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„Female athlete triad“ und Stressfrakturen

Female athlete triad and stress fractures

Zusammenfassung

Die Triade der Sport treibenden Frau bezieht sich auf die Energieverfügbarkeit, den Menstruationszyklus und die Knochendichte, klinisch manifestiert sie sich in einer Essstörung (Frauen:Männer 10:1), einer Amenorrhö und Osteoporose oder auch in Stressfrakturen. Die Energieverfügbarkeit wird definiert als Gesamtenergieaufnahme minus Energieverbrauch durch körperliche Aktivität. Eine geringe Energieverfügbarkeit scheint sowohl die reproduktive Fähigkeit als auch die Knochengesundheit in der Triade zu verschlechtern. Eine Grenze unter 30 kcal pro kg fettfreier Masse (Muskelmasse) pro Tag gilt als Grenze. Restriktives Essverhalten oder SportlerInnen aus Sportarten, die die Schlankheit betonen, sind von besonderem Interesse. Präventionsmaßnahmen und frühe Interventionen mit Einbezug des gesamten Umfelds mit Eltern, Trainern und Freunden sind notwendig. Aufklärung über den Beginn der Triade sollte Inhalt jeder jährlichen sportmedizinischen Untersuchung sein, und der Fokus sollte generell auf die klinischen Symptome gerichtet sein. Ungesunde Gewichtsreduktionspraktiken mit Diuretika, Laxanzien oder „Gewichtmachen“ von mehr als 2–3 kg sind per se gefährlich. Ausdauersport, gewichtsabhängige und ästhetische Sportarten sind mit einem besonderen Risiko verbunden. Ein multidisziplinäres Team mit Arzt, Ernährungsexperte und Psychologe wird benötigt. Das erste Ziel der Maßnahme ist immer die Energieverfügbarkeit, d. h. die Gesamtenergie zu erhöhen und oder die körperliche Aktivität zu reduzieren.

Abstract

The female athlete triad includes energy availability, menstrual cycle disturbances and bone density. Clinical symptoms are eating disorders (ratio of women to men 10:1), amenorrhoea and osteoporosis or stress fractures. Physical activity with proper nutrition provides a healthy balance for both the endocrine system and bone structure. The continuum from health to complete illness is described as total energy expenditure minus physical activity. Energy availability is defined as whole energy. Low energy availability seems to have a negative effect on reproductive capacity and bone health and in the triad may become psychopathological. Energy availability should not be under 30 kcal per kg fat-free mass (muscle mass) per day. At risk are women with restrictive eating disorders, who practice sports and stress leanness. Preventive or early intervention must include lifestyle, surroundings, parents, coaches and friends. Preventive counselling with a focus on early clinical symptoms of the triad must be held regularly at the yearly sport medicine examinations. The unhealthy practise of weight reduction with diuretics, laxatives or weight cycling in excess of 2–3 kg body weight is risky. Endurance sports, weight-dependent sports and aesthetic sports require an interdisciplinary team with a physician, a nutritionist and a psychologist. The first step of intervention must be an increase in energy availability which means an increase in total energy or a decrease in energy expenditure by means of physical activity.

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Correspondence to U. Korsten-Reck.

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Korsten-Reck, U. „Female athlete triad“ und Stressfrakturen. Gynäkologische Endokrinologie 8, 230–235 (2010). https://doi.org/10.1007/s10304-010-0368-8

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Schlüsselwörter

  • „Female athlete triad“
  • Essstörungen
  • Amenorrhö
  • Osteoporose
  • Stressfrakturen

Keywords

  • Female athlete triad syndrome
  • Eating disorders
  • Amenorrhoea
  • Osteoporosis
  • Fractures, stress