title: Adolescent elite Kenyan runners are at risk for energy deficiency, menstrual dysfunction and disordered eating.
abstract: Limited data are available on the female athlete triad (Triad) in athletes from minority groups. We explored subclinical and clinical Triad components amongst adolescent elite Kenyan athletes (n = 61) and non-athletes (n = 49). Participants completed demographic, health, sport and menstrual history questionnaires as well as a 5-day weighed dietary record and exercise log to calculate energy availability (EA). Ultrasound assessed calcaneus bone mineral density (BMD). Eating Disorder Inventory subscales and the Three-Factor Eating Questionnaire's cognitive dietary restraint subscale measured disordered eating (DE). EA was lower in athletes than non-athletes (36.5 ± 4.5 vs. 39.5 ± 5.7 kcal ∙ kg FFM(-1) ∙ d(-1), P = 0.003). More athletes were identified with clinical low EA (17.9% vs. 2.2%, OR = 9.5, 95% CI 1.17-77, P = 0.021) and clinical menstrual dysfunction (32.7% vs. 18.3%, χ(2) = 7.1, P = 0.02). Subclinical (75.4% vs. 71.4%) and clinical DE (4.9% vs. 10.2%, P = 0.56) as well as BMD were similar between athletes and non-athletes. More athletes had two Triad components than non-athletes (8.9% vs. 0%, OR = 0.6, 95% CI 0.5-6.9, P = 0.05). Kenyan adolescent participants presented with one or more subclinical and/or clinical Triad component. It is essential that athletes and their entourage be educated on their energy needs including health and performance consequences of an energy deficiency.
authors.affiliation: a Department of Food, Nutrition and Dietetics, School of Applied Human Sciences , Kenyatta University , Nairobi , Kenya.
authors.forename: Esther N
authors.initials: EN
authors.lastname: Muia
authors.affiliation: b Centre of Excellence in Nutrition , North-west University , Potchefstroom , South Africa.|c School of Health and Sport Sciences, Faculty of Health Science , University of the Sunshine Coast , Sippy Downs , Queensland , Australia.
authors.forename: Hattie H
authors.initials: HH
authors.lastname: Wright
authors.affiliation: d Department of Recreation Management and Exercise Science , School of Applied Human Sciences, Kenyatta University , Nairobi , Kenya.
authors.forename: Vincent O
authors.initials: VO
authors.lastname: Onywera
authors.affiliation: a Department of Food, Nutrition and Dietetics, School of Applied Human Sciences , Kenyatta University , Nairobi , Kenya.
authors.forename: Elizabeth N
authors.initials: EN
authors.lastname: Kuria
mesh_terms: D000293:Adolescent; D001823:Body Composition; D015519:Bone Density; D004032:Diet; D004435:Eating; D001068:Feeding and Eating Disorders / Q000453:epidemiology / Q000208:ethnology*; D005260:Female; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008599:Menstruation Disturbances / Q000453:epidemiology / Q000208:ethnology*; D015995:Prevalence; D012307:Risk Factors; D012420:Running / Q000502:physiology*; D011795:Surveys and Questionnaires
keywords: bone mineral density; energy availability; menstrual function; young athlete