The female athlete triad: special considerations for adolescent female athletes.
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ABSTRACT:
SUBMITTER: Brown KA
PROVIDER: S-EPMC5532188 | biostudies-other | 2017 Jul
REPOSITORIES: biostudies-other
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Project description:BackgroundThis study aimed to clarify the relationship between the triad risk assessment score and the sports injury rate in 116 female college athletes (average age, 19.8 ± 1.3 years) in seven sports at the national level of competition; 67 were teenagers, and 49 were in their 20s.MethodsThose with menstrual deficiency for >3 months or <6 menses in 12 months were classified as amenorrheic athletes. Low energy availability was defined as adolescent athletes having a body weight <85% of ideal body weight, and for adult athletes in their 20s, a body mass index ≤17.5 kg/m2. Bone mineral density (BMD) was measured on the heel of the right leg using an ultrasonic bone densitometer. Low BMD was defined as a BMD Z-score <-1.0. The total score for each athlete was calculated. The cumulative risk assessment was defined as follows: low risk (a total score of 0-1), moderate risk (2-5), and high risk (6). The injury survey recorded injuries referring to the injury survey items used by the International Olympic Committee.ResultsIn swimming, significantly more athletes were in the low-risk category than in the moderate and high-risk categories (p = 0.004). In long-distance athletics, significantly more athletes were in the moderate-risk category than in the low and high-risk categories (p = 0.004). In the moderate and high-risk categories, significantly more athletes were in the injury group, whereas significantly more athletes in the low-risk category were in the non-injury group (p = 0.01). Significantly more athletes at moderate and high-risk categories had bone stress fractures and bursitis than athletes at low risk (p = 0.023).DiscussionThese results suggest that athletes with relative energy deficiency may have an increased injury risk.
| S-EPMC8034341 | biostudies-literature
Project description:ContextFemale endurance athletes exhibit an increased risk of the female athlete triad (Triad) and relative energy deficiency in sport (RED-S). The triad and RED-S are conditions that involve the health and performance consequences of low energy availability. Few authors of studies to date have assessed the knowledge that athletes, coaches, and athletic trainers (ATs) have regarding the Triad or RED-S. Proper education has been shown to be effective in increasing knowledge of sports medicine concerns for athletes, yet no known continuing education programs for the Triad or RED-S exist at collegiate institutions.ObjectiveTo assess the knowledge, confidence, and educational impact of identifying, screening, treating, and preventing the Triad or RED-S.DesignCross-sectional study.SettingAn evidence-based online survey was developed and administered via Qualtrics.Patients or other participantsFemale collegiate cross-country athletes (n = 275, age = 20 ± 1 years), collegiate cross-country coaches (n = 55, age = 34 ± 9 years), and ATs working with cross-country teams (n = 30, age = 36 ± 11 years).Main outcome measure(s)Knowledge, confidence, and educational impact scores were assessed among groups using analysis of variance. Independent t tests were calculated to determine differences in impact scores between people who had or had not received education on the topic.ResultsFemale cross-country athletes' total knowledge, confidence, and educational impact scores (mean scores = 25.00 ± 5.27, 95.42 ± 28.83, and 18.81 ± 7.05, respectively) were different from those of coaches (mean scores = 26.92 ± 5.02, 111.35 ± 24.14, and 22.41 ± 6.33, respectively) and ATs (mean scores = 28.66 ± 4.02, 117.67 ± 22.53, and 23.93 ± 5.69, respectively; P < .05).ConclusionsKnowledge, confidence, and educational impact scores regarding Triad or RED-S were lowest in female cross-country athletes and highest in ATs. These findings support the call for education, which should be regarded as the primary tool for increasing knowledge, to improve the prevention and treatment of the Triad or RED-S.
| S-EPMC9020605 | biostudies-literature
Project description:BackgroundInvestigations of the female athlete triad (Triad) in high school athletes have found that 36% had low energy availability, 54% had menstrual abnormalities, and 16% had low bone mineral density (BMD). Limited data are available showing the prevalence of these risk factors in high school distance runners or regarding best practice on screening for the Triad in the adolescent population.PurposeTo (1) evaluate the prevalence of Triad risk factors and iron supplementation in high school distance runners and (2) pilot a screening tool for Triad risk score.Study designDescriptive epidemiology study.MethodsThe study population included female high school athletes who participated in cross-country/track. Participants completed a survey including questions regarding dietary habits, menstrual history, and bone stress injury (BSI) history. They then underwent evaluation of 25-hydroxyvitamin D, free triiodothyronine (T3), and dual-energy x-ray absorptiometry scan to measure body fat and BMD through use of age-, sex-, and ethnicity-matched Z scores. Triad scores were calculated. Relationships were analyzed using Spearman correlation coefficient.ResultsThere were 38 study participants (mean age, 16.9 years). Average body mass index was 19.8 kg/m2. Disordered eating or eating disorders were reported in 76.3% of runners; in addition, 23.7% reported delayed menarche, 45.9% had a history of amenorrhea or oligomenorrhea, 42.1% had low BMD (Z score < -1.0), and 15.8% reported prior BSI. Low free T3 was significantly associated with higher Triad risk scores (r S = -0.36; P = .028). More than 42% of athletes were supplementing iron.ConclusionThe prevalence of Triad risk factors in high school distance runners was high. Free T3 was inversely associated with Triad score, which may serve as an indicator of low energy availability. Nearly half of the athletes were using iron supplementation.
