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    Female Athlete Triad
    Syndrome
    Sammie Seaman
    NTR 300
+
    What is the Female Athlete Triad?

       The triad is a combination of 3 health complications; energy
        deficit/disordered eating, menstrual disturbances/Amenorrhea,
        and bone loss/Osteoporosis. It is likely that an athlete suffering
        from just one of the elements is suffering from all three as well.
        Most athletes are not diagnosed with extreme cases but may
        display intermediate symptoms. For example, an athlete may
        show signs of restrictive eating but not meet the criteria for an
        eating disorder. It is most common among athletics that require
        leanness, train an excessive amount of hours, and demand of the
        body.
+
    The New Model




    The Triad was first identified 25 years ago. Recently the model has advance with more
    research upon the topic. Originally the three components were disordered eating, low bone
    mass, and amenorrhea. The components have been proven to be related to each other as
    energy deficiency is linked to development of menstrual disturbances, as well as, low
    estrogen initiating bone loss. The new model reaffirms this but, it is being represented as a
    continuum of severity of healthy disease. This model also highlights athletes that may not
    present the extreme ends of the continuum, but the intermediate cases and the
    progressions along the three main points. While the conditions represented by each
    continuum can occur independent of the other two conditions, it is likely that an athlete
    suffering from one condition is suffering from the other three too.
+
    Signs of the Female Athlete Triad

       There are many signs and symptoms that an athlete may have
        the syndrome. The most common is restriction of food intake
        which will leave an athlete feeling tired and fatigue. Many
        athletes have the a constant feeling to be thin. They eat less
        then needed in an effort to improve their performance and
        physical appearance. Since athletes aren’t getting enough
        caloric intake, the body shuts down. Stress fractures and
        recurrent injuries are also a side effect of the triad. Other side
        effects may include trouble sleeping, cold hands and feet, and
        irregular menstrual cycles.
+
    Which Sport Does this Effect the
    Most?
       The Triad is seen in sports that emphasize leanness. It is
        most commonly seen in cross country, gymnastics, ballet
        and figure skating. Female athletes are expected to be fit,
        lean and competitive in their sport. They also have the
        pressures of today’s society, which places a high
        emphasis on body image and thinness. Because of this,
        some athletes will use extreme measures to reshape their
        bodies. Female athletes will diet or restrict various food
        groups in the hope that a thinner body will make them
        better in their sport.
+ Energetic Efficiency, Menstrual Irregularity, and Bone Mineral Density in
   Elite Professional Female Ballet Dancers
   By: Ashley F. Doyle-Lucas, Ph. D., Jeremy D. Akers, Ph.D., and Brenda
   M. Davy, R.D., F.A.C.S.M.




      The graph above shows the relationship         This second graph explains how
      between female dancers and lean control        energy efficiency is related to resting
      women and the resting metabolic rate. The      metabolic rate. The lower the
      less calories consumed the lower the           metabolic rate the less energy an
      metabolic rate. This only proves that eating   athlete will have.
      less does not always benefit the body
+
                                      Nutrition

       As you can imagine, constant dieting and/or restriction of energy intake
        can have a negative impact on nutritional status, repair of muscle tissue
        and recovery from injury. Many athletes do not know how to lose weight in
        a healthy way. They frequently fast, skip meals and/or eliminate food
        groups, such as meat and dairy. Energy restriction and the elimination of
        food groups can dramatically reduce the intake of protein, carbohydrate
        and health fats, which are necessary to fuel exercise and recover from
        hard training. Protein intake may be inadequate for the building and repair
        of muscle tissues, while inadequate carbohydrate intake will reduce
        muscle glycogen replacement. In addition, many of the micronutrients
        needed for bone (calcium, magnesium, vitamin D), energy production (B
        vitamins), red blood cell and hemoglobin synthesis (iron, folate, B12) and
        immune function (zinc, antioxidants, iron) may be missing from the diet. In
        young athletes, reduced energy intake can also compromise growth.
        Female athletes need to learn that food will help fuel them in their sport
        and give them the energy and nutrients for growth and good health.
+
    Nutrition: Calcium

       Calcium is important when building and maintaining strong bones.
        This is essential when talking to athletes about nutrition linked to the
        Female Athlete Triad Syndrome. Overtime if your diet is too low in
        calcium your bones become weak and will be more susceptible to
        breaking. Here is a chart of important calcium sources:
+
    Nutrition: Vitamin D

       Vitamin D is a nutrient found in some foods that is needed for health and to maintain strong
        bones. It does so by helping the body absorb calcium form food. Athletes with little vitamin
        D intake develop soft bones. The amount of vitamin D you need each day depends on your
        age. Average daily recommended amounts from the Food and Nutrition Board (a national
        group of experts) for different ages are listed below in International Units (IU):




