Triad athlete syndrome may affect teens too

By Charnicia E. Huggins

NEW YORK (Reuters Health) - The triad syndrome of disordered eating, menstrual irregularity, and low bone mass observed among some college students and young adults, may also affect teenagers, new study findings suggest.

"The triad is usually thought to occur mostly in elite athletes, however, the girls in our study were average high school athletes," Dr. Jeanne F. Nichols, of San Diego State University, California, told Reuters Health.

"This suggests that coaches and athletic trainers need to take time to encourage and reinforce healthy eating and training behaviors in all athletes," the researcher added.

Previous reports indicate more than half of collegiate and elite athletes have eating disorders and menstrual irregularity.

During the 2003-to-2004 school year, nearly 3 million girls in the United States competed in high school sports, according to the National Federation of High School Associations. Yet, little research has been conducted one the prevalence of the female athlete triad among in high school athletes.

To investigate, Nichols and her team studied 170 girls, ages 13 to 18, from six high schools in southern California, where they participated in track and field, cross-country running, soccer, softball, swimming, volleyball, tennis or lacrosse. The girls completed questionnaires about their eating attitudes and behaviors, menstrual status and history, and they were measured for bone mineral density.

About 20 percent of the girls met the criteria for at least one component of the female athlete triad syndrome, the investigators report in this month's issue of Archives of Pediatrics and Adolescent Medicine.

Eighteen percent of the girls had disordered eating behaviors, 24 percent had menstrual irregularities, and 22 percent had low bone mass, the report indicates. Ten girls (6 percent) met the criteria for two components of the triad and two girls (1 percent) met the criteria for the full triad.

Nichols and her team conclude that "screening for disordered eating and menstrual irregularity is potentially more important for high school than for college athletes as a first step in preventing comorbidities associated with the triad, particularly because adolescence is a critical period for optimizing bone mineral accrual."

"At minimum," Nichols told Reuters Health, "young athletes should be monitored for changes in body weight, especially when significant weight is lost fairly rapidly."

Further, the researcher added, "having menstrual dysfunction and/or restricting calories during adolescence increases a young woman's risk of having low bone mass as an adult. Given the fact that we are living longer, there is a greater chance that compared to women with normal or high peak bone mass, women with a low peak bone mass will more likely suffer osteoporotic fractures as older adults."

SOURCE: Archive of Pediatrics and Adolescent Medicine, February 2006.