scholarly journals Bone-Mineral Density and Other Features of the Female Athlete Triad in Elite Endurance Runners: A Longitudinal and Cross-Sectional Observational Study

2010 ◽  
Vol 20 (5) ◽  
pp. 418-426 ◽  
Author(s):  
Noel Pollock ◽  
Claire Grogan ◽  
Mark Perry ◽  
Charles Pedlar ◽  
Karl Cooke ◽  
...  

Low bone-mineral density (BMD) is associated with menstrual dysfunction and negative energy balance in the female athlete triad. This study determines BMD in elite female endurance runners and the associations between BMD, menstrual status, disordered eating, and training volume. Forty-four elite endurance runners participated in the cross-sectional study, and 7 provided longitudinal data. Low BMD was noted in 34.2% of the athletes at the lumbar spine, and osteoporosis in 33% at the radius. In cross-sectional analysis, there were no significant relationships between BMD and the possible associations. Menstrual dysfunction, disordered eating, and low BMD were coexistent in 15.9% of athletes. Longitudinal analysis identified a positive association between the BMD reduction at the lumbar spine and training volume (p = .026). This study confirms the presence of aspects of the female athlete triad in elite female endurance athletes and notes a substantial prevalence of low BMD and osteoporosis. Normal menstrual status was not significantly associated with normal BMD, and it is the authors’ practice that all elite female endurance athletes undergo dual-X-ray absorptiometry screening. The association between increased training volume, trend for menstrual dysfunction, and increased loss of lumbar BMD may support the concept that negative energy balance contributes to bone loss in athletes.

Author(s):  
Ivana Petrović

The Female Athlete Triad (Triad) is a medical condition of female athletes consisting of three components: low energy availability (EA), menstrual dysfunction (MD), and low bone mineral density (BMD). The prevalence of all three components of the Triad ranges from 1-14%. In last ten years, it has ranged from 1.3% up to 23% with 78% of female athletes having at least one of the three components of the Triad. The aim of this systematic review is to collect and analyze recent studies of the Female Athlete Triad. Based on an analysis of electronic databases and the inclusion criteria set, 20 studies were included in the analysis. The following conclusions are proposed based on their analysis: MD was the most prevalent among endurance athletes with ranges from 35.5% to 60.7%, with the presence of secondary amenorrhea and oligomenorrhea, 30% to 64.0% and 18% to 27.0% and with a very high level of cases with irregular menorrhea, 72.3%. Low/negative EA ranges from 19.8% among non-leanness athletes and up to 77%. The greatest proportion of athletes in moderate- and high-risk categories for expressing the Triad participated in sports that emphasize leanness, including cross-country, gymnastics running, and lacrosse. A recommendation for future research is that they should focus on enhanced monitoring of physically active women, and the prevention of the Triad, stress fractures and osteoporosis.


2018 ◽  
Vol 8 (2) ◽  
pp. 69-92
Author(s):  
Patricia Katherine Doyle-Baker ◽  
Leanne P McLean ◽  
Tak Fung

Female hockey players have high energy expenditure and may enter a negative energy balance (EB) without noticeable body composition changes. Menstrual cycle (MC) and luteal phase (LP) length, EB, and bone mineral density (BMD) were tracked over nine months (mean, SD, ±) in 12 ice hockey players (HP; age 21.1 ± 3.4 yrs; height (HT) 165.9 ± 4.6 cm; weight (WT) 64.7± 8.1 kg, body fat percent (BF%) 22.8 ± 3.8%) and 12 non-athlete controls (C; age 21.4 ± 2.8 yrs., HT 169.5 ± 5.5 cm; WT 65.4 ± 5.4 kg; BF% 20.0 ± 3.1%). HP MC (35.8 ± 11.2 days) was longer than C (29.8 ± 4.3 days) and HP LP (10.1 ± 2.1 days) was also longer than C (9.6 ± 2.8 days). Anovulation occurred in 50.0 % of HP versus 39.2 % of C. No group BMD differences were observed in lumbar spine (p = 0.9), hip (p = 0.5), and radial (p = 0.7) sites. A negative EB was identified (HP = -1026.52 ± 450.1; C = -780.00 ± 310.19 kcal / day), yet no significant within-group differences in WT (HP p = 0.7; C p = 0.8), BF % (HP p = 0.97; C p = 0.6), or fat free mass (HP p = 0.6; C p = 0.98) were found over the study duration. Rigorous hockey schedule likely contributed to 28 % completion of the Basal Body Temperature and MC recordings in HP compared to 70 % in C. Both groups entered a state of negative EB, but did not exhibit a BF % change associated with the Female Athlete Triad. 


