longer term future of the sport.   
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: dr_botnik on August 07, 2023, 07:24:51 pm
I think any notion of introducing weight classes or weight belts is nonsense, addressing the symptoms not the cause.

Just implement the recommendations of the outgoing doctors that the IFSC continue to ignore FFS....
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: sdm on August 07, 2023, 10:30:06 pm
If everyone was weighted down to a certain (fairly high) BMI wouldn't it be expected that %bodyfat of competition climbers would become more like that of athletes in sports where low %bodyfat provided no advantage (eg swimming I guess)? That's the aim isn't it?

Swimming actually has a big problem with disordered eating.

I think it is a bigger problem in youth swimming squads than youth climbing squads.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: stone on August 08, 2023, 08:04:15 am

Swimming actually has a big problem with disordered eating.

I think it is a bigger problem in youth swimming squads than youth climbing squads.

I suppose that emphasises that eating disorders can be induced/exacerbated by competitive sport even if it provides no performance advantage. Sobering. 
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Stabbsy on August 08, 2023, 08:14:02 am
I suppose that emphasises that eating disorders can be induced/exacerbated by competitive sport even if it provides no performance advantage. Sobering.

I’d be surprised if weight conferred no performance advantage in swimming, although maybe via the impact on drag rather than body weight itself.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: moose on August 08, 2023, 08:22:16 am
I vaguely recall hearing that for speed in swimming it's better to be slightly less buoyant - as you get more drag when more of the body is breaking the surface of the water. So less fat / more muscle can help.

Conversely, I think with long distance open water swimming, not drowning and energy conservation is the issue, so fat is more helpful - which is why women are comparatively good at those events.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: James Malloch on August 08, 2023, 08:40:21 am
Could they mandate that athletes need to take an accurate body fat percentage measurement at a registered clinic, say within 2 weeks of the competition?

Combine it with some other easier measurements (weight etc) which could be repeated and checked for change at the competition to ensure there wasn't a significant difference.

Out even buy one of the Bod-Pod machines for on-site testing. With the amount of holds etc that need moving around, I’m sure they could sort something substantial like that out too.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: dr_botnik on August 08, 2023, 10:18:24 am
Could they mandate that athletes need to take an accurate body fat percentage measurement at a registered clinic, say within 2 weeks of the competition?

This is what was recommended by the doctors who recently resigned, it does not appear to have been effectively implemented

Quote
There is no unique tool globally which works easily,' Dr Schöffl argues. 'At present, IOC Medical Commission experts recommend using BMI, which will change in the future to body fat ultrasound measurements. Presently it is a valid screening tool, since nothing else works across five continents and different societies so easily.'

To enable more thorough assessments, Dr Schöffl and the commission recommended using BMI - and setting higher thresholds - as a filter of sorts to help identify at-risk athletes, before suggesting that they undergo a series of extensive medical tests including blood tests, body fat measurement, bone density checks, hormone level assessments and psychological screening.

A triage system would prevent 'critical' athletes from competing and refer them to immediate medical care, while others just below the threshold would be placed in an 'observation' category involving further monitoring.

Again I say: just do what the doctors have recommended FFS
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Fultonius on August 08, 2023, 10:22:51 am
Quote from: dr_botnik
Again I say: just do what the doctors have recommended FFS
[/quote

Don't be silly. Of course we're better solving it here on UKB.

I reckon all males should be normalised to 78kg. It woukd make things MUUUCH fairer*.






*I.e.would neutralise the advantages of all you wee crimp waifs  :jab:
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: dr_botnik on August 08, 2023, 10:39:16 am
I've been working in the field of mental health for years, and I've met people who were professional athletes as adolescents who have gone on to have debilitating problems as a result of being dropped after injury, which I believe in some instances led to their untimely death.

If anyone wants to come and try and fix things, there are plenty of job opportunities available on the NHS jobs website, feel free to apply. I'm not sure the topic will seem quite as funny after spending 12 hours a day holding people for feeds whilst they scream about how you're feeding them too much
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: stone on August 08, 2023, 11:01:41 am
Again I say: just do what the doctors have recommended FFS

They and you are probably right and that is the only hope. I saw though in swimming there have apparently been arguments against weighing and monitoring because that in itself can foster an unhealthy preoccupation and anxiety. I remember being told by someone who used to do athletics how she was freaked out by being subjected to calliper testing. Perhaps it all needs to be done in a way that emphasises it being purely a health screen -eg not telling the athlete (or coaches etc) the result unless it raises health concerns.

