2 The prevalence of musculoskeletal injuries, menstrual irregularity and disordered eating in junior elite athletics in the UK

2021 ◽  
Vol 55 (16) ◽  
pp. 940.2-941
Author(s):  
J Wilkinson ◽  
L Mayhew

The prevalence of injury in adolescent elite track and field competitors is high,1 however only one study has been conducted with UK athletes.2 Relative Energy Deficiency in Sport (RED-S), encapsulating the Female Athlete Triad, is a syndrome whereby decreased energy availability affects health and performance, potentially leading to an increased injury risk; particularly to bone (3). Calculating decreased energy availability is difficult, however identifying contributing factors, such as disordered eating and menstrual dysfunction, is more viable.3AimThis study was conducted to identify the prevalence of musculoskeletal injury, disordered eating and menstrual dysfunction in elite junior UK track and field athletes.MethodData was collected from track and field athletes ranked within the top 10 of the UK U17 rankings in 2017 or 2018, with 138 athletes participating. Participants completed a self-reported musculoskeletal injury, disordered eating and menstrual dysfunction questionnaire relating to a 12-month time period.ResultsThis study found a 12-month retrospective injury prevalence of 43.5%. 13% of participants presented with disordered eating, whilst 37.7% of female participants presented with menstrual dysfunction. There was a statistically significant difference in injury prevalence according to gender, with more male athletes sustaining an injury compared with female athletes. No differences in injury prevalence were noted according to event group, menstrual dysfunction or disordered eating. The anatomical location displaying the highest prevalence of injury was the ankle and foot (22.5%). The anatomical structure displaying the highest 12-month injury prevalence was muscle (43.6%), followed by bone (30.9%). Additionally, 21.7% of respondents reported having previously sustained a stress fracture prior to taking part in this study.ConclusionThere is a high prevalence of injuries in junior UK track and field athletes, with most injuries affecting the lower limb. Although there was no difference noted in injury risk for athletes with menstrual dysfunction or disordered eating, the prevalence of bone injuries was alarmingly high. This study indicates the requirement for future research investigating RED-S within this population.ReferenceZemper, E. Track andField Injuries. In: Caine DJ, Maffulli N. (eds). Epidemiology of Pediatric Sports Injuries. Individual Sports. Med Sport Science: Volume 48. Basel, Karger; 2005. p. 138–151D’Souza D. Track and field athletics injuries - a one-year survey. British Journal of Sports Medicine 1994; 28 (3): 197–202.Mountjoy M, Sundgot-Borgen J, Burke L, et al. The IOC consensus statement: beyond the Female Athlete Triad—Relative Energy Deficiency in Sport (RED-S). British Journal of Sports Medicine 2014; 48: 491–497.

2019 ◽  
Vol 29 (6) ◽  
pp. 569-575 ◽  
Author(s):  
Bryan Holtzman ◽  
Adam S. Tenforde ◽  
Allyson L. Parziale ◽  
Kathryn E. Ackerman

This study’s objective was to identify differences in risk for low energy availability and athletic clearance level by comparing scores on Female Athlete Triad Cumulative Risk Assessment (Triad CRA) and Relative Energy Deficiency in Sport Clinical Assessment Tool (RED-S CAT). A total of 1,000 female athletes aged 15–30 years participating in ≥4 hr of physical activity/week for the previous ≥6 months completed an extensive survey assessing health, athletic history, family disease history, and specific Triad/RED-S risk factors. Retrospective chart review ascertained laboratory and bone mineral density measures. Triad CRA and RED-S CAT were used to assign each athlete’s risk level (low, moderate, and high), and case-by-case comparison measured the level of agreement between the tools. We hypothesized that the tools would generally agree on low-risk athletes and that the tools would be less aligned in the specific elevated risk level (moderate or high). Most of the sample was assigned moderate or high risk for Triad CRA and RED-S CAT (Triad: 54.7% moderate and 7.9% high; RED-S: 63.2% moderate and 33.0% high). The tools agreed on risk for 55.5% of athletes. Agreement increased to 64.3% when only athletes with bone mineral density measurements were considered. In conclusion, Triad CRA and RED-S CAT provide consensus on the majority of athletes at elevated (moderate or high) risk for low energy availability, but have less agreement on the specific risk level assigned.


Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 979
Author(s):  
Kelly Pritchett ◽  
Alicia DiFolco ◽  
Savannah Glasgow ◽  
Robert Pritchett ◽  
Katy Williams ◽  
...  

(1) Background: The purpose of this study was to examine the symptoms of low energy availability (LEA) and risk of relative energy deficiency in sport (RED-S) symptoms in para-athletes using a multi-parameter approach. (2) Methods: National level para-athletes (n = 9 males, n = 9 females) completed 7-day food and activity logs to quantify energy availability (EA), the LEA in Females Questionnaire (LEAF-Q), dual energy X-ray absorptiometry (DXA) scans to assess bone mineral density (BMD), and hormonal blood spot testing. (3) Results: Based on EA calculations, no athlete was at risk for LEA (females < 30 kcal·kg−1 FFM·day−1; and males < 25 kcal·kg−1 FFM·day−1; thresholds for able-bodied (AB) subjects). Overall, 78% of females were “at risk” for LEA using the LEAF-Q, and 67% reported birth control use, with three of these participants reporting menstrual dysfunction. BMD was clinically low in the hip (<−2 z-score) for 56% of female and 25% of male athletes (4) Conclusions: Based on calculated EA, the risk for RED-S appears to be low, but hormonal outcomes suggest that RED-S risk is high in this para-athlete population. This considerable discrepancy in various EA and RED-S assessment tools suggests the need for further investigation to determine the true prevalence of RED-S in para-athlete populations.


