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Make Sure Your Young Women Players Are Eating -- and Training -- Properly

By Mary Helen Sprecher

Increasing after-school and summer rec opportunities for kids. Having professional athletes endorse youth programs. The goal? Show a kid the satisfaction of mastering a sport rather than a PlayStation, and you’ve helped to create an athlete for life.

But what happens when a kid gets the wrong idea about what makes an athlete successful?

Tennis pros and coaches need to be aware of a disorder that could affect young female athletes, ages 10 to 18, who are particularly involved in competitive sports. Called “Female Athlete Triad,” it’s a three-part disorder that includes eating problems, but is not an eating disorder in the same way that anorexia nervosa or bulimia is.

Female Athlete Triad is not about a distorted body image; it’s a belief that weighing less will improve athletic performance. And that could lead to all sorts of problems for girls.

According to licensed dietitian Jordan B. Davidson, a clinical dietitian specialist at Johns Hopkins Bayview Medical Center in Baltimore, the components of Female Athlete Triad are reduced eating (generally with increased training), amenorrhea (the loss of menstruation) and osteoporosis (weakening of the bones).

How It Starts

A young tennis player affected by Female Athlete Triad might think that being lighter on her feet will make her faster and better on the court. She’ll cut her food intake and train harder in an effort to excel. She might be so focused on how much she weighs that she doesn’t remember missing her period. She might be training so hard that she ignores the nagging ache in her foot, later diagnosed as a stress fracture.

And then there’s the fact that she’s not eating much. According to Davidson, one component of Triad is the problem of Athletic Energy Deficit, which means the person is not consuming enough food to fuel the body for the exercise she is doing. The results are fatigue and inability to perform well in the sport, which are misinterpreted by the athlete to mean that she is not working hard enough.

It’s a vicious cycle, says Davidson. “The person does not realize that optimum nutrition and optimum weight will actually improve their performance, and that they won’t perform better because they’re not eating. It can turn into a chain of events with long-term issues.”

Because girls are supposed to be building bone mass in their teen years, early osteoporosis can have devastating consequences as a woman ages. Amenorrhea, caused by decreased estrogen levels that are a result of weighing too little, may require treatments including hormone therapy to get the patient’s menstrual cycle back to normal.

Davidson says a patient suffering from Triad should be treated by a multidisciplinary team including a physician, psychologist and clinical dietitian. The focus is on both remedying the physical symptoms and educating the patient. The athlete must be made aware of the importance of “stoking the engine,” or feeding the body for maximum performance.

Know the Symptoms

Coaches, pros, tennis instructors, camp directors and others should be vigilant in identifying the symptoms of Female Athlete Triad (see box) and referring athletes for treatment. Some symptoms are noticeable, but others are subtle and might be overlooked, particularly in the early stages of the disorder.

Reminding young athletes of the importance of eating well in order to perform well, says Davidson, is the key, since “the most important thing is to focus on preventive strategies.”

Watch Out for These Symptoms

Make sure your young female tennis players are training smart and eating right. Note that athletes with Female Athlete Triad typically will continue and even increase their training regimen. The three main components of Triad are:

• Disordered eating habits: Look for decreased eating or avoidance of what the person considers “bad” foods, such as carbs, sugars, fats, etc.
• Osteoporosis: Weak bones can result in stress fractures.
• Amenorrhea: Irregular menstruation or periods that stop altogether.

Other symptoms to look for include muscle pain, fatigue, difficulty concentrating and longer healing periods after injuries. But players with Female Athlete Triad can have other symptoms, too (and some symptoms above can be indicative of other health problems). Diagnosis and treatment should be made by health professionals.

For more information:

• femaleathletetriad.org — A user-friendly website with information published by the American College of Sports Medicine.
• fore.org — The website of the Foundation for Osteoporosis Research and Education includes a pdf handout about Athletic Energy Deficit.

See all articles by Mary Helen Sprecher

About the Author

Mary Helen Sprecher  is the managing editor of Sports Destinations Management Magazine, a niche business-to-business publication for planners of sports travel events, in addition to being an RSI Contributing Editor. She is the technical writer for the American Sports Builders Association and works as a newspaper reporter in Baltimore City.

From the July 2008 issue
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