title: Effects of an energy balance educational intervention and the COPE cognitive behavioral therapy intervention for Division I U.S. Air Force Academy female athletes.
abstract: OBJECTIVE
  Female athletes struggle harder than male athletes to lose body fat and maintain a leaner physique. The purpose of this study was to determine the effects of an educational and cognitive behavioral therapy (CBT)-based intervention on knowledge, body composition, anxiety, stress, and nutritional intake.
  
  
  METHODS
  A randomized controlled trial was conducted with 153 female athletes from the U.S. Air Force Academy (USAFA). Participants were assigned to one of three groups: (a) a combined energy balance and CBT-based intervention (E1); (b) a CBT-based intervention alone (E2); and (c) a control group (C). Main outcomes included a DXA scan for body composition, a knowledge test, the GAD-7 for anxiety, the brief inventory of perceived stress (BIPS) for stress, and a 24-h food recall.
  
  
  RESULTS
  Significant improvement on knowledge of energy balance occurred in all three groups E1 (p < .001), E2, and C (p < .05). Significant reductions in percentage of body fat occurred in E1 (p < .001) and E2 (p < .05). There also were significant reductions in the percent of fat consumed by E1 (p < .05) and saturated fat consumed by both E1 and E2 (p < .05). The control group only demonstrated a significant increase in stress as measured by the BIPS (p < .05).
  
  
  CONCLUSIONS
  A combined energy balance and CBT-based intervention improves knowledge and body fat.
  
  
  CONCLUSIONS
  The importance to assess knowledge, anxiety, stress, nutrition intake, and percentage of body fat in female athletes and to deliver evidence-based interventions to improve their health outcomes.
authors.affiliation: The Office of the Chief Wellness Officer, College of Nursing, The Ohio State University, Columbus, Ohio.
authors.forename: Brenda C
authors.initials: BC
authors.lastname: Buffington
authors.affiliation: Department of Pediatrics & Psychiatry, College of Nursing, The Ohio State University, Columbus, Ohio.
authors.forename: Bernadette M
authors.initials: BM
authors.lastname: Melnyk
authors.affiliation: United States Air Force Academy, Colorado.
authors.forename: Shelly
authors.initials: S
authors.lastname: Morales
authors.affiliation: CWPX, Colorado.
authors.forename: Amanda
authors.initials: A
authors.lastname: Lords
authors.affiliation: Human Performance Laboratory, United States Air Force Academy, Colorado.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Zupan
mesh_terms: D000328:Adult; D056352:Athletes; D015928:Cognitive Behavioral Therapy / Q000379:methods* / Q000592:standards; D005260:Female; D006266:Health Education / Q000379:methods* / Q000592:standards; D006801:Humans; D008889:Military Personnel / Q000523:psychology; D064133:Sports Nutritional Physiological Phenomena
keywords: Young adult women; cognitive behavioral therapy (CBT); stress; stress and coping; student health; weight management; women's health