    The best source of vitamin D in foods is fatty fish such as salmon, tuna, and mackerel. The
    body makes vitamin D when it is directly exposed to the sun, and most people meet their
    vitamin intake this way.
+
    Risk Factors

       The Female Athlete Triad is a serious syndrome and is being
        seen more in women’s athletics. Health consequences are
        linked to each point of the triad. Eating disorders can also lead
        to medical complications involving the cardiovascular system,
        endocrine, reproductive, skeletal, gastrointestinal, renal, and
        central nervous system. Amenorrheic women are infertile due
        to the absence ovulation. This can also effect the skeletal
        muscle oxidative metabolism, low-density lipoprotein
        cholesterol levels, and muscle fatigue. Low bone mineral
        density can be a result of not enough nutrient intake which can
        lead to reoccurring stress fractures. Women with low bone
        mineral density increase their chances by four times as much.
+
    Prevention
       The best way to prevent the Female Athlete Triad from happening is by educating athletes,
        coaches, and parents on the subject. This will allow them to recognize it and take steps to
        prevent it.
           As a coach:
               Remind athletes that eating is an important part of successful training and
                performance.
               Focus on a healthy body image, and NOT on weight.
               Support athletes through training and everyday life
               Have available resources such as nutritionists, trainers, or counselors.
           As an athlete:
               Monitor menstrual cycle by using a calendar.
               Consult a physician if you have an irregular menstrual cycle and recurrent injuries
                like stress fractures.
               Talk to a counselor if you are overly concerned about your body image.
               See a sport nutritionist to help you design a healthy diet that is specific to your sport.
               Seek emotional support from coaches, guardians, or teammates.
+
    Sources

       Thompson, S. (2007). Characteristics of the female athletic triad in collegiate cross-country
        runners. Journal Of American College Health, 56(2), 129-136. chart collegiate female
        athlete article

       Doyle-Lucas, A. F., Akers, J. D., & Davy, B. M. (2010). Energetic Efficiency, Menstrual
        Irregularity, and Bone Mineral Density in Elite Professional Female Ballet Dancers. Journal
        Of Dance Medicine & Science, 14(4), 146-154.

       Female Athlete Triad Coalition. Female Athlete Triad Organization, 2012. Web. 30 Sep
        2012. <http://www.femaleathletetriad.org>.

       Office of Dietary Supplement. National Institute of Health, June 24, 2011. Web. 30 Sep
        2012. <http://ods.od.nih.gov/factsheets/VitaminD-QuickFacts/>.

       Manore, Melinda. "The Female Athlete Triad: Nutrition and Eating." Sports Coach. National
        Institute of Health, June 24, 2011. Web. 30 Sep 2012.

