Body Mass-Related Predictors of the Female Athlete Triad Among Adolescent Athletes

Abstract

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.

The Impact of Nutritional Intervention on Menstrual Dysfunction in Female Athletes: a Systematic Review

“…Additionally, the endurance athletes in the study by Cialdella-Kam et al]/Guebels et al [20,21], who all resumed menses, had an average weight gain of 1.64 kg. These findings support the work of Thralls et al [14] who, in studying predictors of the triad in adolescent athletes, reported that those at less than 85% of their ideal body weight were four times more likely to report menstrual dysfunction. These results support the suggestion that nutritional interventions should likely aim to not only increase EA which might not be sustained over a prolonged period of time, but also to allow for controlled weight gain.…”

“…Regardless of whether the triad or RED-S is used to describe this spectrum of health problems, energy deficit can clearly be a problem in athletes and can be related to menstrual dysfunction. In a study of high school female athletes, 70% of whom were endurance runners, 30% experienced menstrual dysfunction [14]. Those that were at less than 85% of their ideal body weight or had a low body mass index (BMI) (less than 18.5 kg/m 2 ) were four times as likely to report menstrual dysfunction [14].…”

“…In a study of high school female athletes, 70% of whom were endurance runners, 30% experienced menstrual dysfunction [14]. Those that were at less than 85% of their ideal body weight or had a low body mass index (BMI) (less than 18.5 kg/m 2 ) were four times as likely to report menstrual dysfunction [14]. Several theories exist regarding the relationship between energy availability and menstrual dysfunction [7,15]; however, it is beyond the focus of this systematic review to discuss these mechanisms.…”

Evidence of a cumulative effect for risk factors predicting low bone mass among male adolescent athletes

“…Low body weight may also occur as a result of chronic LEA and serves as a key factor in the diagnosis of anorexia nervosa. Prior studies document low body weight as a predictor of low bone mass in samples of active girls and women,8 and female adolescent athletes 30…”

Effect of type of sport, weekly physical exertion and body mass index on values of bone turnover markers in elite female athletes

“…Do sličnog rezultata je došla i nedavna studija Ambroszkiewicz-a i saradnika [33] kojom je utvrđeno da eumenoreične djevojke adolescentne dobi koje imaju manji BMI imaju veće vrijednosti markera razgradnje kosti CTX, a manje vrijednosti osteokalcina. Slične tvrdnje je pokazala i nedavna studija Thralls-a i saradnika [34] u kojoj su potvrdili da smanjene vrijednosti opštih antropometrijskih indeksa (BMI I IBW) mogu biti prediktori smanjene vrijednosti BMD kod aktivnih sportistkinja. Ovakvi nalazi idu u prilog našoj tvrdnji, iako se u navedenoj studiji radilo o fizički neaktivnim djevojkama.…”