Skip to main content
Log in

Special nutritional concerns for the female athlete

  • Published:
Current Sports Medicine Reports

Abstract

Inadequate dietary intake is the primary nutritional concern of today’s female athlete. As these athletes fail to consume enough energy to support the physical demands of training, they become at risk for disordered eating, amenorrhea, and osteoporosis, conditions collectively identified as the female athlete trial. This review addresses nutritional concerns of the female athlete, identification of those at risk, relationship of energy intake to menstrual irregularities, and recently identified chronic diseases associated with the female athlete triad. Strategies are offered to prevent harmful behaviors leading to the comorbidities associated with inadequate dietary intakes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Tammelin T, Nayha S, Hills AP, Jarvelin MR: Adolescent participation in sports and adult physical activity. Am J Prev Med 2003, 24:22–28.

    Article  PubMed  Google Scholar 

  2. Otis CL, Goldingay R: The Athletic Woman’s Survival Guide. Champagne, IL: Human Kinetics; 2000.

    Google Scholar 

  3. Bean A, Wellington P: Sports Nutrition for Women.London: A & C Black; 2001.

    Google Scholar 

  4. Braakhuis AJ, Meredith K, Cox GR, et al.: Variability in estimation of self-reported dietary intake data from elite athletes resulting from coding by different sports dietitians. Int J Sport Nutr Exerc Metab 2003, 13:152–165.

    CAS  PubMed  Google Scholar 

  5. Koutedakis Y, Jamurtas A: The dancer as a performing athlete: Physiological considerations. Sport Med 2004, 34:651–661.

    Article  Google Scholar 

  6. Cupisti A, D’Alessandro C, Castrogiovanni S, et al.: Nutrition knowledge and dietary composition in Italian adolescent female athletes and non-athletes. Int J Sport Nutr Exerc Metab 2002, 12:207–219.

    PubMed  Google Scholar 

  7. Petrie HJ, Stover EA, Horswill CA: Nutritional concerns for the child and adolescent competitor. Nutrition 2004, 20:620–631. For those working with children and adolescents, this review presents general nutritional needs for young athletes in endurance sports, strength and weight-class sports, and nutrition specific to team sports.

    Article  CAS  PubMed  Google Scholar 

  8. Kristiansen M, Levy-Milne R, Barr S, Flint A: Dietary supplement use by varsity athletes at a Canadian University. Int J Sport Nutr Exerc Metab 2005, 15:195–210.

    CAS  PubMed  Google Scholar 

  9. International Olympic Committee Medical Commission Working Group on Women in Sport: Position stand on the female athlete triad. Available at: http://multimedia. olympic.org/pdf/en_report_917.pdf. Accessed June 9, 2006. This position stand should be viewed as required reading for any health professional working with female athletes. Information in the appendices can be helpful to coaches and health professionals.

  10. Nichols JF, Rauh MJ, Lawson MJ, et al.: Prevalence of the female athlete triad syndrome among high school athletes. Arch Pediatr Adolesc Med 2006, 160:137–142.

    Article  PubMed  Google Scholar 

  11. Otis CL, Drinkwater B, Johnson M, et al.: American College of Sports Medicine position stand. The female athlete triad. Med Sci Sports Exerc 1997, 29:i-ix.

    Article  CAS  PubMed  Google Scholar 

  12. Torstveit MK, Sundgot-Borgen J: The female athlete triad: Are elite athletes at increased risk? Med Sci Sport Exerc 2005, 37:184–193.

    Article  Google Scholar 

  13. