title: Associations between disordered eating, menstrual dysfunction, and musculoskeletal injury among high school athletes.
abstract: METHODS
  Retrospective cohort study.
  
  
  OBJECTIVE
  To determine the prevalence of, and association between, disordered eating (DE), menstrual dysfunction (MD), and musculoskeletal injury (MI) among high school female athletes.
  
  
  BACKGROUND
  Female athlete triad (Triad) syndrome is the interrelatedness of DE, MD, and low bone mass. Few studies have examined 2 or more Triad components simultaneously, or their relationship to injury, among female high school athletes.
  
  
  METHODS
  The subject sample consisted of 311 female high school athletes competing on 33 interscholastic high school teams during the 2006-2007 school year. Athletes completed the Eating Disorder Examination Questionnaire (EDE-Q) and Healthy Wisconsin High School Female Athletes Survey (HWHSFAS). Athletes were classified by sport type as aesthetic (AES), endurance (END), or team/anaerobic (T/A).
  
  
  RESULTS
  Of those surveyed, 35.4% reported DE, 18.8% reported MD, and 65.6% reported sustaining a sports-related musculoskeletal injury during the current sports season. Athletes reporting DE were twice as likely to be injured compared to those reporting normal eating behaviors (odds ratio [OR], 2.3; 95% confidence interval [CI]: 1.4, 4.0). Multivariate logistic regression analyses revealed that athletes who reported a history of DE (OR, 2.1; 95% CI: 1.1, 3.9) or prior injury (OR, 5.1; 95% CI: 2.9, 8.9) were more likely to be injured during the sports season.
  
  
  CONCLUSIONS
  A high prevalence of DE and MD exists among high school female athletes. Additionally, athletes with DE were over 2 times more likely to sustain a sports-related injury during a sports season. Screening and intervention programs designed to identify and decrease the prevalence of DE should be implemented with high school females.
  
  
  METHODS
  Prognosis, level 2b.
authors.affiliation: University of Wisconsin School of Medicine and Public Health, Madison, WI 53706, USA. thein@pt.wisc.edu
authors.forename: Jill M
authors.initials: JM
authors.lastname: Thein-Nissenbaum
authors.forename: Mitchell J
authors.initials: MJ
authors.lastname: Rauh
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Carr
authors.forename: Keith J
authors.initials: KJ
authors.lastname: Loud
authors.forename: Timothy A
authors.initials: TA
authors.lastname: McGuine
mesh_terms: D000293:Adolescent; D056352:Athletes / Q000706:statistics & numerical data*; D001265:Athletic Injuries / Q000453:epidemiology*; D015331:Cohort Studies; D001068:Feeding and Eating Disorders / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008599:Menstruation Disturbances / Q000453:epidemiology*; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014922:Wisconsin / Q000453:epidemiology