| S-EPMC7605010 | biostudies-literature
Project description:To determine bone mineral density (BMD) and the associations among BMD, menstrual history, disordered eating (DE), training history, intentional weight loss (IWL) and rib pain for the first time in female lightweight rowers.9 lightweight rowing clubs, UK.29 Caucasian female lightweight rowers volunteered. 21 (12 active, 9 retired) completed the study.female lightweight rowers aged over 18 years.participants with a history of bone disease, used medications known to influence BMD or if they were pregnant, lactating or postmenopausal.Dual-energy X-ray absorptiometry measured total body (TB) composition and BMD at the spine, femoral neck (FN), radius and TB. DE, oligomenorrhoea/amenorrhoea years; rib pain and training history.DE was reported in six of the rowers. The active with DE started rowing younger (p<0.05) than those without, and their amount of IWL was associated with Eating Attitudes Test-26 score (p<0.05). Some participants reported a history of oligomenorrhoea/amenorrhoea 17 (76%) and/or rib pain 7 (32%) with those with rib pain having lower spine and TB Z-scores (p<0.05) than those without. Those with oligomenorrhoea/amenorrhoea had lower spine Z-scores (p<0.01) than those without. Twelve participants had low BMD; three at spine; one at FN; and eight at radius. Thirteen per cent of mean total training hours (18.6±9.1 h/week) were spent strength training (2.4±2.2 h/week).Upper body exercises incorporating multidimensional high peak bone strain were not reported and may need to be considered in their strength training to improve radial BMD. Results suggest IWL and high-level training at a young age increases the likelihood of DE and there may be a lack of quality nutritional support for these athletes. Thus, multidisciplinary sport science support should be offered at a young age and perhaps also to consider changing the weight rules to prevent the development of the Triad.
| S-EPMC3927798 | biostudies-other
Project description:Accepting a continued rise in the prevalence of vegan-type diets in the general population is also likely to occur in athletic populations, it is of importance to assess the potential impact on athletic performance, adaptation, and recovery. Nutritional consideration for the athlete requires optimization of energy, macronutrient, and micronutrient intakes, and potentially the judicious selection of dietary supplements, all specified to meet the individual athlete's training and performance goals. The purpose of this review is to assess whether adopting a vegan diet is likely to impinge on such optimal nutrition and, where so, consider evidence based yet practical and pragmatic nutritional recommendations. Current evidence does not support that a vegan-type diet will enhance performance, adaptation, or recovery in athletes, but equally suggests that an athlete can follow a (more) vegan diet without detriment. A clear caveat, however, is that vegan diets consumed spontaneously may induce suboptimal intakes of key nutrients, most notably quantity and/or quality of dietary protein and specific micronutrients (eg, iron, calcium, vitamin B12, and vitamin D). As such, optimal vegan sports nutrition requires (more) careful consideration, evaluation, and planning. Individual/seasonal goals, training modalities, athlete type, and sensory/cultural/ethical preferences, among other factors, should all be considered when planning and adopting a vegan diet.
| S-EPMC10334161 | biostudies-literature
Project description:Orthopaedic surgeons and other orthopaedic care providers have expressed a desire to care for transgender patients but have a self-perceived knowledge deficit. Transgender athletes experience many psychosocial barriers to sport that are useful for clinicians to understand. Medical and surgical gender-affirming care can impact musculoskeletal physiology and pathophysiology. Transgender women (TW) have demonstrated an increased risk of insufficiency fractures and thromboembolism in patients receiving exogenous estrogen therapy. The impact of gender-affirming care on sex-based differences in athletic injuries is less well studied.
| S-EPMC10461145 | biostudies-literature
Project description:BackgroundIt has been noticed that Female Athlete Triad (Fat) and Relative Energy Deficiency (Red-S) in Sport are characterized by the symptoms of impaired endocrine-metabolic function and bone health in female athletes. In addition, it may be evaluated with a qualitative tool, such as Low Energy Availability in Females questionnaire (LEAF-Q) and quantitative measurements: bone mineral density (BMD), resting energy expenditure (REE), body composition, 24-hour dietary recall.MethodsThe aim of this study was to assess the prevalence of Triad and Red-S using the LEAF-Q in youth female football players. Additionally, the difference in the BMD, body composition, REE and energy intake (EI) were assessed between the Triad/Red-S risk and not at-risk groups.ResultsAlmost two thirds (64.7%) of participants are classified as being at-risk for the triad according to their LEAF-Q scores. There were no statistically significant differences (p > 0.05) between most of the values among children from the analyzed groups. There was a statistically significant difference (p < 0.001) between the EI values among girls from the two analyzed groups: at-risk (1,773.18 kcal ± 232.57) and not at-risk (2,054.00 kcal ± 191.39). Girls who did not meet the energy intake recommendations were 10.00 as likely to be in the Triad/Red-S risk group.ConclusionEarly identification of Fat/Red-S symptoms by screening tools such as the LEAF questionnaire is important in protecting young athletes from long-term damage due to the progression of the risk factors associated with the Fat/Red-S.