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Female Athlete Triad

  • 1. + Female Athlete Triad Syndrome Sammie Seaman NTR 300
  • 2. + What is the Female Athlete Triad?  The triad is a combination of 3 health complications; energy deficit/disordered eating, menstrual disturbances/Amenorrhea, and bone loss/Osteoporosis. It is likely that an athlete suffering from just one of the elements is suffering from all three as well. Most athletes are not diagnosed with extreme cases but may display intermediate symptoms. For example, an athlete may show signs of restrictive eating but not meet the criteria for an eating disorder. It is most common among athletics that require leanness, train an excessive amount of hours, and demand of the body.
  • 3. + The New Model The Triad was first identified 25 years ago. Recently the model has advance with more research upon the topic. Originally the three components were disordered eating, low bone mass, and amenorrhea. The components have been proven to be related to each other as energy deficiency is linked to development of menstrual disturbances, as well as, low estrogen initiating bone loss. The new model reaffirms this but, it is being represented as a continuum of severity of healthy disease. This model also highlights athletes that may not present the extreme ends of the continuum, but the intermediate cases and the progressions along the three main points. While the conditions represented by each continuum can occur independent of the other two conditions, it is likely that an athlete suffering from one condition is suffering from the other three too.
  • 4. + Signs of the Female Athlete Triad  There are many signs and symptoms that an athlete may have the syndrome. The most common is restriction of food intake which will leave an athlete feeling tired and fatigue. Many athletes have the a constant feeling to be thin. They eat less then needed in an effort to improve their performance and physical appearance. Since athletes aren’t getting enough caloric intake, the body shuts down. Stress fractures and recurrent injuries are also a side effect of the triad. Other side effects may include trouble sleeping, cold hands and feet, and irregular menstrual cycles.
  • 5. + Which Sport Does this Effect the Most?  The Triad is seen in sports that emphasize leanness. It is most commonly seen in cross country, gymnastics, ballet and figure skating. Female athletes are expected to be fit, lean and competitive in their sport. They also have the pressures of today’s society, which places a high emphasis on body image and thinness. Because of this, some athletes will use extreme measures to reshape their bodies. Female athletes will diet or restrict various food groups in the hope that a thinner body will make them better in their sport.
  • 6. + Energetic Efficiency, Menstrual Irregularity, and Bone Mineral Density in Elite Professional Female Ballet Dancers By: Ashley F. Doyle-Lucas, Ph. D., Jeremy D. Akers, Ph.D., and Brenda M. Davy, R.D., F.A.C.S.M. The graph above shows the relationship This second graph explains how between female dancers and lean control energy efficiency is related to resting women and the resting metabolic rate. The metabolic rate. The lower the less calories consumed the lower the metabolic rate the less energy an metabolic rate. This only proves that eating athlete will have. less does not always benefit the body
  • 7. + Nutrition  As you can imagine, constant dieting and/or restriction of energy intake can have a negative impact on nutritional status, repair of muscle tissue and recovery from injury. Many athletes do not know how to lose weight in a healthy way. They frequently fast, skip meals and/or eliminate food groups, such as meat and dairy. Energy restriction and the elimination of food groups can dramatically reduce the intake of protein, carbohydrate and health fats, which are necessary to fuel exercise and recover from hard training. Protein intake may be inadequate for the building and repair of muscle tissues, while inadequate carbohydrate intake will reduce muscle glycogen replacement. In addition, many of the micronutrients needed for bone (calcium, magnesium, vitamin D), energy production (B vitamins), red blood cell and hemoglobin synthesis (iron, folate, B12) and immune function (zinc, antioxidants, iron) may be missing from the diet. In young athletes, reduced energy intake can also compromise growth. Female athletes need to learn that food will help fuel them in their sport and give them the energy and nutrients for growth and good health.
  • 8. + Nutrition: Calcium  Calcium is important when building and maintaining strong bones. This is essential when talking to athletes about nutrition linked to the Female Athlete Triad Syndrome. Overtime if your diet is too low in calcium your bones become weak and will be more susceptible to breaking. Here is a chart of important calcium sources:
  • 9. + Nutrition: Vitamin D  Vitamin D is a nutrient found in some foods that is needed for health and to maintain strong bones. It does so by helping the body absorb calcium form food. Athletes with little vitamin D intake develop soft bones. The amount of vitamin D you need each day depends on your age. Average daily recommended amounts from the Food and Nutrition Board (a national group of experts) for different ages are listed below in International Units (IU): The best source of vitamin D in foods is fatty fish such as salmon, tuna, and mackerel. The body makes vitamin D when it is directly exposed to the sun, and most people meet their vitamin intake this way.
  • 10. + Risk Factors  The Female Athlete Triad is a serious syndrome and is being seen more in women’s athletics. Health consequences are linked to each point of the triad. Eating disorders can also lead to medical complications involving the cardiovascular system, endocrine, reproductive, skeletal, gastrointestinal, renal, and central nervous system. Amenorrheic women are infertile due to the absence ovulation. This can also effect the skeletal muscle oxidative metabolism, low-density lipoprotein cholesterol levels, and muscle fatigue. Low bone mineral density can be a result of not enough nutrient intake which can lead to reoccurring stress fractures. Women with low bone mineral density increase their chances by four times as much.
  • 11. + Prevention  The best way to prevent the Female Athlete Triad from happening is by educating athletes, coaches, and parents on the subject. This will allow them to recognize it and take steps to prevent it.  As a coach:  Remind athletes that eating is an important part of successful training and performance.  Focus on a healthy body image, and NOT on weight.  Support athletes through training and everyday life  Have available resources such as nutritionists, trainers, or counselors.  As an athlete:  Monitor menstrual cycle by using a calendar.  Consult a physician if you have an irregular menstrual cycle and recurrent injuries like stress fractures.  Talk to a counselor if you are overly concerned about your body image.  See a sport nutritionist to help you design a healthy diet that is specific to your sport.  Seek emotional support from coaches, guardians, or teammates.
  • 12. + Sources  Thompson, S. (2007). Characteristics of the female athletic triad in collegiate cross-country runners. Journal Of American College Health, 56(2), 129-136. chart collegiate female athlete article  Doyle-Lucas, A. F., Akers, J. D., & Davy, B. M. (2010). Energetic Efficiency, Menstrual Irregularity, and Bone Mineral Density in Elite Professional Female Ballet Dancers. Journal Of Dance Medicine & Science, 14(4), 146-154.  Female Athlete Triad Coalition. Female Athlete Triad Organization, 2012. Web. 30 Sep 2012. <http://www.femaleathletetriad.org>.  Office of Dietary Supplement. National Institute of Health, June 24, 2011. Web. 30 Sep 2012. <http://ods.od.nih.gov/factsheets/VitaminD-QuickFacts/>.  Manore, Melinda. "The Female Athlete Triad: Nutrition and Eating." Sports Coach. National Institute of Health, June 24, 2011. Web. 30 Sep 2012.