Kathy (not her real name), a star performer on her high school soccer team, was concerned. The slender 15-year-old had missed her last couple of menstrual periods and was experiencing fatigue and general malaise. Pregnancy was not the cause…athletics and poor nutrition were.
Kathy is one of more than 2.9 million teenage girls participating in high school sports across the United States. While sports can provide numerous health benefits, women on the playing fields can incur some health risks.
According to Bonnie Nye, MD, Kathy's doctor and medical director of the Sports Medicine Clinic at The Children's Hospital of Philadelphia, the teenager's physical condition is not uncommon. Dr. Nye, as well as the American Academy of Pediatrics (AAP), believes that young women in sports face a trio of possible health complications. Called the "female athlete triad," these risks are disordered eating, amenorrhea (absence of menstruation), and decreased bone mineral density.
According to Dr. Nye, Kathy's lifestyle is similar to that of many young girls. The high school sophomore would often dash to school in the morning, leaving home without eating breakfast or drinking any fluids. If she had anything to drink, it would be a cup of coffee, the caffeine in which would act as a diuretic, causing Kathy to lose rather than retain vital fluids.
At school, Kathy would have nothing to eat or drink until lunch. Kathy's lunch was a hurried 20-minute affair, washed down by ice tea purchased from a cafeteria vending machine. Ice tea, and most sodas, also contain caffeine and have a diuretic effect. So, by the time Kathy reached soccer practice, she was already dehydrated , before even engaging in vigorous athletic activity.
Dr. Nye refers to Kathy's eating patterns as "disordered eating." This is different than an eating disorder, which Dr. Nye says is the intentional manipulation of a diet for unhealthy reasons. In Kathy's case, her lifestyle and lack of proper nutritional guidance were keeping her from eating properly.
The AAP says that disordered eating can cause amenorrhea, another component of the female athlete triad. The abnormal absence of menstrual periods puts young women at risk for osteoporosis , a disease that leads to fragile bones and an increased risk of fractures to the hip, spine, and wrist.
It is because athletic teenagers need plenty of calories that physicians at The Nemours Foundation, a nonprofit children's health organization, state that, absent a doctor's specific instructions, "Dieting is not a part of being an athlete."
Sue Sanders, RD, a former college athlete and professor of Food Science and Technology at New York University, says that young girls are more likely than boys to engage in disordered eating. This is because they tend to take part in sports in which weight and appearance are concerns, such as gymnastics, dancing, diving, skating, swimming, and running. This can lead to poor nutritional habits or worse, anorexia and bulimia .
In addition, a young girl's perception of her body is susceptible to outside influences. A peer-reviewed study of 550 girls in grades 5-12 published in Pediatrics, the journal of the AAP, found that 69% of the girls said pictures in magazines influenced their ideas of the perfect body shape. Nearly half of the girls surveyed said they wanted to lose weight because of the magazine pictures; however, only 29% of them were actually overweight.
The experts offer the following tips to parents to help prevent poor body image in their children:
RESOURCES:
American Academy of Pediatrics
http://www.aap.org
Osteoporosis and Related Bone Diseases National Resource Center
http://www.osteo.org
CANADIAN RESOURCES:
Canadian Association for the Advancement of
Women and Sport and Physical Activity
http://www.caaws.ca/
The Female Athlete Triad
http://femaleathletetriad.ca/
References:
2007 statistics—gender equity in high school and college athletics: most recent participation and budget statistics. Women's Sports Foundation website. Available at:http://www.womenssportsfoundation.org/cgi-bin/iowa/issues/article.html?record=1017. Accessed April 1, 2008.
Benjamin HJ. The female adolescent athlete: specific concerns. Pediatric Annals. 2007; 36:719-726.
Last reviewed February 2008 by Kari Kassir, MD
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