2018 ◽  
pp. 288-301
Author(s):  
Jennifer L. Carlson ◽  
Katherine B. Hill

In 2007, the female athlete triad was redefined to include (1) low energy availability with or without disordered eating; (2) menstrual dysfunction; and (3) decreased bone mineral density. Components of the triad are common during adolescence, a critical period for bone acquisition and growth, but the prevalence varies among athlete populations based on several factors. Screening for the triad should be a routine part of the preparticipation physical examination of adolescent athletes, and new recommendations exist for the screening and management of athletes at risk for complications from the triad. Awareness and education are critical for prevention and early intervention.


2010 ◽  
Vol 42 ◽  
pp. 318-319
Author(s):  
Noel Pollock ◽  
Claire Grogan ◽  
Mark Perry ◽  
Charles Pedlar ◽  
Karl Cooke ◽  
...  

Author(s):  
Katie J. Thralls ◽  
Jeanne F. Nichols ◽  
Michelle T. Barrack ◽  
Mark Kern ◽  
Mitchell J. Rauh

Early detection of the female athlete triad is essential for the long-term health of adolescent female athletes. The purpose of this study was to assess relationships between common anthropometric markers (ideal body weight [IBW] via the Hamwi formula, youth-percentile body mass index [BMI], adult BMI categories, and body fat percentage [BF%]) and triad components, (low energy availability [EA], measured by dietary restraint [DR], menstrual dysfunction [MD], low bone mineral density [BMD]). In the sample (n = 320) of adolescent female athletes (age 15.9± 1.2 y), Spearman’s rho correlations and multiple logistic regression analyses evaluated associations between anthropometric clinical cutoffs and triad components. All underweight categories for the anthropometric measures predicted greater likelihood of MD and low BMD. Athletes with an IBW ≤85% were nearly 4 times more likely to report MD (OR = 3.7, 95% CI [1.8, 7.9]) and had low BMD (OR = 4.1, 95% CI [1.2, 14.2]). Those in <5th percentile for their age-specific BMI were 9 times more likely to report MD (OR 9.1, 95% CI [1.8, 46.9]) and had low BMD than those in the 50th to 85th percentile. Athletes with a high BF% were almost 3 times more likely to report DR (OR = 2.8, 95% CI [1.4, 6.1]). Our study indicates that low age-adjusted BMI and low IBW may serve as evidence-based clinical indicators that may be practically evaluated in the field, predicting MD and low BMD in adolescents. These measures should be tested for their ability as tools to minimize the risk for the triad.


2012 ◽  
Vol 5 (2) ◽  
pp. 33-43
Author(s):  
Dana Brewington ◽  
Derrick Johnson ◽  
Mark Stovak ◽  
AT Harvey

Background. The Female Athlete Triad (Triad) is characterized by negative energy balance, disordered menstrual cycles, and low bone mineral density. The understanding and practices of primary care physicians (PCPs) regarding the Triad and the benefit of an educational intervention were assessed. Methods. PCPs attending a regional conference were surveyed prior to, immediately after, and three months following the plenary lecture on the Triad. Surveys included knowledge about the components, diagnostics, treatment, clinician practice, and comfort level with regard to the Triad. Results. The pre-test survey was completed by 84 of 126 (67%) attendees. The lecture increased from 53% to 98% the proportion of PCPs who identified the three domains of the Triad. Knowledge scores improved over the course of the lecture (from 3.4 to 5.1, p < 0.05), particularly regarding Triad components (effect size = 1.2) and treatment (effect size = 1.6) with only small gains in diagnostic knowledge (effect size = 0.1 to 0.3). The three-month follow-up survey, completed by only seven clinicians (8%), suggested good retention of knowledge though little practice changes. Conclusions. A 50-minute educational session improved knowledge about the Triad. Particular improvement was noted in understanding the underlying etiology and treatment.


Genes ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 76
Author(s):  
Jorge Gutiérrez-Hellín ◽  
Gabriel Baltazar-Martins ◽  
Millán Aguilar-Navarro ◽  
Carlos Ruiz-Moreno ◽  
Jesús Oliván ◽  
...  

