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Nutritional Considerations for Female Athletes

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Nutritional Considerations for Female Athletes Nutritional Considerations for Female Athletes Guillermo Escalante, DSc, MBA, ATC, CSCS Department of Kinesiology, California State University, San Bernardino, San Bernardino, California ABSTRACT with a range of indicators of physiolog- a wealth of erroneous information ical and psychological well-being such available on the Internet and hundreds THIS ARTICLE PROVIDES AN as cardiovascular fitness, mood, and of unqualified/improperly credentialed OVERVIEW OF CURRENT LITERA- self-esteem (7), most of the literature “experts” providing nutritional advice TURE RELATED TO NUTRITIONAL shows that the prevalence of eating to the public. Female athletes seeking CONSIDERATIONS FOR THE disorders and disordered eating (DE) to lose body fat, gain muscle mass, or FEMALE ATHLETE. THE PREVA- is higher in athletes compared to that improve performance may seek guid- LENCE OF THE FEMALE ATHLETE of nonathletes (30,51). ance from unreliable sources and hence TRIAD, EATING DISORDERS, AND may put their bodies, and/or perfor- Research also indicates that women, BODY IMAGE ISSUES AMONG mance, at risk. Research indicates that regardless of whether they participate FEMALE ATHLETES WILL BE RE- athletes who are encouraged to diet by in sports or not, are at greater risk for VIEWED. FURTHERMORE, DETRI- their coaches may resort to faster more body dissatisfaction (14,15) and DE MENTS IN HEALTH AND/OR dangerous methods of weight control (17,19) than men. Compared to male SPORTS PERFORMANCE FROM (e.g., self-induced vomiting or fasting) athletes, female athletes are more likely LACK OF PROPER NUTRITION WILL to shed pounds quickly (46). The to engage in compulsive exercising and strength and conditioning professional BE DISCUSSED. RECOMMENDA- pathological weight-loss methods such can help to guide female athletes in the TIONS FOR APPROPRIATE NUTRI- as abuse of laxatives or diets pills, self- right direction and steer them to seek TIONAL GUIDELINES TO SAFELY induced vomiting, and fasting with the advice from reliable/qualified sources DECREASE BODY FAT, INCREASE goal to achieving top sporting perfor- and provide them with appropriate MUSCLE MASS, AND IMPROVE mance and superior physical condition support. Recognition of DE behaviors OVERALL SPORTS PERFORMANCE (12). Data indicate that although the or body image issues among athletes WILL BE ADDRESSED. CONSIDER- prevalence of clinical eating disorders ATIONS WHEN PROVIDING BODY should be identified as quickly as pos- ranges from 0 to 8% among profes- sible by strength and conditioning COMPOSITION ADVICE FOR THE sional and college female athletes coaches so that they may be properly FEMALE ATHLETE ARE REVIEWED. (49), many of them are “at risk” for referred to a mental health professional eating disorders which places them at for further intervention because these risk for menstrual irregularity, bone in- INTRODUCTION issues could create major health and juries, cardiovascular problems, depres- he participation of females in psychological problems. sion, lower athletic performance, social sports has greatly increased over isolation, and poorer quality of life (32). In an effort to prevent athletes from Tthe last several decades. Accord- following nutritional recommendations ing to the National Federation of State The purpose of this article is to from unreliable sources, it is recom- High School Associations, of the 7.5 provide practical nutrition-related mended that strength and conditioning million athletes who participated in information to the strength and condi- professionals work in conjunction with a school-sponsored activity in 2008– tioning professional when working team coaches, athletic trainers, physi- 2009, 41% were females (4). In 1972, with female athletes. Research has cians, psychologists, and sports trained females comprised only 7% of the total indicated that although risk factors dieticians to readily provide reliable re- number of athletes (4). Naturally, as the such as menstrual disorders, DE, low sources for their athletes. Instead of trend of increased participation in high bone mineral density (BMD), and school athletics has risen, so has the body image issues are prevalent among KEY WORDS: female athletes, knowledge and recog- number of women participating in col- body image; eating disorders; female nition of these risk factors among lege, professional, and recreational athlete; weight loss; body fat; muscle coaches and athletes was low (13). sports increased. Although participa- mass; sports performance tion in sports and exercise is associated When it comes to nutrition, there is Copyright Ó National Strength and Conditioning Association Strength and Conditioning Journal | www.nsca-scj.com 57 Copyright © National