Katherine A. Beals

Subclinical Eating Disorders in Female Athletes

ince the passage of Title IX legislation in 1972, there has been S a dramatic increase in the number of females participating in organized sports. For most of these female athletes, sports participation is a positive experience, providing improved physical fitness and better health and well being (Nattiv, Agostini, Drinkwater, & Yeager, 1994). Yet for some, the desire for athletic success combined with the pressure to achieve a prescribed body weight can lead to the development of eating disorders. There have been several recent reports of elite female athletes suffering from eating disorders. Perhaps the most well known is the case of former U.S. Olympic gymnast Christy Henrich, who died in 1994 at the age of 22 from multiple organ failure due to an eightyear struggle with anorexia nervosa (Parks &Read, 1997). Less publicized, yet probably much more prevalent, are athletes possessing partial or subclinical eating disorders. While athletes with subclinical eating disorders may not suffer the severe, lifethreatening medical complications of those with clinical eating disorders, they typically experience a decrement in athletic performance, endure considerable psychological distress, and expose themselves to significant health risks. KATHERINE A. BEALS

Eating Disorder and Menstrual Dysfunction Screening, Education, and Treatment Programs

ABSTRACT OBJECTIVE: To describe the nature, scope, and perceived effectiveness of selected National Collegiate Athletic Association (NCAA) Division 1 programs for the screening, education, and treatment of eating disorders (ED) and menstrual dysfunction (MD). METHODS: Surveys were mailed to the team physician or the head athletic trainer of all NCAA Division 1 schools currently supporting at least two of the following womens sports: cross-country/track, swimming, and gymnastics. The survey contained closed-and open-ended questions to ascertain the types of ED and MD screening, education, and treatment programs and their perceived effectiveness. RESULTS: A total of 170 surveys were sent, and 81% were returned. Although 79% of schools reported screening for MD, only 24% used a comprehensive menstrual history questionnaire. An MD treatment protocol was used by 33% of schools, and 7% reported withholding those with MD from athletic participation. Screening for ED was reported by 60% of schools, but less than 6% used a structured interview or a validated ED questionnaire. Athletes with confirmed ED were withheld from athletic participation by 21% of the schools; athletes with suspected ED were withheld by 9%. Education about ED and MD was made available to athletes by 73% of the schools, and 61% of the schools made this education available to coaches. However, less than 41 % of schools made such education a requirement. Thirty-five percent of respondents perceived their MD screening programs to be successful or very successful, compared with 26% for ED screening programs. CONCLUSIONS: These results indicate a pressing need for more standardized ED and MD screening, prevention, and treatment programs among NCAA Division 1 schools. At the very least, all NCAA-member institutions should implement mandatory ED and MD education for all athletes and athletic personnel.

Body Weight Concerns and Dieting Practices of Female Collegiate Athletes

Abstract The purpose of this study was to compare the body weight concerns and dieting practices of female collegiate athletes participating in aesthetic, endurance, and team/anaerobic sports. Participants consisted of 425 female athletes from 7 universities across the United States. Body weight concerns and dieting practices were assessed by the Eating Attitudes Test (EAT-26), the Eating Disorder Inventory Body Dissatisfaction Subscale (EDI-BD), and a weight and dieting history questionnaire. Athletes in aesthetic sports weighed less (55.2±5.8kg) than athletes in endurance (64.1±11.0kg) and team sports (65.8±8.5kg) (P

Recent Recommendations and Current Controversies in Sport Nutrition

Adequate nutrition is absolutely essential for optimal training and performance of the athlete. Unfortunately many athletes lack sufficient nutrition knowledge to guide proper food choices. Similarly, the health professionals that athletes most frequently turn to for nutrition advice are often ill-equipped to address specific nutritional needs and issues. This article will summarize the most recent macronutrient (i.e., carbohydrate, protein and fat) and fluid recommendations for athletes. Micronutrients that have been shown to be inadequate in the diets of athletes will also be addressed. Finally, current controversies in sport nutrition will be examined in light of the most recent research and guidelines for applications to the athlete will be provided.

Energy Balance And Nutritional Status Of Female Athletes With Subclinical Eating Disorders

OBJECTIVE To assess the energy and nutritional status of female athletes with subclinical eating disorders and compare them with that of control subjects and standard norms. DESIGN Group classification (subclinical eating disorder or control) was based on responses to a health and diet history questionnaire, a battery of self-report eating disorder questionnaires, and an in-depth interview. Energy and nutrient intakes and energy expenditure were determined by means of 7-day weighed food records and 7-day activity logs. Micronutrient status was assessed for iron, zinc, magnesium, vitamin B-12, and folate. SUBJECTS Twenty-four female athletes with subclinical eating disorders and 24 female control athletes. STATISTICAL ANALYSES Descriptive statistics were used to analyze demographic data. One-way analysis of variance was used to determine group differences in energy and nutrient intakes, energy balance, and blood values. RESULTS Groups were similar in age, height, weight, fat-free mass, and body mass index. Mean energy intake was lower in the group with subclinical eating disorders (1,989 kcal/day) than in the control group (2,300 kcal/day; P=.004), whereas mean energy expenditures were similar (2,405 and 2,293 kcal/day, respectively). The group with subclinical eating disorders had significantly (P<.05) lower mean protein and fat intakes compared with the control group; mean micronutrient intakes were not significantly different. Mean status measures for iron, zinc, magnesium, vitamin B-12, and folate were within the normal ranges for both groups and no differences were noted between the groups. A similar number of athletes within each group used vitamin/mineral supplements < or = 4 times per week. CONCLUSION Although female athletes with subclinical eating disorders had dietary intakes of energy, protein, carbohydrate, and certain micronutrients that were below recommended levels, micronutrient status appeared relatively unaffected, probably due to their use of supplements.