The p.R577X polymorphism (rs1815739) in the ACTN3 gene causes individuals with the ACTN3 XX genotype to be deficient in functional α-actinin-3. Previous investigations have found that XX athletes are more prone to suffer non-contact muscle injuries. This investigation aimed to determine the influence of the ACTN3 R577X polymorphism in the injury epidemiology of elite endurance athletes. Using a cross-sectional experiment, the epidemiology of running-related injuries was recorded for one season in a group of 89 Spanish elite endurance runners. ACTN3 R577X genotype was obtained for each athlete using genomic DNA samples. From the study sample, 42.7% of athletes had the RR genotype, 39.3% had the RX genotype, and 18.0% had the XX genotype. A total of 96 injuries were recorded in 57 athletes. Injury incidence was higher in RR runners (3.2 injuries/1000 h of running) than in RX (2.0 injuries/1000 h) and XX (2.2 injuries/1000 h; p = 0.030) runners. RR runners had a higher proportion of injuries located in the Achilles tendon, RX runners had a higher proportion of injuries located in the knee, and XX runners had a higher proportion of injuries located in the groin (p = 0.025). The ACTN3 genotype did not affect the mode of onset, the severity, or the type of injury. The ACTN3 genotype slightly affected the injury epidemiology of elite endurance athletes with a higher injury rate in RR athletes and differences in injury location. However, elite ACTN3 XX endurance runners were not more prone to muscle-type injuries.


2018 ◽  
Author(s):  
Irfan M Asif ◽  
Kimberly Harmon ◽  
Mallory Shasteen

Stress fractures are more common in the female athlete. Stress fractures of the pubic ramus and femoral neck are particularly more common in females than in males. Rib stress fractures are an important injury to consider in the female rower, whereas spondylolysis is a common cause of low back pain in female athletes who hyperextend their spines. The higher incidence of stress fractures in females is mainly due to the higher prevalence of disordered eating and subsequent energy imbalance, which leads to detrimental effects on bone. This review discusses stress fractures and unique issues related to exercise and the female reproductive system. This review contains 6 figures, 5 tables and 49 references Key words: amenorrhea, bone mineral density, disordered eating, female athlete triad, femoral neck, pregnancy, pubic ramus, rib, spondylolysis, stress fracture


2018 ◽  
Author(s):  
Irfan M Asif ◽  
Kimberly Harmon ◽  
Mallory Shasteen

Stress fractures are more common in the female athlete. Stress fractures of the pubic ramus and femoral neck are particularly more common in females than in males. Rib stress fractures are an important injury to consider in the female rower, whereas spondylolysis is a common cause of low back pain in female athletes who hyperextend their spines. The higher incidence of stress fractures in females is mainly due to the higher prevalence of disordered eating and subsequent energy imbalance, which leads to detrimental effects on bone. This review discusses stress fractures and unique issues related to exercise and the female reproductive system. This review contains 6 figures, 5 tables and 49 references Key words: amenorrhea, bone mineral density, disordered eating, female athlete triad, femoral neck, pregnancy, pubic ramus, rib, spondylolysis, stress fracture


Sports ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 82 ◽  
Author(s):  
Majid Syed-Abdul ◽  
Dhwani Soni ◽  
Jason Wagganer

Low caloric intake or excessive energy expenditure can lead to a negative energy balance, which, in female athletes, may result in a condition called the female athlete triad. While several guidelines identified proper nutrition as a first line of treatment, little research has been reported to show the effect of a professional nutrition program (PNP) on the female athlete triad. The purpose of this case report was to measure the short- and long-term effects of a PNP on a female athlete presenting triad characteristics. A 20-year-old female track-and-field athlete at a Division I university who was in negative energy balance and amenorrheic underwent a one-month PNP. Short- and long-term effects measured by a dual X-ray absorptiometry scan prior to and after attending a PNP showed increased total energy intake from 2188 kcals to 3187 kcals, which resulted in an increase in body fat percent (BF%) from 4.7% to 6.7%. However, by the end of four months, energy intake and BF% (5.7% and 6.0%) values were reduced, respectively. After the twelve-month follow-up, BF% was increased (10.5%), suggesting that increasing energy intake to meet energy demands, without compromising athletic training, can be an effective treatment for the female athlete triad.


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