Ultra-Marathon Athletes at Risk for the Female Athlete Triad

Abstract

BackgroundWorldwide female participation in ultra-endurance events may place them at risk for the female athlete triad (FAT). The study objectives were to establish triad knowledge, occurrence of disordered eating and triad risk amongst participants of the 2014 89-km Comrades Marathon event.MethodsA survey utilising the Low Energy Availability in Females questionnaire (LEAF-Q) and Female Athlete Screening Tool (FAST) questionnaire was conducted on female participants in order to determine the risk. In addition, seven questions pertaining to the triad were asked in order to determine the athlete’s knowledge of the triad. Athletes were requested to complete the anonymous questionnaire after written informed consent was obtained while waiting in the event registration queues. Statistical analyses included Pearson product–moment correlations, chi-square tests and cross-tabulations to evaluate associations of interest.ResultsKnowledge of the triad was poor with 92.5 % of participants having not heard of the triad before and most of those who had, gained their knowledge from school or university. Only three athletes were able to name all 3 components of the triad. Amenorrhoea was the most commonly recalled component while five participants were able to name the component of low bone mineral density. Of the 306 athletes included in the study, 44.1 % were found to be at risk for the female athlete triad. One-third of participants demonstrated disordered eating behaviours with nearly half reporting restrictive eating behaviours. There is a significant association between athletes at risk for the triad according to the LEAF-Q and those with disordered eating (χ2(1) = 8.411, p = 0.014) but no association (or interaction) between triad knowledge and category (at risk/not at risk) of LEAF-Q score (χ2(1) = 0.004, p = 0.949). More athletes in the groups with clinical and sub-clinical eating disorders are at risk for the triad than expected under the null hypothesis for no association.ConclusionsOnly 7.5 % of the female Comrades Marathon runners knew about the triad despite 44.1 % being at a high risk for the triad. Therefore, education and regular screening programmes targeting these athletes are overdue. Postmenopausal athletes are at particularly high risk for large losses in bone mass if they experience chronic energy deficiency and hence require special focus.

Could current factors be associated with retrospective sports injuries in Brazilian jiu-jitsu? A cross-sectional study

“…Moreover, female sex constituted another predictive factor for the occurrence of sports injuries in adolescent practitioners. Authors postulated that the female-athlete triad is the main factor responsible for the increased female susceptibility to sports injuries in comparison to male subjects [ 10 ]. This condition is characterized by increased physical fatigue associated with nutritional disorders, menstrual disturbances, and lower bone density.…”

“…In this context, possible associations among different characteristics and musculoskeletal injuries occurrence have been continuously reported in many sport modalities, such as track and field [ 10 ], volleyball [ 11 ], soccer [ 12 ], and judo [ 13 ]. However, regarding Brazilian jiu-jitsu, relationships among different external and internal features with respect to the injuries occurrence still need to be clarified.…”

Energy Availability in Athletics: Health, Performance, and Physique

“…The LEAF-Q validated in adult elite female endurance athletes, is constructed to identify physiological symptoms of LEA, and it is recommended to also include a validated DE questionnaire during screening (Melin et al, 2014). In a study combining the LEAF-Q with the Female Athlete Screening Tool (McNulty et al, 2001), 44.1% of long-distance runners were categorized being at risk while 32.0% had DE (Folscher et al, 2015). In addition, the International Olympic Committee developed the RED-S Clinical Assessment Tool to assist clinicians with the screening and return to play of athletes at risk (Mountjoy et al, 2015), although validation of the RED-S Clinical Assessment Tool is required.…”

Contribution of Hormonal Cytology in Girls and Adolescents to Reproductive Health: A Traditional Technique Monitoring Recent Problems

“…The main role of hormonal cytology has shifted from the questions of incipient pregnancy, an impending miscarriage or childbirth term [20,21] to vaginal health [22,23] , postmenopausal atrophy and its treatment [24][25][26][27][28][29][30] , tamoxifen breast cancer patient therapy and its safety [31,32], prolonged contraceptive use [33] , and adolescent disorders [34][35][36] . The latter represent the main work of the child gynecology outpatient department, which we diagnostically serve.…”