Prevalence of the female athlete triad syndrome among high school athletes.
OBJECTIVE
To estimate the prevalence of the female athlete triad (disordered eating, menstrual irregularity, and low bone mass) among high school athletes.


METHODS
Observational cross-sectional study.


METHODS
High school.


METHODS
Female athletes (n= 170) representing 8 sports were recruited from 6 high schools in southern California.


METHODS
Disordered eating and menstrual status were determined by interviewer-assisted questionnaires. Bone mineral density was measured by dual-energy x-ray absorptiometry of the hip, spine (L1-L4), and total body.


RESULTS
Among all athletes, 18.2%, 23.5%, and 21.8% met the criteria for disordered eating, menstrual irregularity, and low bone mass, respectively. Ten girls (5.9%) met criteria for 2 components of the triad, and 2 girls (1.2%) met criteria for all 3 components. Oligomenorrheic/amenorrheic athletes had higher mean +/- SD eating restraint (1.55 +/- 1.60 vs 1.04 +/- 1.27; P = .02) and Eating Disorder Examination Questionnaire global scores (1.68 +/- 1.20 vs 1.33 +/- 1.14; P = .03) than eumenorrheic athletes. After controlling for age, age at menarche, body mass index, race/ethnicity, and sport type, athletes with oligomenorrhea/amenorrhea had significantly lower mean +/- SD bone mineral densities for the trochanter (0.884 +/- 0.090 g . cm(-2)) than eumenorrheic athletes (0.933 +/- 0.130 g . cm(-2); P = .04).


CONCLUSIONS
The prevalence of the full female athlete triad was low in our sample; however, a substantial percentage of the athletes may be at risk for long-term health consequences associated with disordered eating, menstrual irregularity, or low bone mass. Preparticipation screening to identify these components should be encouraged as a preventive approach to identify high-risk athletes.
Nichols
Jeanne F
JF
Department of Exercise and Nutritional Sciences and Graduate School of Public Health, San Diego State University, San Diego, CA 92182, USA. jeannebernhard@cox.net
Rauh
Mitchell J
MJ
Lawson
Mandra J
MJ
Ji
Ming
M
Barkai
Hava-Shoshana
HS
D000293:Adolescent; D015519:Bone Density; D001847:Bone Diseases / Q000453:epidemiology; D003430:Cross-Sectional Studies; D001068:Feeding and Eating Disorders / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008599:Menstruation Disturbances / Q000453:epidemiology*; D015995:Prevalence; D013177:Sports; D013577:Syndrome