When it comes to priorities, “getting a period” is often not first on the list. However, a regular menstrual cycle might just be one of your best signs of health.
Relative Energy Deficiency in Sport (or “RED-S”) encompasses a syndrome that results from low energy availability. Since calories are our body’s #1 source of energy, then “low energy availability” results when not enough calories are available to support both your physical activity (AKA your dance schedule) and your metabolic activity.
Low-calorie diets are one culprit for the energy shortage, along with intense physical activity (think Summer Intensives!). Simply put, if you’re not fueling your body with enough food, then you’re vulnerable to developing RED-S.
What exactly happens when we develop RED-S?
Just a few years ago, we knew RED-S as the Female Athlete Triad, which represents 3 realms that, when intertwined, result in injury. If you’re not eating enough and/or you’re exercising excessively, then you risk a series of hormonal imbalances that result in weak bones. Since weak bones are unable to support the heavy load of a dancer’s training, injuries arise (stress fractures… ouch!)
Help! I’m Still Confused
Think about it like this… Despite how fatigued you may feel, your body still wants to push through your classes, rehearsals, and performances. To do so, it prioritizes this activity and reduces the energy available for other metabolic processes not immediately needed for your survival. One such metabolic process is reproduction. As a result, the production of hormones, like estrogen in females and testosterone in males, both of which play a role in building strong bones, decreases.
The most obvious indicator of these imbalances is a missing period (3+ months in those with regular cycles and 6+ months in those with irregular cycles). This is known as Functional Hypothalamic Amenorrhea.
So Male Dancers Shouldn’t Worry?
Not exactly… Male dancers are also at risk. Over time, clinicians learned that this hormonal phenomenon is equally as prominent in males as it is in females, however, there’s no obvious clinical sign (2,3). Therefore, it’s recommended that both female and male dancers consult with a medical doctor for appropriate bloodwork to better identify his or her risk for RED-S.
Relative Energy Deficiency in Sport has also redefined the previous Female Athlete Triad to include a broader range of negative health consequences that result from low energy availability. Some of these include a lack of concentration, chronic fatigue, irritability, depression, loss of muscle strength, and decreased coordination.
Why Dancers?
Despite a changing industry, many dancers are still immersed in a world where antiquated body ideals are at the forefront of their school’s or company’s priorities. As a result, at least 10-12 percent of classical dancers weigh below ideal body weight for health.
It’s critical to take steps to reduce your risk of RED-S and thus, your risk of injury. Let’s discuss 3 important steps to consider to ensure that your body has enough energy for not only your dancing but also for your metabolic functioning.
#1: Eat Enough
A dancer’s diet should focus on abundance and variety. Build a meal plan that consists of at least 3 meals and 2 snacks, each dispersed throughout your morning, afternoon, and evening. If you’re struggling to find time between classes and rehearsals, then consider packable snacks like bars, fruit, and nuts. Remember, your priority is a successful performance and your energy availability plays a major role in that performance!
#2: Rest More
Does your dance schedule lend time for adequate rest? Are you sleeping at least 7-8 hours each night? The CDC recommends 8-10 hours of sleep for teens and 7 or more hours per night for adults (4). Rest is an essential part of a dancer’s training as it allows for muscle recovery, reduces the risk of injury, and improves mental clarity.
#3: Seek a Professional
A Registered Dietitian Nutritionist can provide individualized guidance to determine your body’s specific calorie and macronutrient requirements. BASEM also offers an invaluable resource for dancers and educators to learn more about RED-S. Last, scroll through this site, DanceNutrition.com, for additional free resources and articles to build a better a balanced meal plan that supports your needs as a dancer.
- Dr Nicky Keay. Raising Awareness of RED-S in Male and Female Athletes and Dancers. BJSM; October 30, 2018.
- Heath4Performance BASEM Educational Resource
- IOC consensus statement on relative energy deficiency in sport (RED-S): 2018 update BJSM 2018
- https://www.cdc.gov/features/sleep/index.html
