Stronger with Time

When & How Does an Energy Deficit Become RED-S? Why Oversimplification Is the Problem- with Professor Louise Burke


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If you've experienced unexplained fatigue, lost your period, or can't build muscle despite training hard - this episode will help you understand why.


Professor Louise Burke - IOC expert panel member on RED-S - explains the complexity behind low energy availability, why it's being oversimplified on social media, and why context matters more than rigid rules.


You'll learn when energy deficit becomes problematic, which body systems are affected first (and why), why stress makes everything worse, and whether the fasted training fears are actually supported by evidence.


We also discuss Professor Burke's groundbreaking Melbourne study using the only metabolic chamber in the Southern Hemisphere to compare diet-induced versus exercise-induced energy deficits.


In this Episode:

  • The difference between low energy availability (exposure) and RED-S (syndrome)

  • Why energy deficits aren't always intentional (training volume, time constraints, budget)

  • Which body systems are affected: reproductive, bone, GI, metabolism, performance

  • Why some systems shut down before others (evolutionary perspective)

  • Stress as a major amplifier of symptoms

  • RED-S CAT 2 clinical diagnosis tool (requires medical expertise, not self-diagnosis)

  • Evolution from Female Athlete Triad to RED-S (males affected, multiple systems involved)

  • Cultural issues in endurance sports (Tour cyclists surviving on coffee for 7-hour rides)

  • Does the method of creating deficit matter? Diet vs exercise-induced

  • Melbourne metabolic chamber study: comparing both methods (results expected 2027)

  • Fasted training controversy: insufficient evidence for rigid rules

  • Sex differences in sensitivity to energy rhythm (confounded by stress factors)

  • Louise's perspective: better to exercise fasted than not exercise at all

Key insight:

RED-S is far more complex than simple numerical thresholds. Context, individual variation, stress, and the method of creating deficit all matter. Oversimplified social media advice may cause more harm than good.


Melbourne Study:

Professor Burke is recruiting runners, triathletes, race walkers (50k+/week) for a study comparing exercise-induced vs diet-induced energy deficit using the only metabolic chamber in the Southern Hemisphere. Results expected 2027.

Contact  ⁠[email protected] for recruitment information.


Go straight to the redcaps screening tool   https://redcap.link/acu-agility


Topics: energy deficit, undereating, overtraining, hormones, bone health, metabolic adaptation, female athlete triad, amenorrhea, stress fractures, fasted training, sports nutrition

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Stronger with TimeBy Dr Tony Boutagy

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