Associations Between Disordered Eating, Menstrual Dysfunction, and Musculoskeletal Injury Among High School Athletes

Abstract Context: Prior authors have reported associations among increased risk of injury and factors of the female athlete triad, as defined before the 2007 American College of Sports Medicine position stand, in collegiate and adult club sport populations. Little is known about this relationship in an adolescent competitive sports population. Objective: To examine the relationship among disordered eating, menstrual dysfunction, and low bone mineral density (BMD) and musculoskeletal injury among girls in high school sports. Design: Prospective cohort study. Setting: The sample consisted of 163 female athletes competing in 8 interscholastic sports in southern California during the 2003–2004 school year. Each participant was followed throughout her respective sport season for occurrence of musculoskeletal injuries. Main Outcome Measure(s): Data collected included daily injury reports, the Eating Disorder Examination Questionnaire that assessed disordered eating attitudes and behaviors, a dual-energy x-ray absorptiometry scan that measured BMD and lean tissue mass, anthropometric measurements, and a questionnaire on menstrual history and demographic characteristics. Results: Sixty-one athletes (37.4%) incurred 90 musculoskeletal injuries. In our BMD z score model of ≤−1 SD, a history of oligomenorrhea/amenorrhea during the past year and low BMD (z score ≤−1 SD) were associated with the occurrence of musculoskeletal injury during the interscholastic sport season. In our BMD z score model of ≤−2 SDs, disordered eating (Eating Disorder Examination Questionnaire score ≥4.0), a history of oligomenorrhea/amenorrhea during the past year, and a low BMD (z score ≤−2 SDs) were associated with musculoskeletal injury occurrence. Conclusions: These findings indicate that disordered eating, oligomenorrhea/amenorrhea, and low BMD were associated with musculoskeletal injuries in these female high school athletes. Programs designed to identify and prevent disordered eating and menstrual dysfunction and to increase bone mass in athletes may help to reduce musculoskeletal injuries.

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An Examination of the Differences of Characteristics Which are Psychologically Related to Disordered Eating of Female High School Athletes in Aesthetic and Non-Aesthetic Sports

Journal of Nutrition Education and Behavior ◽

10.1016/j.jneb.2017.05.289 ◽

2017 ◽

Vol 49 (7) ◽

pp. S23-S24

Author(s):

Nanako Nakayama ◽

Yuka Shudo ◽

Haruo Sakuma ◽

Atsushi Yuhaku ◽

Kumiko Ebi

Keyword(s):

High School ◽

Disordered Eating ◽

High School Athletes ◽

Female High School ◽

Aesthetic Sports

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Disordered Eating and Menstrual Irregularity in High School Athletes in Lean-Build and Nonlean-Build Sports

International Journal of Sport Nutrition and Exercise Metabolism ◽

10.1123/ijsnem.17.4.364 ◽

2007 ◽

Vol 17 (4) ◽

pp. 364-377 ◽

Cited By ~ 50

Author(s):

Jeanne F. Nichols ◽

Mitchell J. Rauh ◽

Michelle T. Barrack ◽

Hava-Shoshana Barkai ◽

Yael Pernick

Keyword(s):

High School ◽

Eating Disorder ◽

Disordered Eating ◽

Menstrual Irregularity ◽

High School Athletes ◽

Eating Disorder Examination Questionnaire ◽

Eating Disorder Examination ◽

Menstrual History

The authors’ purpose was to determine the prevalence and compare associations of disordered eating (DE) and menstrual irregularity (MI) among high school athletes. The Eating Disorder Examination Questionnaire (EDE-Q) and a menstrual-history questionnaire were administered to 423 athletes (15.7 ± 1.2 y, 61.2 ± 10.2 kg) categorized as lean build (LB; n = 146) or nonlean build (NLB; n = 277). Among all athletes, 20.0% met the criteria for DE and 20.1% for MI. Although the prevalence of MI was higher in LB (26.7%) than NLB (16.6%) athletes (P = 0.01), no differences were found for DE. For both sport types, oligo/amenorrheic athletes consistently reported higher EDE-Q scores than eumenorrheic athletes (P < 0.05). Athletes with DE were over 2 times as likely (OR = 2.3, 95%CI: 1.3, 4.2) to report oligo/amenorrhea than athletes without DE. These data establish an association between DE and MI among high school athletes and indicate that LB athletes have more MI but not DE than NLB athletes.

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Disordered Eating and Body Image Perception in Male High School Athletes and Non-Athletes

Journal of the American Dietetic Association ◽

10.1016/s0002-8223(99)00761-0 ◽

1999 ◽

Vol 99 (9) ◽

pp. A103 ◽

Cited By ~ 1

Author(s):

L. Moss ◽

R.C. Bessinger

Keyword(s):

High School ◽

Body Image ◽

Disordered Eating ◽

High School Athletes ◽

Image Perception ◽

Body Image Perception ◽

Male High School

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Lower Extremity Musculoskeletal Injury Risk After Concussion Recovery in High School Athletes

Journal of Athletic Training ◽

10.4085/1062-6050-52.11.22 ◽

2017 ◽

Vol 52 (11) ◽

pp. 1028-1034 ◽

Cited By ~ 21

Author(s):

Robert C. Lynall ◽

Timothy C. Mauntel ◽

Ryan T. Pohlig ◽

Zachary Y. Kerr ◽

Thomas P. Dompier ◽

...

Keyword(s):

High School ◽

Lower Extremity ◽

Musculoskeletal Injury ◽

Lower Extremity Injury ◽

Extremity Injury ◽

High School Athletes ◽

Time Loss ◽

Lower Extremity Injuries ◽

Subsequent Time ◽

Extremity Injuries

Context: Although an association between concussion and musculoskeletal injury has been described in collegiate and professional athletes, no researchers have investigated an association in younger athletes. Objective: To determine if concussion in high school athletes increased the risk for lower extremity musculoskeletal injury after return to activity. Design: Observational cohort study. Setting: One hundred ninety-six high schools across 26 states. Patients or Other Participants: We used data from the National Athletic Treatment, Injury and Outcomes Network surveillance system. Athletic trainers provided information about sport-related concussions and musculoskeletal injuries in athletes in 27 sports, along with missed activity time due to these injuries. Main Outcome Measure(s): Three general estimating equations were modeled to predict the odds of sustaining (1) any lower extremity injury, (2) a time-loss lower extremity injury, or (3) a non–time-loss lower extremity injury after concussion. Predictors were the total number of previous injuries, number of previous concussions, number of previous lower extremity injuries, number of previous upper extremity injuries, and sport contact classification. Results: The initial dataset contained data from 18 216 athletes (females = 39%, n = 6887) and 46 217 injuries. Lower extremity injuries accounted for most injuries (56.3%), and concussions for 4.3% of total injuries. For every previous concussion, the odds of sustaining a subsequent time-loss lower extremity injury increased 34% (odds ratio [OR] = 1.34; 95% confidence interval [CI] = 1.13, 1.60). The number of previous concussions had no effect on the odds of sustaining any subsequent lower extremity injury (OR = 0.97; 95% CI = 0.89, 1.05) or a non–time-loss injury (OR = 1.01; 95% CI = 0.92, 1.10). Conclusions: Among high school athletes, concussion increased the odds of sustaining subsequent time-loss lower extremity injuries but not non–time-loss injuries. By definition, time-loss injuries may be considered more severe than non–time-loss injuries. The exact mechanism underlying the increased risk of lower extremity injury after concussion remains elusive and should be further explored in future research.

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