By Jennifer Nitson
Gazette-Times reporter | Posted: Monday, August 13, 2007 12:00 am
A new report says that coaches, doctors, female athletes and their parents need to heed the signs and symptoms of a sports-related medical syndrome known as the "female athlete triad."
Researchers at Oregon State University have undertaken in-depth study of the syndrome, focusing on prevention through education, medical screening and treatment.
The female athlete triad was identified by the American College of Sports Medicine in 1997. The triad's components are inadequate food intake, menstrual disruption and low bone density in female athletes.
The first element of the triad n not consuming enough food to fuel not only sports training but the rest of an athlete's physiological functions n causes the other two components of the syndrome.
The reasons women in our culture sometimes fail to eat enough food are myriad, but most commonly the reason is "thin is in."
For female athletes in some sports, being thin or compact gives them an edge over the competition. Unfortunately this edge can be temporary and the drive to be small or thin can have unintended results.
"If you don't get enough energy and nutrients, what happens is menstrual function shuts down," Manore said. This disruption of a woman's hormonal balance also affects bone growth, she explained, and female athletes who do not eat enough suffer reduced bone mass.
"They get lots of stress fractures and bone injuries," she said.
Even if these athletes finish their athletic careers without any bone injuries, they have set themselves up for problems in the future.
"The reason that it is such a problem is that the end outcome is osteoporosis," Manore said. "What you do when you're growing - when you're growing healthy bone - impacts what you end up with as an old woman."
Manore has been studying sports-related nutrition issues for 20 years. She earned her doctorate in nutrition, with a minor in exercise science, from OSU in 1984, at a time when the links between nutrition and exercise were rarely studied.
Though such research has become more common over the years, most studies have focused on men, Manore said. This is because studies of male physiology are not complicated by that monthly fluctuation of hormones, the menstrual cycle, she explained.
Leaving women out of the research loop can have unintended negative consequences if female athletes, their coaches and their physicians do not fully understand the short- and long-term ramifications of under fueling.
With an apparent recognition of how important proper nutrition is to athletes, OSU hired sports nutritionist Ingrid Skoog last winter.
"Fueling is so key to that triad," Skoog said. "The cascade of (medical) events starts with that."
Skoog - who is quick to point out that the under fueling component of the female athlete triad is not necessarily the same as an eating disorder - estimates that up to 50 percent of the female athletes at OSU "deal with one or more components of the triad."
"I would say that it is representative of collegiate athletics, because most athletes are under fuled," Skoog said.
She works to educate athletes and coaches about proper fueling and why it is important.
Education is key, agreed OSU gymnastics coach Tanya Chaplin.
"Making sure they have the knowledge, and that they can understand what can happen to their bodies without sufficient fuel," Chaplin said.
University medical staff, along with Skoog and OSU coaches all work together to ensure athletes have the resources and education they need to take care of their health, Chaplin added.
Chaplin expressed appreciation of Skoog's efforts to teach student athletes - many of whom are away from home for the first time - to grocery shop for themselves and prepare nutritious meals within the constraints of a busy schedule.
"It's teaching them to do that with the time schedule and the commitments in their lives right now," Chaplin said.
Volleyball coach Terry Liskevych believes it is important to rely on the nutritional and medical professionals at OSU for advice on diet and exercise.
"It's their priority to make sure that we know what are the key ingredients for health for our athletes," Liskevych said. "In my 30-plus years as a coach I always defer to the professionals."
With the teachings of Skoog and a recent exercise physiology class in mind, OSU gymnast D'Anna Piro said she continues a lifetime of good eating habits. That involves eating well-rounded, nutritious meals throughout the day and high protein snacks about an hour before gymnastics practice.
Half of a peanut butter sandwich, a peanut butter sports bar or some nuts and dried fruit provide enough protein and fat to carry her through a workout.
"It definitely gives you more energy without making you feel so heavy that you feel lethargic," Piro said.
Piro seems to embody what Manore is hoping to achieve through her work: healthy, active women.
"We want girls to be active and keep their weight healthy," Manore said. "What we don't want is people going to extremes, doing crazy things."
A paper on the female athlete triad will be published in the Journal of Sports Science this fall and Manore is co-authoring a position paper on the subject for the American College of Sports Medicine.
For more information on the female athlete triad, go to: http://www. femaleathletetriad.org/faq.html.