Prevalence of the Female Athlete Triad in High School Athletes and Sedentary Students

Abstract

Objective To determine the prevalence of the female athlete triad (low energy availability, menstrual dysfunction and low bone mineral density) in high school varsity athletes in a variety of sports compared with sedentary students/controls. Design Prospective study. Setting Academic medical center in the Midwest. Participants Eighty varsity athletes and eighty sedentary students/controls volunteered for this study. Intervention Subjects completed questionnaires, had their blood drawn and underwent bone mineral density testing. Main Outcome Measures Each participant completed screening questionnaires assessing eating behavior, menstrual status and physical activity. Each subject completed a 3-day food diary. Serum hormonal, TSH and prolactin levels were determined. Bone mineral density (BMD) and body composition were measured by dual energy x-ray absorptiometry (DXA). Results Low energy availability was present in similar numbers of athletes (36%) and sedentary/control subjects (39%; p=0.74). Athletes suffered more menstrual abnormalities (54%) compared with sedentary students/controls (21%) (p=<0.001). DXA revealed that 16% of the athletes and 30% of the sedentary/controls had low BMD (p=0.03). Risk factors for reduced BMD include sedentary control student, low BMI and increased caffeine consumption. Conclusions A substantial number of high school athletes (78%) and a surprising number of sedentary students (65%) suffer from one or more components of the triad. Given the high prevalence of triad characteristics in both groups, education in the formative elementary school years has the potential to prevent several of the components in both groups, therefore, improving health and averting long-term complications.

Menstrual Irregularity and Musculoskeletal Injury in Female High School Athletes

“…Using a definition of MI similar to ours, Hoch et al lO reported an overall much higher prevalence of MI in the athletic population (54%). 10 The difference in their findings compared with ours and those of other studies l3 ,14 cannot be explained. Interestingly, Hoch et al lO reported the prevalence of MI in their sedentary control population as 21 %, which is similar to that in our population of female athletes and in other studies of female athletes.…”

Efeitos do estado de humor sobre os comportamentos alimentares inadequados de atletas de atletismo

“…Por outro lado, a literatura aponta que a insatisfação corporal acomete tanto as atletas quanto as não atletas (Hoch et al, 2009;Reiking & Alexander, 2005). Rosendahl et al (2009) explicam que as atletas são expostas às mesmas mensagens socioculturais direcionadas para a magreza que as não atletas.…”

The Female Athlete Triad

“…Furthermore, 39% of athletes and 36% of controls had an EA <45 kcal/ kg FFM per day. 9 Disordered eating in adolescent athletes has been evaluated by using a variety of survey tools, such as the Eating Disorder Exam Questionnaire, the Eating Disorder Inventory, and the Three-Factor Eating Questionnaire. Studies that used these tools provide estimates of disordered eating ranging from 0% to 54%.…”

“…7,8 It is difficult to estimate the true prevalence of the triad because of the complexity of evaluation of each of the components. Reports have indicated that the prevalence of individuals with all 3 components simultaneously is only 1% to 1.2% in high school girls 9,10 and 0% to 16% in all female athletes. In high schoolaged female athletes, the prevalence of 2 concurrent components of the triad is 4% to 18% and of any 1 component is as high as 16% to 54%.…”

“…In high schoolaged female athletes, the prevalence of 2 concurrent components of the triad is 4% to 18% and of any 1 component is as high as 16% to 54%. [9][10][11][12][13][14][15] Education of pediatricians, who are most likely to encounter adolescents with triad-related disorders, is especially important. Unfortunately, a 2009 study found that only 20% of pediatricians were able to correctly identify all 3 components of the triad, compared with 50% of family medicine physicians and 41% of orthopedic surgeons.…”