| S-EPMC8420870 | biostudies-literature
Project description:While athletes' nutrient intakes have been widely reported, few studies have assessed the diet quality of athletes. This is the first study to evaluate the diet quality of athletes using the purpose-built Athlete Diet Index (ADI). A convenience sample of 165 elite athletes from Australian sporting institutions completed the ADI online, with subsequent automated results provided to their respective accredited sports dietitians (ASDs). At the completion of athlete participation, ASDs (n = 12) responded to a range of survey items using a Likert scale (i.e., 1 = strongly agree to 5 = strongly disagree) to determine the suitability of the ADI in practice. Differences in ADI scores for demographics and sport-specific variables were investigated using independent t-tests, analysis of variance (ANOVA) and Bonferroni multiple comparisons. Spearman's rank correlation was used to assess the association between total scores and demographics. The mean total ADI score was 91.4 ± 12.2 (range 53-117, out of a possible 125). While there was no difference in total scores based on demographics or sport-specific variables; team sport athletes scored higher than individual sport athletes (92.7 vs. 88.5, P < 0.05). Athletes training fewer hours (i.e., 0-11 h/week) scored higher on Dietary Habits sub-scores compared with athletes training more hours (> 12 h/week; P < 0.05), suggesting that athletes who train longer may be at risk of a compromised dietary pattern or less than optimal nutrition practices that support training. Most (75%) ASDs surveyed strongly agreed with the perceived utility of the ADI for screening athletes and identifying areas for nutrition support, confirming its suitability for use in practice.
| S-EPMC7823332 | biostudies-literature
Project description:Young athletes, though often healthy, can carry a variety of symptoms that may impede their participation in sports or other activities. Typically we might think of musculoskeletal and respiratory problems primarily, however disorders of the gastrointestinal (GI) tract must also be considered. In some instances musculoskeletal complaints may bring to light activity of an underlying GI condition as is the case with inflammatory bowel disease. Gastrointestinal symptoms in the young athlete can be quite significant and a nuisance for participation. We aim to describe and discuss treatment options of a few conditions targeted specifically for your young athlete both that arise specifically from athletic participation and those GI disorders that are chronic in nature whose presence must not be neglected in the athlete.
| S-EPMC5532198 | biostudies-other
Project description:BackgroundDuring a period of intensified exercise (e.g. training/identification camps), often undertaken by competitive youth athletes, the maintenance of muscle function and peak performance can become challenging due to an accumulation of fatigue. The provision of post-exercise dairy protein in adults has been previously shown to accelerate recovery; however, its efficacy in youth athletes is currently unknown. Therefore, the purpose of this study was to examine the effects of increased dairy protein consumption with plain Greek yogurt (GY) on performance and recovery indices during an intensified soccer training camp in adolescent female soccer players.MethodsThirteen players (14.3 ± 1.3 years) participated in a randomized, double blinded, crossover design study where they received 3 servings/day of either GY (~115 kcal, 17 g protein, ~11.5 g carbohydrates) or an isoenergetic carbohydrate control (CHO, ~115 kcal, 0.04 g protein, ~28.6 g carbohydrates) during two 5-day soccer-specific training camps. Performance was assessed before and after each training camp. Fasted, morning, creatine kinase (CK), insulin-like growth factor-1 (IGF-1), C-reactive protein (CRP), interleukin 6 (IL6), interleukin 10 (IL10) and tumor necrosis factor-α (TNFα) were measured in plasma pre- and post-training.ResultsTraining led to decrements in counter-movement jump (p = 0.01), broad jump (p = 0.04) and aerobic capacity (p = 0.006), with no effect of GY. A significant increase in anti-inflammatory cytokine IL10 was observed from pre- to post-training in GY (+26% [p = 0.008]) but not in CHO (p = 0.89). CRP and CK increased (+65% [p = 0.005] and +119% [p ≤ 0.001], respectively), while IGF-1 decreased (-34% [p ≤ 0.001]) from pre- to post-training with no difference between conditions.ConclusionsThese results demonstrate that consumption of GY did not offer any added recovery benefit with respect to measures of performance and in the attenuation of exercise-induced muscle damage above that achieved with energy-matched carbohydrate in this group of young female soccer players. However, regular consumption of GY may assist with the acute anti-inflammatory response during periods of intensified training in adolescent athletes.
| S-EPMC9116412 | biostudies-literature