Fueling and Adrenal Fatigue in Female Athletes
By Drew Mulvey MS, CDN, CNS, CLT, PNL1, CISN
February 15, 2024
You are working day in and day out on and off the field. There are so many different factors that we need to think about when it comes to performing at our best. In fact, it can be overwhelming right? Do you really know what that work is doing to your body and how fueling can not only help reach your athletic goals but create a quality of life where one remains active and healthy?
We often don’t given credit to the little things such as listening to our body cues, fueling properly around workouts, getting enough sleep and making the necessary modifications that are body needs just for functioning properly. Unfortunately, if we don’t pay attention to these, it can cause more serious problems down the road. This is where disordered eating and RED-S come in.
Relative Energy Deficiency in Sport (RED-s)
The actual definition of RED-s is “A condition where energy imbalance leads to impaired physiological function of multiple organ systems.” 1 This may not be as pronounced as it may be done out of ignorance. Still, there is a disorder arise in the body where the proper fuel is not being introduced to meet the demands of the body. This can also be an issues when a said disordered eating pattern is at hand as there is a “fear” and misunderstanding of how food, and lack there of, is affecting their body.
For those with disordered eating, this can be accompanied by several other patterns such as OCD, perfectionism, self esteem issues, etc. which can be added stressors in the pot of stressors being introduced to their body. It is not only the lack of food being introduced but can be the lack of self worth, positive talk and relationships, extreme discipline, etc.
Then, one day, at practice, you’re fatigued easier. You can not quite comprehend the workouts accordingly, you are not sleeping as well, you are more anxious, your energy and stamina have started to decrease and your monthly friend decided not to show up. What does this do? Your body starts to elevate production of cortisol. Is this a problem? Let’s look at what cortisol actually does.
What is Cortisol?
Cortisol is our stress hormone, and can also referred to as adrenaline and noradrenaline. Although it has been given a bad rap, we need this compound for several functions in the body to operate and perform at our best. These includes:
Immune Regulation
Cortisol has anti-inflammatory properties and helps regulate the immune response. In acute situations, this can be beneficial for managing inflammation associated with injury or infection.
Fat Metabolism
Promotes the breakdown of fat stores into fatty acids through the enzyme hormone sensitive lipase. This can then be used as an energy source.
Focus and Alertness
Cortisol levels usually peak in the morning hours to prepare our body to focus and be alert for the day’s activities. This is also important when it comes to making decision during games and at practice. It suppresses non-essential processes for our body to utilize it’s resources efficiently to provide energy to keep up with the demands being place on it.
As you can see, we need cortisol! The problem lies when cortisol levels are elevated for extended periods of time. When this happens, the athlete can then experience chronic depletions in energy levels and manifest as adrenal fatigue.
Overtraining Syndrome
We need stress as part of life to adapt to our environment and get stronger and faster as athletes. Yet, when this becomes too much for the body to handle, and the demands become too high for the body to come up with, the athlete starts slowing down significantly. One of the most common predecesssors to this is underfueling the body for the demands being placed on. This then trickles down to a little something called Overtraining Syndrome.
Overtraining syndrome is defined as an imbalance between training/competition versus recovery. This typically is not in and of itself the driving factor, but is brought on by to total amount of stress experienced by the individual that exceeds the ability of the body to cope.2 This can then lead to Adrenal Fatigue and Adrenal Insufficiency, which if not addressed appropriately by the a coach and a team of professionals, can take an athlete out of the game for weeks and even months.
Why is this? When the demands exceed the body’s ability to recover, cortisol levels never get a chance to drop or become imbalanced. RED-S can be a significant driver of this as the energy to fuel the body simply is not being met for the training level of the athlete.
Calculating Energy Needs
Now there is much more to it than just the amount of calories one needs in order to fuel the body effectively for sport, but this is a starting point. Here is a simple equation to assess if the athlete is meeting his or her energy demands.
[TEE] = BMR + TEF + NEAT + EAT
Total Energy Expenditure (TEE) Summary
BMR: Basal Metabolic Rate. This number represents amount of energy the body requires at rest to fuel all natural functions. Here is the equation for that.
Men:
BMR = (13.397 × weight in kg) + (4.799 × height in cm) – (5.677 × age in years) + 88.362
Women:
BMR = (9.247 × weight in kg) + (3.098 × height in cm) – (4.330 × age in years) + 447.593
TEF: Thermic Effect of Food: (6-10% BMR.) The types of food we eat have different energy burns. The more carbohydrate ingested will trend more towards the former while the more protein we eat with be the greater number. Typically a balanced diet is between these two numbers.
NEAT: Non-Exercise Activity Thermogenesis. (8-18% BMR) This includes daily movement such as fidgeting, moving around at the desk, etc. and can be impacted by activity at job or college (ie sitting vs standing job.)
EAT: Exercise Activity Thermogenesis: 15-70% TEE. This is directly correlated to activities such as sports and walking. Typically, as athletes, this is going to fall between the 20 and 50% range. (I would recommend looking up ranges based on activity levels to calculate energy requirements)
Other variables will come into play such as micronutrient intake and macronutrient distribution of proteins, carbohydrates and fats. Macronutrient needs are heavily dependent on the athlete’s sport, as some are more demanding that others. For instance, an Olympic or Half Ironman Triathlete vs a Pole Vaulter. For all intensive purposes, find this number first. Does it have to be perfect? No. Let is act as a guide to ensure that the athlete is getting enough.
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References:
- Dave SC, Fisher M. Relative energy deficiency in sport (RED – S). Curr Probl Pediatr Adolesc Health Care. 2022 Aug;52(8):101242. doi: 10.1016/j.cppeds.2022.101242. Epub 2022 Jul 30. PMID: 35915044.
- Lensu S, Pekkala S. Gut Microbiota, Microbial Metabolites and Human Physical Performance. Metabolites. 2021; 11(11):716. https://doi.org/10.3390/metabo11110716
