This is a specialty 4-week module, led by three integrative nutrition and endocrinology experts with specialist interest in REDs. Simone do Carmo, Renee McGregor and Nicky Keay.
Next live course start date: 21 November 2025
Relative Energy Deficiency in Sport (REDs) is a multifactorial syndrome that can negatively impact health and performance outcomes in both male and female athletes.
The current REDs model identifies low energy availability (LEA) as the underlying cause of REDs, while acknowledging other contributory factors. Some researchers suggest other causes, such as nutrient deficiencies, the pressure to perform or lingering illness/infections, which can also lead to REDs independently or in combination, affecting an athlete’s allostatic load.
Nevertheless, an athlete’s energy availability (EA) is important to consider from a nutrition and exercise point of view while recognising the many pitfalls in estimating EA. As such, interventions should focus on broadly improving EA while considering other potential contributing causes/factors of REDs.
In this specialty unit, you’ll learn about the history of REDs and how the current model is both recognised and challenged. We’ll discuss factors that may independently impact health outcomes of REDs, such as a lack of mechanical loading on bone, low carbohydrate availability and psychogenic stress, while also recognising the importance of other macro- and micronutrients.
We’ll explore intentional REDs, where individuals intentionally restrict energy intake and may engage in excessive exercise patterns, leading to reduced EA.
Additionally, we’ll examine the effect of REDs on endocrine health in both males and female athletes, considering its connection with other body systems and potential strategies for managing REDs.
Who's it for?
Relative Energy Deficiency in Sport (REDs) has been set up as a postgraduate-level speciality unit of study, aimed at exercise and nutrition practitioners, and final year and postgraduate students.
It can be completed as a standalone module for purposes of CPDs or CEUs, for your professional or personal development, or as speciality unit within our larger Certificate of Integrative Sports Nutrition course.
These specialty courses attract a diverse mix of nutrition, exercise, medical, and integrative health professionals, along with advanced coaches and athletes looking for a training edge.
As such, participation on this module should facilitate learning from not only your lecturers and tutors, but also your peers.
Module content
Relative Energy Deficiency in Sport (REDs) consists of four 60-minute live Zoom workshops, weekly pre-recorded videos and educational materials, interaction with your lecturers and peers online, and case study focussed assignments.
All in all, you’ll need approximately five hours per week to do this course, depending on your depth of study.
An overview of Relative Energy Deficiency in Sport (REDs) from a sport nutritionist perspective
Sport nutritionist and exercise physiologist Simone do Carmo leads this week with a lecture on REDs and the concept of EA, focusing on specific factors beyond EA. She concludes with a case study to showcase her integrative thinking and delivers a live workshop.
Lecture 1 content
Week 1 begins with an overview of REDs history, the concept of EA, and strategies for working with athletes at risk of LEA or REDs from a sport nutritionist’s perspective.
Topics include:
The current REDs model: We review how the current REDs model is defined and challenged, the concept of LEA as an underlying cause, and the many pitfalls associated in estimating an athlete’s EA while recognising the importance of improving it.
Beyond energy availability: We discuss exacerbating factors that could impact certain health outcomes of REDs along with the relevant research. These factors include high fibre intake, a lack of nutrients to support bone health and a lack of mechanical bone loading. We bring in other considerations such as the importance of looking at carbohydrate quality when trying to increase carbohydrate availability, and why not to overlook other macronutrients, micronutrients and the gut-muscle axis.
Case study of an aspiring female Powerlifter: To showcase integrative thinking as a sport nutritionist, Simone presents a case study of an aspiring female Powerlifter who is undernourished, pulling together the theory covered in the lecture and applying it to the athlete.
WEEK 2 – Intentional Relative Energy Deficiency in Sport (REDs)
Sports dietitian and clinical specialist Renee McGregor leads this week, focusing on intentional REDs where disordered eating or an eating disorder may combine with excessive exercise behaviours. Renee provides case studies and delivers a live workshop to showcase her clinical thinking.
Lecture 2 content
Week 2 covers the definition of intentional REDs, origins of dysfunctional behaviours, practical issues commonly seen in intentional REDs, and case studies highlighting the need for multidisciplinary collaboration.
Topics include:
Eating disorders and disordered eating (ED/DE): We discuss the difference between ED and DE, how social media influences these, and why athletes may be more at risk of DE or developing an ED.
Potential practical issues and diagnosing REDs: After highlighting the concept of energy availability, we look at some practical issues such as food trends and balance between school/work/social life and training. Renee then outlines how REDs is diagnosed with case study examples.
The road to REDs recovery: We discuss key considerations for recovery from REDs, emphasising the need for a multidisciplinary approach and how to manage certain challenges such as limiting beliefs around food and social media.
WEEK 3 – Relative Energy Deficiency in Sport (REDs): a focus on endocrine health
Exercise endocrinologist Dr Nicola Keay leads this week with her lecture on REDs and endocrine health, integrating different body systems. She provides an action plan for managing REDs and delivers a live workshop.
Lecture 3 content
Week 3 covers the hormonal network effects on performance, unbalanced athlete behaviours, the long-term consequences of LEA, and the diagnosis and management of REDs.
Topics include:
Harnessing hormones: We review key considerations to support healthy hormones for optimal health-based performance.
Clinical consequences of long-term LEA: We discuss the effects of LEA on endocrine networks and the clinical consequences of REDs, focusing on the impact on bone mineral density.
How to identify athletes at risk of REDs: After highlighting the primary and other potential indicators of REDs risk, we review how REDs is diagnosed by exclusion and look at the International Olympic Committee’s Clinical Assessment tool. Nicola concludes her lecture with the management of REDs and how to support restoration to full health and performance.
WEEK 4 – Action Learning Workshop
Your learning is now flipped from a state of expert-led presentation to participant-led discussion, where you will tap into your prior life learning and experiences, along with that of your peers, to move towards ‘action’ steps of professional development before departing from this module.
Module assignment
In a concise 1000 words, you will be asked to write a flowing essay on a case study of an athlete, or active individual, who has the goal of improving signs and symptoms associated with REDs, while undertaking a challenging exercise training programme. Honouring the professional practice style of your base career, you’ll look to incorporate learnings from this module in your case description and intervention strategies.
Live Course
Our tutorials occur at 1pm UK time, allowing most time zones to be accommodated.
You can find all the tutorial dates here.
Next start date:
21st of November 2025
Self Study
If you’d like the flexibility to study at a pace of your choosing, this option is for you. You’ll work through the readings and lectures for each session, covering the same material as in the live course, and then book a 30-minute finishing session with your tutor.
Start any time:
We work on an honesty system. You may be asked to provide proof of your BANT, ANA or Student