PS Full respect to you for the work you do in mental health.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: abarro81 on August 08, 2023, 11:16:57 am
in swimming there have apparently been arguments against weighing and monitoring because that in itself can foster an unhealthy preoccupation and anxiety

You can imagine it working almost as a goal - if a BMI of 18.5 is the limit then it could be quite easy for an athlete to think/feel they should surely be aiming to hit that for optimum performance without compromising health too much. Even if that's too thin for their body (for me that would be a full 2kg lighter than the lightest I've ever been, at which point people started asking me if I was ok and probably 4kg off a low-but-just-about-ok weight).
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Fultonius on August 08, 2023, 11:25:08 am
I've been working in the field of mental health for years, and I've met people who were professional athletes as adolescents who have gone on to have debilitating problems as a result of being dropped after injury, which I believe in some instances led to their untimely death.

If anyone wants to come and try and fix things, there are plenty of job opportunities available on the NHS jobs website, feel free to apply. I'm not sure the topic will seem quite as funny after spending 12 hours a day holding people for feeds whilst they scream about how you're feeding them too much

For the avoidance of doubt (I'd be surprised if it read differently?) I was wholeheartedly agreeing with your sentiment of "listen to the fecking Drs". I then followed it with some banter about the weight class idea, which was non-constructive.

Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: dr_botnik on August 08, 2023, 12:23:44 pm
Apologies for losing my shit. It is getting scarier, each year it seems we get people younger and younger who require medical stabilisation and feeding. It's getting to the point where its not uncommon for children under 10 to be that unwell.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Fultonius on August 08, 2023, 12:33:14 pm
Shit.

I can see why any flippancy can't look good for your perspective. I struggle to maintain a low (i.e. <18%!!) bodyfat and stay happy, healthy and motivated, so I've just accepted this is the genetics I have and work within that but it's a hard pillow to swallow when your mates that climb harder all have rippling 6-packs and low BF, while seemingly not struggling with energy levels etc...

I can only imagine this struggle is much more rife when you have the mix of competition, hormones, puberty etc. all in the mix.

Like you say - we should be following the Drs recommendations! (but whatever we do, it's not going to be an easy thing to enact / manage without unintended consequences.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Muenchener on August 11, 2023, 05:57:43 pm
Since the topic of RED-S made the climbing news with Volker Schöffl's protest resignation from the IFSC Medical Commission a couple of weeks, back, the only in depth interview I've been able to find with him was one from last October, in German and with no transcript or English translation available.

Now Alex Megos has an interview up on his youtube channel. Haven't listened to all of it yet, but the previous one was informative (and shocking!) and this one is in English. RED-S discussion stars around 13 minutes

https://www.youtube.com/watch?v=w0Ev_b6w3GY&t=795s.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: remus on August 12, 2023, 01:17:33 pm
Now Alex Megos has an interview up on his youtube channel. Haven't listened to all of it yet, but the previous one was informative (and shocking!) and this one is in English. RED-S discussion stars around 13 minutes

https://www.youtube.com/watch?v=w0Ev_b6w3GY&t=795s.

Good interview, and pretty damming of the inactivity of the IFSC.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Fiend on August 14, 2023, 12:25:49 pm
Now Alex Megos has an interview up on his youtube channel. Haven't listened to all of it yet, but the previous one was informative (and shocking!) and this one is in English. RED-S discussion stars around 13 minutes

https://www.youtube.com/watch?v=w0Ev_b6w3GY&t=795s.

Good interview, and pretty damming of the inactivity of the IFSC.
Indeed. Makes it very clear. I thought Megos was once an anorexia athletica posterboy?? Some rumours about him having to be helped off stage at a world cup or something? Maybe if that was the case, he's been helped enough that he realises the issue is worth highlighting.

I wonder how many amateur AA climbers are reading this, and watching that video, and thinking "Well, it's still worth it, I'm not giving up those gainz for anything...."??

Also fair enough for clearly highlighting that climbing IS a weight-orientated sport. Before watching this video I was labouring under the illusion that the best thing for my own climbing would be to lose 10+kg. Now I realise that it would actually be to lose 20+kg...


Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Fiend on August 14, 2023, 01:39:27 pm
I've just had another semi-terrible idea (as much as I'm already in agreement with stone's crimp-waif-punishing weight belt idea).

On the climber intro images that get shown on IFSC comps, as well as Age and Height, also have Weight - with an automated BMI calculation with the position shown on the "healthy range" bar, and ditto for Body Fat Percentage. Then viewers could appreciate the situation with reactions like "Well she looks skinny but well she's still in both healthy ranges so that's good inspiration" or "He's ripped but he only podiumed because he's unhealthily underweight, so that won't last". Of course nothing could possibly go wrong with posting those stats publicly  :look:
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Fultonius on August 14, 2023, 03:51:53 pm
They used to post weight on the IFSC althete pages. I once went on to check Laura Rogora's and it was not disclosed.....................             
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: battery on September 10, 2023, 07:27:08 pm
https://olympics.com/en/news/slovenia-janja-garnbret-eating-disorders-sport-climbing-exclusive-interview
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: duncan on January 13, 2024, 03:51:01 pm
Climbing athletes demand eating disorder action before Olympics (https://www.reuters.com/sports/athletes-demand-eating-disorder-action-before-olympics-2024-01-10/)

Article about RED-S in Reuters, a very good overview I thought. Lead author is known to some here.

Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Dac on February 10, 2024, 01:20:03 pm
Not seen mention of this on UKC, so I thought I’d post this up:

https://gripped.com/indoor-climbing/ifsc-releases-new-relative-energy-deficiency-in-sport-reds-policy/

Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: Fultonius on February 10, 2024, 05:24:50 pm
On the face of it, it seems like they've taken most things on board. I guess the success of it will be in the implementation and how seriously they take the random tests etc.

Good to see they're doing something.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: ian dunn on February 10, 2024, 09:09:55 pm
The real proof of whether the policy works is if Federations implement it. Will national federations stop their top climbers competing if they are in the red category? I suspect pressure from athletes, sponsors, funding organisations etc etc will be difficult for some countries. Its great that there is a policy and it should be attached as an appendix to the recent BMC GB Climbing policy on Climbers Health however it will need enforcing.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: slab_happy on February 11, 2024, 07:19:41 am
If I'm reading that correctly, it's relying almost entirely on blood pressure and heartrate in addition to BMI for the initial screening -- there's also the "two questionnaires", but it's not specified whether they're assessing anything beyond "personal parameters for such criteria as height, weight, heart rate and blood pressure".

It's not something I know much about, but based on a quick Google, RED-S can result in low blood pressure and heartrate, but they're not a given, and it sounds like they may only occur in more severe cases; the IOC paper just calls them "potential indicators":

https://stillmed.olympics.com/media/Documents/Athletes/Medical-Scientific/Consensus-Statements/REDs/IOC-REDs-CAT2.pdf

But based on the flow chart, if your BMI is in the normal range heart rate and blood pressure aren't abnormally low, you won't be screened any further.
Title: Re: Relative Energy Deficiency in Sport (RED-S)
Post by: mattbirddog on February 11, 2024, 08:34:52 pm
The real proof of whether the policy works is if Federations implement it. Will national federations stop their top climbers competing if they are in the red category? I suspect pressure from athletes, sponsors, funding organisations etc etc will be difficult for some countries. Its great that there is a policy and it should be attached as an appendix to the recent BMC GB Climbing policy on Climbers Health however it will need enforcing.

Hey Ian, just to chip in here from a commercial angle. I have never seen examples in my experience of a sponsor pressuring an athlete to compete, especially not around such a sensitive topic. I have examples of where sponsors have proactively sought help and support for athletes through injuries etc.

Where this situation could get sticky from a commercial basis is with the Olympic sponsors as a few of them have non-attendance clauses in the games (through injury or non-selection) which could come into play here BUT that is already set out in the contract. The only instance where this could get sticky is if that contract was signed before the new rules came into place as the athlete could argue the goal posts have changed.

National Federations and there home nation Olympic funding however... Discuss...

The biggest focus for me with this policy is ensuring the athlete(s) get the level of support to go through this process so there is a positive outcome at the end of any negative flags. I.e. they are ok, healthy and still have a positive relationship with climbing.

That is the next big step on from this first announcement hopefully.
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