Author(s):  
Braeden T. Charlton ◽  
Sara Forsyth ◽  
David C. Clarke

The Female Athlete Triad (Triad) and the more encompassing Relative Energy Deficiency in Sport (RED-S) are disorders caused by low energy availability (LEA). LEA is a state of insufficient energy intake by an athlete relative to their energy expenditure. Persistent LEA results in the deleterious consequences to health and performance that comprise RED-S. With respect to both the Triad and RED-S, researchers have called for more education of those involved with sport, particularly coaches, to help reduce the incidence of these disorders. Recent studies have shown that as few as 15% of coaches are aware of the Triad, with up to 89% unable to identify even one of its symptoms. RED-S is a more recently established concept such that coach knowledge regarding it has only begun to be assessed, but the results of these initial studies indicate similar trends as for the Triad. In this review, we synthesize research findings from 1986 to 2021 that pertains to LEA and RED-S, which coaches should know so they can better guide their athletes.


Author(s):  
Alexandra Ruivo Coelho ◽  
Gonçalo Cardoso ◽  
Marta Espanhol Brito ◽  
Inês Neves Gomes ◽  
Maria João Cascais

AbstractIn a healthy athlete, the caloric intake is sufficient for sports energy needs and body physiological functions, allowing a balance between energy availability, bone metabolism, and menstrual cycle. On the other hand, an imbalance caused by low energy availability due to a restrictive diet, eating disorders or long periods of energy expenditure leads to multisystemic deregulation favoring the essential functions of the body. This phenomenon, described as the female athlete triad, occurs in a considerable percentage of high-performance athletes, with harmful consequences for their future. The present review was carried out based on a critical analysis of the most recent publications available and aims to provide a global perception of the topic relative energy deficit in sport (RED-S). The objective is to promote the acquisition of more consolidated knowledge on an undervalued theme, enabling the acquisition of preventive strategies, early diagnosis and/or appropriate treatment.


2018 ◽  
pp. 288-301
Author(s):  
Jennifer L. Carlson ◽  
Katherine B. Hill

In 2007, the female athlete triad was redefined to include (1) low energy availability with or without disordered eating; (2) menstrual dysfunction; and (3) decreased bone mineral density. Components of the triad are common during adolescence, a critical period for bone acquisition and growth, but the prevalence varies among athlete populations based on several factors. Screening for the triad should be a routine part of the preparticipation physical examination of adolescent athletes, and new recommendations exist for the screening and management of athletes at risk for complications from the triad. Awareness and education are critical for prevention and early intervention.


Proceedings ◽  
2019 ◽  
Vol 37 (1) ◽  
pp. 24
Author(s):  
Winter ◽  
Black ◽  
Brown

Background: Low Energy Availability (LEA), Relative Energy Deficiency in Sport (RED-S) and the Female Athlete Triad (Triad) are generally related to the negative health effects of consuming insufficient energy to meet exercise energy expenditure and maintain normal physiological function. [...]


2018 ◽  
Vol 28 (4) ◽  
pp. 332-334 ◽  
Author(s):  
Susan Carter

Barbara Drinkwater has been a lifelong champion of equality for women in many areas of life well before it was widely accepted. Her “walking the walk” of women breaking barriers in traditional male roles in administration and leadership is exemplified by her election as the first woman president of the American College of Sports Medicine in 1988. Some of the controversial areas in which Barbara was vocal in the arena of women in sport, besides triad/relative energy deficiency in sport, include increased opportunity and participation, total equality, acceptance of diversity, intolerance of harassment and abuse, and fairness with transgender athletes. She co-founded the evidence-based advocacy group on the international stage known as Women Sport International. As a physiologist, Barbara has had a major influence on attention to the health of the female athlete, and she produced the original pioneering work in the field. Her impactful study, “Bone mineral density after resumption of menses in amenorrheic athletes,” was published in theJournal of the American Medical Associationin 1986. Since that time, the female athlete triad has set the stage for research and treatment to enhance women in physical activity at all levels.


2016 ◽  
Vol 10 (2) ◽  
pp. 67-75
Author(s):  
Michal Kumstát

Sport nutrition is progressively increasing scientific discipline being an important part of the field of sports medicine. Competition and training nutrition strategies that focus on sufficient macronutrient intake and ergogenic aids to promote energy availability and delay determinants of fatigue are currently based on sound scientific evidence. The aim of the review is to analyze the guidelines for exercise and sport nutrition published by the American College of Sport Nutrition (ACSM) and the International Olympic Committee (IOC) in the period before and after 2010. Energy availability (EA), relative energy deficiency in sport (RED-S), carbohydrate feeding during exercise (such as a mouth rinse and multitransportable carbohydrate feeding during long term exercise) and eventually “trainlow, compete high“ nutrition strategy intentionally manipulating with carbohydrate availability have been identified as novel and innovative. Sport nutrition recommendations issued by well-respected scientific authorities are currently revised according to the above mentioned topics and are now well accepted even by athletes.


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