Risk of female athlete triad development in Japanese collegiate athletes is related to sport type and competitive level

Sawai, Akemi; Mathis, Bryan J.; Natsui, Hiroaki; Zaboronok, Alexander; Mitsuhashi, Risa; Warashina, Yuki; Mesaki, Noboru; Shiraki, Hitoshi; Watanabe, Koichi

doi:10.2147/ijwh.s175446

Cited by 10 publications

(10 citation statements)

References 40 publications

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“…Two questions were used to determine LEA risk in female Japanese collegiate athletes ( n = 531] [ 33 ]. LEA risk was identified when participants answered that they usually consume meals less than twice per day, and frequently lose weight intentionally – 2.7% athletes were identified to be at risk [ 33 ]. The advantage of the approach is that the two items are easy to understand and answer.…”

Section: Resultsmentioning

confidence: 99%

Review: questionnaires as measures for low energy availability (LEA) and relative energy deficiency in sport (RED-S) in athletes

Sim

Burns

2021

J Eat Disord

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Background A sustained mismatch between energy intake and exercise energy expenditure (EEE) can lead to Low Energy Availability (LEA), health and performance impairments characteristic of Relative Energy Deficiency in Sport (RED-S). Questionnaires can conveniently identify symptoms and/or LEA/ RED-S risk factors. This study aimed to systematically identify, and critique questionnaires used or developed to measure LEA/ RED-S risk in athletic populations. Methods A systematic search was conducted using PubMed database. Full text articles were included if: (i) the questionnaire(s) in the study identified LEA and/or RED-S risk; (ii) studies developed questionnaires to identify LEA and/or RED-S risk; (iii) participants belonged to athletic population(s); and (iv) in English. Results Thirty-three articles met the inclusion criteria and were reviewed, 13 questionnaires were identified. Eight questionnaires had undergone validation procedures, and three questionnaires included questions related to EEE. The most widely used validated questionnaires were Low Energy Availability in Females Questionnaire (LEAF-Q) (48% articles) and Eating Disorder Examination Questionnaire (EDE-Q) (12% articles). The LEAF-Q determines LEA risk from symptoms but cannot be used in males as nearly half of the items (n = 12) relate to menstrual function. The EDE-Q serves as a surrogate marker of LEA risk in both sexes, as it measures a major risk factor of LEA, disordered eating. Better validation is needed for many questionnaires and more are needed to address LEA/RED-S risk in male athletes. Conclusion These questionnaires may be effective in identifying intentional energy restriction but less valuable in identifying inadvertently failure to increase energy intake with increased EEE.

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Section: Resultsmentioning

confidence: 99%

Review: questionnaires as measures for low energy availability (LEA) and relative energy deficiency in sport (RED-S) in athletes

Sim

Burns

2021

J Eat Disord

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“…18 Furthermore, sport intensity has been positively correlated with components of the female athlete triad and, thus, athletes in high-training-volume sports are at greater risk. 19 Rowing at the collegiate level is a physically demanding sport that requires high training volumes for much of the year. To the best of our knowledge, we are the first to explore risk factors and symptoms of the female athlete triad in collegiate rowers.…”

