NUTRITIONAL CONCERNS

SPORTS ANAEMIA

• Hard exercise results in an increase in the volume of plasma in the blood. This can dilute haemoglobin levels and incorrectly suggest that there is a problem with iron status - FALSE ANAEMIA. This condition is known as ‘sports anaemia’.

• Most likely to occur in the early stages of a training program or when training load is increased.

• Sports anaemia does not need treatment. It is usually transitory and is unlikely to affect performance.

• Typical of ‘endurance’ athletes—e.g., long-distance runners, cyclists

FEMALE ATHLETE TRIAD

Female athlete triad is a combination of three conditions:

1. Disordered eating2. Amenorrhea3. Osteoporosis.

A female athlete can have one, two, or all three parts of the triad.

These components are known to be interrelated, as energy deficiency associated with disordered eating plays a causal role in the development of menstrual disturbances, and both energy deficiency and a low estrogen environment associated with amenorrhea play a role in initiating bone loss.

FEMALE ATHLETE TRIAD (new MODEL)

At the “healthy” end of the continuums are optimal energy availability, the presence of normal ovulatory menstrual cycles, and optimal bone health.

At the “unhealthy” end of the continuums are the clinical outcomes associated with each Triad component, including energy deficiency, with or without disordered eating; abnormal menstrual cycles, and bone loss, the most severe cases of which are called osteoporosis.

Another point the new model of Female Athlete Triad highlights is that many athletes may not present with the extreme ends of the continuum, but rather may display intermediate, or “subclinical,” presentations of one or more of the conditions, and, most importantly, that progression along the three continuums can occur at different rates.

For example, an athlete may show signs of restrictive eating, but not meet the clinical criteria for an eating disorder. She may also display subtle menstrual disturbances, such as a change in menstrual cycle length, anovulation, or luteal phase defects, but not yet have developed amenorrhea. Likewise, she may be losing bone, but may not yet have dropped below her age-matched normal range for bone density.

What causes the Triad?

CALORIE RESTRICTION

• Intentional :Restricted eating

• Non intentionalA busy class schedule, travel, stress, and other factors can hinder female athletes from maintaining an adequate diet for training

Signs of the triad

1. Irregular or absent menstrual cycles2. Always feeling tired and fatigued3. Problems sleeping4. Stress fractures and frequent or recurrent injuries5. Often restricting food intake6. Constantly striving to be thin7. Eating less than needed in an effort to improve

performance or physical appearance8. Cold hands and feet

Risk Factors

1. Playing sports that require weight checks2. Social isolation due to sporting activities3. Exercising more than necessary for a sport4. Pressure to “win at all costs”5. Punitive consequences for weight gain6. Controlling parents and/or coaches7. Being a gymnast, figure skater, ballet dancer,

distance runner, swimmer or diver where undue emphasis is placed on having a low body weight and a lean physique

Prevention

The best way to prevent The Female Athlete Triad is through educating athletes, parents, and coaches about what it is, how to recognize it, and how to take steps to prevent it.

AS A COACH:

Remind your athletes that eating is an important part of successful training and performance.

• Focus on health and a positive body image, do NOT focus on body weight.

• Support athletes throughout their training and competition, as well as during their everyday life.

• Mobilize available resources – nutritionists, athletic trainers, counselors, and physicians.

AS AN ATHLETE

• Monitor your menstrual cycle by using a diary or calendar

• Consult your physician if you have mentsrual irregularities, have recurrent injuries or stress fractures

• Seek counseling if you suspect you are overly concerned about your body image, for example, if you are constantly striving to be thin

• Consult a sport nutritionist to help you design an appropriate diet that is specific to your sport and to your body’s energy needs.

• Seek emotional support from parents, coaches and teammates.

The condition is most common in sports that emphasize leanness, such as cross country running, gymnastics, and figure skating. In the past 25 years, much has been learned about symptoms, risk factors, causes, and treatment strategies for Female Athlete Triad.

FOOD FOR THOUGHT

Anorexia has the highest death rate of any psychiatric disorder, as high as 20 percent, with most deaths resulting from medical complications of starvation or from suicide.

Just as athletes with anorexia lose arm and leg muscle that helps them be strong athletes, they simultaneously lose heart muscle. The heart gets smaller and cannot respond to stress. The resulting arrhythmias can be a cause of death.

What makes you feel good about yourself? In the spaces below, make a list of the things that you like about yourself.

Profile of an Anorexic

A high achieving, self-disciplined perfectionist who aims to please others and rarely disobeys.

• She is intelligent, thoughtful, and demanding and critical of herself.

• She keeps her feelings to herself.

• She has a low opinion of her worth as a person.

• She decides that by controlling her body, she will feel more in charge of her life and will start to feel better about herself.

• Her whole life—all her thinking, planning, and dreaming become focused on avoiding food and getting thinner

Risk Factors for Disordered Eating Among Athletes

Pressure to optimize performance and/or modify appearance

Psychological factors, such as low self-esteem, poor coping skills, perceived loss of control, perfectionism, obsessive-compulsive traits, depression, anxiety, and history of sexual/physical abuse

The same traits that make an athlete excel in sports—compulsive, driven, dichotomous thinker, perfectionist, competitive, compliant and eager to please (“coachable”), and self-motivated—increase risk for developing an eating disorder.

Eating Disorders Affect Exercise Performance

Semistarvation, purging, and excessive exercising adversely affect health, energy reserves, and physiologic function and the ability to train and compete at an optimal level.

Chronic restriction of energy intake or reduced energy availability through purging rapidly depletes glycogen reserves.

Reduced protein intake contributes to lean tissue loss.

ACTIVITY - GROUP DISCUSSION

The Role of a Sport in Eating Disorders

Does dedication to training for a specific sport induce development of an eating disorder?

Do individuals with potentially pathologic concerns about body size and shape gravitate to the sport?