A diet can be beneficial to any person trying to develop a healthy lifestyle, while an athlete’s diet is essentially important to gain muscle strength and energy for the field of competition.

For the female athlete the stress of a positive self image can sometimes conflict with the need for muscle strength and energy on the athletic field, thus leading to disordered eating and having long-term effects.

Disordered eating is becoming more common in female high school athletes, according to the American Athletic Trainers Association.

Tina Bonci, Director of Sports Medicine and Athletic Training at the University of Texas in Austin, said proper dieting among female athletes is a challenge to athletic trainers and coaches because of self image and concerns.

“A lot of times the diets are poor and there are athletes training with negative energy,” Bonci said. “If an athlete continues without a proper diet and is not taking in the proper carbohydrates and proteins, disordered eating can develop.”

Disordered eating is one component of a condition recognized by the American College of Sports Medicine in 1993 as the Female Athlete Triad.

The Female Athlete Triad is made up of Amenorrhea, also known as the absence of menstrual bleeding, disordered eating and osteoporosis.

Dr. Boone Barrow, who specializes in sports medicine at the Scott and White Clinic in College Station, has published articles in medical periodicals on the subject of the Female Athlete Triad.

Barrow said that the disordered eating effects an estimated 62 percent of the female athletic population, with anorexia and bulimia effecting four to 39 percent of female athletes.

In a phone interview, Barrow said that disordered eating is part of a self-image problem and an athlete not being able to balance what their body needs and maintaining a healthy intake of needed nutrients.

“Sometimes athletes almost make deals with themselves like, ‘I’ll eat a half of a cookie and just run an extra mile tomorrow’,” Barrow said. “Some will even adopt restrictive diets by becoming vegetarian or vegan.”

Bonci said while diets are normal, a controlled diet for weight loss among athletes could lead to more serious eating problems.

“Meloadaptive eating problems can lead to more serious problems such as anorexia and bulimia,” Bonci said. “In young athletes there is more of a risk because excessive dieting can trigger these problems.”

A concern both Bonci and Barrow stated was the trouble of recognizing when there is a problem with disordered eating.

Bonci said that coaches and parents should educate themselves of the four signs of an eating disorder and look for behaviors such as preoccupation with weight loss, controlled calorie intake, use of diet pills, binging and excessive exercise that is not part of an athletes normal exercise program.

“There is a factor of fear, shame and denial that leads to most athletes with a problem not reporting it,” Bonci said. “Sometimes even coaches will not admit a problem with an athlete if the athlete is performing well because they don’t want to lose that athlete.”

Barrow said that while detecting the problem early is essential, confrontation could lead to more secrecy and denial of the issue.

“You should not confront anyone you suspect of having an eating disorder,” Barrow said. “It’s best to look out for the signs and letting trainers handle it.”

Disordered eating is linked to the other components of the Female Athlete Triad, according to several reports issued about the subject.

Bonci said if one component is recognized then there should be a high index of suspicion of the development of other components.

“Disordered eating can lead into Amenorrhea and then later on osteoporosis,” she said. “Sometimes Amenorrhea is not evaluated properly and goes unrecognized.”

Amenorrhea is the absence or loss of a woman’s menstrual cycle over a period of time.

There are two types of Amenorrhea — primary and secondary.

Primary Amenorrhea, which is more common in young athletes according to Barrow, is the absence of menstrual bleeding and the development of secondary sexual characteristics by the age of 14.

Secondary Amenorrhea is the absence of a menstrual period in a woman who has been regular for a period of three months or more in the absence of pregnancy, lactation or cycle suppression due to birth control pills or menopause.

Barrow said Amenorrhea can lead to the loss of bone density and it puts athletes at the risk for premature osteoporosis.

“We are finding that there is a strong link between female hormones and bone densities,” Barrow said. “Sometimes this goes unrecognized because a females’ periods will stop and they think, ‘well its basketball season so I won’t have my period’. More than likely that is not the case.”

Barrow said that early detection is necessary due to the severeness of the problem.

Brown University Health Services issued a report that said Amenorrhea can directly effect bone density loss and make athletes susceptible to reoccurring stress fractures and broken bones.

Doctor Anne Zeni Hoch, of the Medical College of Wisconsin, said in a report published on the school’s Web site that one-fourth of all high school and college female athletes may have abnormal menstrual cycles with high rates being in runners.

While all three components are an issue athletic trainers and doctors are dealing with, Bonci said that the real challenge is that people are not educated enough of the triad.

In a survey of 50 randomly selected female high school athletes in the area done by the Palestine Herald-Press, all 50 said they had no knowledge of the Female Athlete Triad.

While the results are not surprising to Bonci, they are alarming.

“That’s the real challenge is people are not aware of the issue and the severity of the condition that it can cause serious health problems later on including death,” Bonci said. “The sad thing is coaches and trainers don’t have the education of this condition either.

“This needs to be discussed early on when kids are starting to get involved in sports because the risk factor is high for prepubescent females while going through those changes.”

More information about the Female Athlete Triad is available on the Internet. Google searches returned 123,00 articles on the Female Athlete Triad and over one million articles on each individual condition.


Michael S. Adams may be contacted via e-mail at sports2@palestineherald.com

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