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Low energy availability, menstrual dysfunction, and impaired bone health: A survey of elite para athletes
Author(s) -
Brook Emily M.,
Tenforde Adam S.,
Broad Elizabeth M.,
Matzkin Elizabeth G.,
Yang Heidi Y.,
Collins Jamie E.,
Blauwet Cheri A.
Publication year - 2019
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.13385
Subject(s) - female athlete triad , athletes , medicine , disordered eating , amenorrhea , stress fractures , physical therapy , population , elite athletes , clinical psychology , eating disorders , pregnancy , environmental health , biology , genetics
The Female Athlete Triad (Triad) is a syndrome describing three interrelated conditions: low energy availability (LEA), menstrual dysfunction, and low bone mineral density (BMD). Relative Energy Deficiency in Sport (RED‐S) expands the Triad to include multiple physiologic consequences of LEA in both sexes. The purpose of this study is to determine the prevalence of factors associated with the Triad/RED‐S in an elite para athlete population. Methods Athletes were U.S. elite para athletes training to qualify for the 2016 or the 2018 Paralympic Games. Participants completed an online questionnaire characterizing nutrition, menstrual status (in females), bone health, and awareness of the Triad/RED‐S. Results The athletes were 260 elite para athletes (150 male, 110 female). While few reported prior eating disorder (3.1%), 32.4% had elevated Eating Disorder Examination Questionnaire (EDE‐Q) pathologic behavior subscale scores. Most athletes (95 male, 65 female) were attempting to change their body composition or weight to improve performance. Forty‐four percent of premenopausal females had oligomenorrhea/amenorrhea. Bone stress injury was reported in 9.2% of athletes; of these, 54.5% (n = 12) had low BMD. Less than 10% of athletes reported awareness of the Triad/RED‐S. Conclusions Factors associated with the Triad/RED‐S are present in an elite para athlete population, regardless of sex or sport type. Awareness of the Triad/RED‐S in para athletes is low. The consequences of LEA in para athlete populations are poorly understood. However, the high prevalence of factors observed suggests value in advancing screening tools and education efforts to optimize health in this population.