Girls' high school sports have come a long way since 1972, when the federal law known as Title IX prohibited sex discrimination in all public school programs, including sports teams. Since that year, girls' sports participation has increased tremendously, but female teen athletes face new pressures from coaches, parents, peers, teammates, and themselves. For girls who overtrain or attempt to lose weight to improve athletic performance, these practices may backfire, leading to eating disorders, menstrual irregularities, and low bone density, according to researchers at San Diego State University in California and Rocky Mountain University of Health Professions in Provo, Utah.
In southern California, 170 13- to 18-year-old girls at six high schools answered questions about their past and present periods (including when they started menstruating and the regularity of their periods) and eating behaviors. The girls noted whether they:
- were concerned about their weight or shape
- restricted calories or threw up after eating
- used laxatives or diuretics to lose weight
Two weeks to a month after completing the questionnaires, the girls underwent full-body scans to determine their body fat and muscle composition, and bone densities.
About 18% of the girls who completed questionnaires reported disordered eating behaviors, such as restrictive eating, eating a lot of calories in one sitting, or throwing up after eating. Also, almost a quarter of girls in the study had menstrual problems, such as irregular or absent periods, and about 22% of girls had low bone mineral density for their age. The study researchers discovered that teen girls who reported having irregular or absent periods were much more likely to restrict calories or foods, compared with teen athletes with regular periods. Teens with irregular or absent periods were also much more likely to have lower bone mineral densities.
If a female athlete has all three of these factors — disordered eating, menstrual irregularities, and low bone density — she may be diagnosed with female athlete triad. In this study, female athlete triad was relatively rare — only about 1% of the girls had all three components of the triad. However, almost 6% of the girls had two components. The study authors suggest that the high prevalence of disordered eating among female athletes is a concern because the sports-minded girls who have these behaviors could be prone to developing more serious health problems later in life, including eating disorders like anorexia and bulimia and fractures and osteoporosis due to weak bones.
What This Means to You
According to this study, disordered eating habits, menstrual irregularities, and low bone density are prevalent among athletes on girls' high school sports teams. If your daughter participates in high school sports, you may want to discuss her diet with a doctor or registered dietitian to make sure she's getting enough calories for growth and bone mass development. If your daughter reports any irregular or absent periods, have her talk to the doctor or a gynecologist. And if you believe she might be secretly cutting back on calories, purging after meals, or using laxatives or diet pills, talk to her doctor or a mental health professional who specializes in eating disorders.
Source: Jeanne F. Nichols, PhD; Mitchell J. Rauh, PhD, PT, MPH; Mandra J. Lawson, MS, RD; Ming Ji, PhD; Hava-Shoshana Barkai, MS; Archives of Pediatrics and Adolescent Medicine, February 2006.
Reviewed by: Steven Dowshen, MD
Date reviewed: March 2006