The warning Jake Smith ignored

British long-distance runner Jake Smith was told by doctors four years ago: if you keep this up, you'll be in a wheelchair at thirty. His body was deteriorating despite his professional Nike contract.

“If you keep this up, you'll be in a wheelchair at 30.”

How Smith's body broke down

At age twenty-three, Smith had signed with Nike and represented Great Britain globally. But intense training combined with disordered eating left him weighing just eight stone at five foot five inches with brittle bones.

The diagnosis: REDs

After two stress fractures in four months, Smith was diagnosed with REDs, relative energy deficiency in sport. The syndrome affects anyone and if untreated causes serious long-lasting health problems and performance collapse.

What REDs does to the body

REDs causes bone stress injuries, disrupted sleep, fatigue and low mood. Left untreated it leads to osteoporosis, cardiovascular disease and fertility issues. The root cause is hormonal disruption from insufficient energy intake.

How hormones fail under energy deficit

Dr Nicky Keay, an expert in hormone health, explains: hormones go to every single bit in your body. If your hormones are not working well, you feel it in all sorts of different areas.

“Hormones go to every single bit in your body. So, if your hormones are not working well for you, you're going to feel it in all sorts of different areas.”

Women have a warning sign men lack

Women suffering from REDs can have their periods switched off, described by Keay as a free monthly medical check. For men, testosterone drops silently, causing reduced libido and fatigue without obvious warning signs.

Why the name changed in 2014

The condition was first called the female athlete triad in the early nineteen nineties. The International Olympic Committee renamed it REDs in twenty fourteen to acknowledge it harms male athletes too and has broader symptoms…

How common is REDs really

A meta-analysis published in Australian journal Sports Medicine last year found forty-four point two percent of female athletes and forty-nine point four percent of male athletes had low energy availability worldwide.

The myth that lighter is faster

For decades, endurance sports like running, cycling and climbing accepted that lighter athletes perform better.Jake Smith believed this for years and started asking: how do I improve my half marathon by ten seconds?

“How do I improve my half marathon by 10 seconds? Is it a drop in weight?”

Why weight loss works at first

When choosing between energy for training or energy to stay healthy, the body prioritises movement through evolution.

Jonny Brownlee's regrets

Olympic and world champion Jonny Brownlee acknowledges under-fuelling mistakes contributed to serious injuries in his triathlon career. He says training came first and they were not educated enough in how important fuelling was.

“I didn't see the importance of it. Training came first and I think we weren't educated enough in how important fuelling was.”

Why men suffer in silence

Brownlee says there is stigma around REDs and a perception it is a female issue.In males it can go under the radar until it hits with a serious injury.

“In females, there are more obvious signs but in males it can go under the radar a little bit and then it hits you by a really serious injury.”

Dr Keay's experiment with cyclists

In twenty nineteen, Dr Nicky Keay assessed fifty male competitive cyclists. Nearly half had poor bone health and twenty-five percent were suffering from REDs. She split them into two groups for six months of intervention.

What the cyclist study proved

The cyclists left to their own devices lost even more bone mineral density, similar to an astronaut in space, and underperformed.

“The good news is that REDs is reversible. But if you don't take action, it's a decline.”

Brian Smith's eating disorder legacy

Former British cycling champion Brian Smith competed in the road race for Great Britain at the nineteen ninety-six Olympics while suffering with bulimia and serious mental health problems.

“I always felt like I was overweight. Everybody was under pressure regarding weight, but nobody really spoke about it.”

Smith's warning about professional cycling

Now fifty-nine, Smith only discovered he had REDs when he started running eight years ago and developed three severe stress fractures.

“It really is not healthy. If you want to go to the highest levels of the sport, you will suffer later on in life. You're destroying your body.”

British Cycling's education approach

British Cycling says progress has been made through education starting at academy level and annual physical and psychological screenings.

“Now, we couch the conversation with an athlete around 'if you under-fuel, you will not be able to perform at your best'.”

World Climbing's mandatory health checks

World Climbing introduced mandatory health checks on athletes two years ago using pre-season questionnaires and random and targeted screenings at competitions, similar to doping tests. Athletes could be prevented from competing if not deemed healthy.

Jake Smith's recovery and future

Jake Smith has reversed his condition and is now racing better than ever, recently completing the Berlin marathon in two hours, nine minutes and twenty-four seconds.

“I'm heavier, I'm faster, I'm happier.”

Smith's mission to help others

Smith shares his recovery on social media and receives hundreds of messages from men and women seeking advice and support.

“I'd never want to see an athlete go through the years I've had.”