In case you didn’t know, February 1st was National Girls & Women in Sports Day. Women have provided amazing contributions to the world of sports, but there are certain challenges that women face uniquely in this realm of fitness and competition. These challenges can be severely detrimental to their health and ability to participate in athletics. The particular challenge to which I am referring is the female athlete triad.
The female athlete triad consists of three conditions: disordered eating, menstrual dysfunction, and premature osteoporosis. The American College of Sports Medicine (ACSM) coined this term in 1993 after decades of observing the connection between bone mineral density, stress fractures, and eating disorders with female athletes. Emerging data may eventually expand the triad to a tetrad to include endothelial dysfunction (a disorder of the inner lining of the blood vessels), but currently it remains a triad.
The key component to the entire triad is disordered eating, or energy availability. Amenorrhea, or the absence of a menstrual cycle during normally fertile years, can occur when the body’s total fat storage has dropped below a normal range; thus, poor nutritional consumption especially in combination with excessive exercising can lead to this condition. A healthy amount of body fat for women should fall within the 15-25% range and for athletic women 14-20% is a common range. Amenorrhea causes a drop in estrogen which is a hormone that keeps bones strong. This menstrual abnormality, especially in combination with poor calcium consumption, can then lead to osteoporotic changes in the body. In other words, if a female athlete does not consume an appropriate amount of nutrients for her level of activity, then over time menstrual dysfunction and premature osteoporosis are the result. Certain sports which either reward a slender physique or in which performance is improved with a smaller body mass (ex. figure skating, gymnastics, ballet, distance running, etc.) place athletes at a higher risk for developing eating disorders. Females in particular are 5-10 times more likely to develop eating disorders than males.
So what kind of damage does this really do? Poor nutrition in general has several negative effects including a reduction in overall energy level and, as previously stated, the eventual reduction in bone density. This reduction in bone density can lead to fractures (ex. stress fractures) which in turn will stunt the athlete’s ability to participate in her sport. Furthermore, there will likely be long term negative effects due to the decrease in bone density. Youth is when bone is supposed to be built while later in life (i.e. menopausal age) bone density decreases. If you begin with poor bone density as a child, then later in life you will have less bone stored up, thus causing greater weakness and increased risk of broken bones as you age.
So what can you do? As a parent or coach, always promote healthy eating habits. The emphasis should be directed away from weight loss and placed more so on healthy eating. Promote healthy sleeping habits, as well. Certain concerns with performance may be improved simply by getting into a proper sleeping routine. If your child or student-athlete has already fallen into a pattern of disordered eating, then you should urge them to seek medical treatment or directly consult a physician regarding your concerns. Most often treatment requires a joint approach including the physician, nutritionist, psychologist, and the support of family, friends, teammates, and coaches. The following chart from The Canadian Journal of Diagnosis provides strategies for both the prevention and treatment of the female athlete triad.