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Energy availability and the female athlete triad in elite endurance athletes
Author(s) -
Melin A.,
Tornberg Å. B,
Skouby S.,
Møller S. S.,
SundgotBorgen J.,
Faber J.,
Sidelmann J. J.,
Aziz M.,
Sjödin A.
Publication year - 2015
Publication title -
scandinavian journal of medicine and science in sports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.575
H-Index - 115
eISSN - 1600-0838
pISSN - 0905-7188
DOI - 10.1111/sms.12261
Subject(s) - female athlete triad , medicine , basal metabolic rate , athletes , body mass index , disordered eating , endocrinology , physical therapy , eating disorders , psychiatry
The female athlete triad ( T riad), links low energy availability ( EA ), with menstrual dysfunction ( MD ), and impaired bone health. The aims of this study were to examine associations between EA / MD and energy metabolism and the prevalence of T riad‐associated conditions in endurance athletes. Forty women [26.2 ± 5.5 years, body mass index ( BMI ) 20.6 ± 2.0 kg/m 2 , body fat 20.0 ± 3.0%], exercising 11.4 ± 4.5 h/week, were recruited from national teams and competitive clubs. Protocol included gynecological examination; assessment of bone health; indirect respiratory calorimetry; diet and exercise measured 7 days to assess EA ; eating disorder ( ED ) examination; blood analysis. Subjects with low/reduced EA (< 45 kcal/kg FFM/day), had lower resting metabolic rate ( RMR ) compared with those with optimal EA [28.4 ± 2.0 kcal/kg fat‐free mass ( FFM )/day vs 30.5 ± 2.2 kcal/kg FFM /day, P  < 0.01], as did subjects with MD compared with eumenorrheic subjects (28.6 ± 2.4 kcal/kg FFM /day vs 30.2 ± 1.8 kcal/kg FFM /day, P  < 0.05). 63% had low/reduced EA , 25% ED , 60% MD , 45% impaired bone health, and 23% had all three Triad conditions. 53% had low RMR , 25% hypercholesterolemia, and 38% hypoglycemia. Conclusively, athletes with low/reduced EA and/or MD had lowered RMR . T riad‐associated conditions were common in this group of athletes, despite a normal BMI range. The high prevalence of ED , MD , and impaired bone health emphasizes the importance of prevention, early detection, and treatment of energy deficiency.

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