Female athlete triad risk stratification in KwaZulu-Natal elite sprint and distance swimmers.

Abstract

Introduction: The Female Athlete Triad (FAT) is a syndrome that poses a serious threat to the health status of physically active females. It comprises of three components that were adapted to the American Collage of Sport Medicine (ACSM) 2007 Position Stands criteria and consists of three interconnected components namely; low energy availability (with or without disordered eating) that occurs due to insufficient calorie intake in combination with high amounts of physical activity, menstrual dysfunctions defined as exercise induced menstrual dysfunction, and low bone mineral density (BMD) in which the bone mineral density is weakened as a result of prolonged menstrual dysfunction. These components are linked across a continuum of healthy (optimal energy availability, eumenorrhea (a menstrual cycle of twenty eight days), and optimal bone health) to unhealthy. Aim(s): To determine the risk stratification for the FAT in elite sprint and distance swimmers. Method(s): Twenty one provincial and national level KwaZulu-Natal sprint (n=11) and distance (n=10) swimmers with a mean age of 18.95 (6.3) years voluntarily participated in this descriptive, cross-sectional study. For descriptive purposes, anthropometric measurements (weight, height, skin folds and Body Mass Index (BMI)) were recorded. Each participant completed three eating disorder questionnaires (Eating Attitude Test (EAT-26), Body shape Questionnaire (BSQ-34) and a Bulimic Investigatory Test, Edinburgh (BITE)), one Menstrual Cycle and Time Spent in Exercise Questionnaire and a Self-Administered Bone Mineral Density questionnaire. A Bioelectrical Impedance Device was used to measure full body composition. The participants were requested to complete an online ASA24 Dietary Recall of the previous day’s food and drink intake. The criteria for the risk of the FAT was determined by a positive score for all three FAT components (low energy availability (with or without eating disorders, menstrual dysfunction and low bone mineral density). Result(s): The comparison between the different sporting disciplines showed that sprint swimmers are more at risk (63.6%) for disordered eating compared to distance swimmers (50%). Low energy availability was significantly evident in sprint swimmers with a result of 9.79 kcal.kg-1FFM.d-1 (SD 9.56). Out of the total sample size, only six (28.57%) swimmers were classified as having a menstrual dysfunction. Sprint swimmers showed to have a 90.9% 10 risk of low BMD. The overall results signified that out of the total sample group, 9.5% were not at risk, 14.3% showed a low risk, 52.4% had a moderate risk and 23.8% were at a high risk for the whole FAT. Conclusion: Elite sprint and distance swimmers are not at risk for the FAT, however, elite level sprint and distance swimmers are susceptible for the risk of FAT components.