Strength and Conditioning Association Unauthorized reproduction of this article is prohibited. Nutritional Considerations allowing athletes to seek information translate to metabolic and reproductive and dietary restraint were related on their own, bringing a qualified pro- suppression (52) that potentially results directly to bulimic symptoms (1). Fur- fessional on board to provide some in a multitude of health concerns. thermore, the researchers suggest that basic nutrition education to the team Research has reported that the preva- general sociocultural pressures are influ- could prove to be beneficial. Further- lence of clinical menstrual disorders ential but weight and appearance pres- more, the professional who comes to (FHA and oligomenorrhea) in female sures in the sport environment may be give the nutrition lesson(s) can poten- athletes include both high school (6) even more pervasive and negative for tially make himself available for one- and premenopausal women (8). Clinical female athletes (1). on-one consultation to help improve signs of menstrual disorders have been Low BMD in female athletes has been the intervention. If budgeting prevents shown to range from 1 to 61% in exer- investigated with the diagnostic crite- these types of services, then it is recom- cising women and are documented at ria set forth by the World Health mended that strength and conditioning significantly higher rates than in Organization for postmenopausal coaches compile a list of reliable resour- nonathletic premenopausal women women, which are based on T scores ces (i.e., books, approved websites, etc.) (5). Lean build athletes and aesthetic instead of Z scores. A T score is that athletes can reference as informa- athletes (cheerleading, dance, and defined as the number of SD above tion on where reliable information can gymnastics) have a significantly higher or below the mean peak BMD of be found. Educating athletes on the prevalence of menstrual disorders—26.7 young adults of the same age and eth- types of credentials that their source and 28.2%, respectively—when com- nicity. Research for female athletes shouldhavecouldalsoprovetobean pared to that of general high school that used the World Health Organiza- effective intervention so that they are not athletes (43). The prevalence of second- tion criteria found the prevalence of T loosely following anybody’s information. ary amenorrhea has been reported to be scores between 21.0 and 22.5, which as high as 65% in elite long distance is classified as osteopenia, to range PREVALENCE OF THE FEMALE runners compared to 2–5% in the gen- from 22 to 50% (42). Furthermore, ATHLETE TRIAD AND EATING eral population (22). Although primary the prevalence of T scores less than DISORDERS amenorrhea prevalence is less than 1% 22.5, which is classified as osteoporo- The female athlete triad was first rec- in the general population, the preva- sis, ranged from 0 to 13% (42). These ognized more than 20 years ago based lence in collegiate cheerleading, diving, prevalence rates are significantly high- on the association of DE, functional and gymnastics athletes has been er than those reported in the normal hypothalamic amenorrhea (FHA), reported to be as high as 22% (9). population. and osteoporosis observed in recrea- tional and elite-level exercising women DE and eating disorders among female (42). After several years of progress in athletes often go unnoticed and it is FEMALE ATHLETES AND BODY IMAGE ISSUES the scientific understanding of the therefore difficult to estimate their real female athlete triad, the American Col- prevalence. Research has indicated Body dissatisfaction is another area of lege of Sports Medicine redefined the that the reported lifetime prevalence concern among female athletes. This triad in 2007. The most recent model of of anorexia nervosa and bulimia nerv- characteristic becomes apparent when the triad is a syndrome linking low osa in female athletes ranges from 0.5 there is discrepancy between an indi- energy availability (EA) with or with- to 3.7% and from 1.1 to 4.2%, respec- vidual’s image of their body, which is out disordered eating (DE), menstrual tively (49). Furthermore, disordered usually in terms of body weight and disturbances, and low BMD across eating, which is characterized by shape, and the body they perceive as a continuum of healthy (optimal EA, abnormal eating behaviors but does being ideal. Research has demon- normal and regular menstrual cycles, include all the diagnostic criteria for strated that body dissatisfaction is asso- and optimal BMD) to unhealthy and eating disorders, has a lifetime preva- ciated with a drive for thinness (28), increasingly severe clinical presenta- lence rate ranging from 0 to 27% (18). dieting (48), disordered eating patterns tions of each component (42). The Due to the lack of standardized
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