Section: Female Athlete Triad Componentsmentioning

confidence: 99%

Exploring Health Demographics of Female Collegiate Rowers

Walsh

Crowell

Merenstein

2020

Journal of Athletic Training

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Context Limited information exists about health patterns among female rowers at the collegiate level. Furthermore, the element of weight class (lightweights classified as <130 lb [59 kg]) as a factor in the physical and mental health of female collegiate athletes has not been investigated, despite weight requirements in sport being a risk factor for the female athlete triad. Objective To test the hypotheses that (1) components of the female athlete triad were more prevalent in lightweight than in openweight rowers; (2) perceived stress levels were greater in lightweight than in openweight rowers; and (3) rowers who were unable to row due to injury had greater perceived stress levels than uninjured athletes. Design Cross-sectional study. Setting Twelve collegiate women's rowing programs consisting of 6 National Collegiate Athletic Association Division I openweight and 6 Intercollegiate Rowing Association–level lightweight teams. Patients or Other Participants A total of 158 female collegiate rowers (78 lightweight, 80 openweight). Main Outcome Measure(s) An electronic survey addressing injury history, diet and eating habits and body image (according to the triad screening questionnaire), stress levels (Perceived Stress Scale), and athlete identity (Athlete Identity Measurement Scale) was administered. Results Lightweight rowers reported limiting or carefully controlling foods more frequently than openweight rowers (41.9% to 29.9%, P = .013). A history of an eating disorder was more prevalent among lightweight than openweight rowers (25.7% to 13.0%, P = .048). Prevalences of stress fractures and menstrual irregularities did not differ between weight classes. Lightweight and openweight rowers' scores on the Perceived Stress Scale (16.0 ± 9.9 and 17.3 ± 6.4, respectively) were not different. Injured rowers scored higher on the Perceived Stress Scale (19.4 ± 7.2) than did uninjured rowers (16.6 ± 5.72). Conclusions Weight class did not contribute to differences in the prevalence of female athlete triad components or perceived stress, although lightweight rowers were more likely to have a history of eating disorder. Injury may be a risk factor for increased stress in this population.

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“…MI is common among athletes and is part of the Triad. The prevalence of MI varies widely, ranging from 19.7% to 49% in high‐school and collegiate athletes 29‐33 . It has been linked to an increased risk of musculoskeletal injury 30,34 .…”

Section: Discussionmentioning

confidence: 99%

Menstrual Irregularity, Hormonal Contraceptive Use, and Bone Stress Injuries in Collegiate Female Athletes in the United States

Cheng

Santiago

Abutalib

et al. 2021

PM&R

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Background Menstrual irregularity (MI) is common in female athletes and is a component of the Female Athlete Triad (Triad). Many athletes with the Triad are started on hormonal contraceptives (HC) for MI, but this interferes with the ability to monitor menstrual cycle regularity and can mask other causes of MI. There are limited studies investigating the relationship between MI, HC use, and injury in female collegiate athletes. Objective To examine the prevalence of and relationship between HC use, MI, and bone stress injuries in female collegiate athletes in the United States. Design Cross‐sectional study. Setting Online survey. Participants 1020 U.S. female collegiate athletes (age ≥ 18 years). Methods or Interventions Assessment of risk factors for menstrual irregularity and bone stress injuries was conducted via a one‐time survey. Main Outcome Measures HC use, MI, history of stress fractures. Results Current HC use prevalence was 65% (95% confidence interval [CI], 61.9%, 67.8%). Of all athletes, 47% reported past MI. Of the athletes who were not currently using HCs, 32% had current MI. Compared with athletes without past MI, more athletes with past MI reported current HC use (73% vs. 57%) and indicated menstrual cycle consistency as the primary reason for use (24% vs. 4%) (P < .001). Additionally, 25% of athletes reported a history of stress fractures, which was associated with lean/aesthetic sports participation (odds ratio [95% CI]: 1.9 [1.4, 2.5]; P < .001) and less oral contraceptive pill (OCP) use (0.7 [0.5, 1.0]; P = .043). Compared with OCPs, injectable HCs were associated with greater odds of a history of stress fractures (4.5[1.6, 12.3]; P = .004). Conclusions HC use was prevalent among this cohort of female collegiate athletes, and almost half of the athletes reported past MI. A goal of menstrual cycle regularity was cited by 24% of athletes as a primary reason to use HCs, which shows that more athlete education is needed to avoid masking MI and the Triad with HCs. Further studies elucidating the relationship between HC use, MI, and sports‐related injury are warranted.

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Risk of female athlete triad development in Japanese collegiate athletes is related to sport type and competitive level

Cited by 10 publications

References 40 publications

Review: questionnaires as measures for low energy availability (LEA) and relative energy deficiency in sport (RED-S) in athletes

Review: questionnaires as measures for low energy availability (LEA) and relative energy deficiency in sport (RED-S) in athletes

Exploring Health Demographics of Female Collegiate Rowers

Menstrual Irregularity, Hormonal Contraceptive Use, and Bone Stress Injuries in Collegiate Female Athletes in the United States

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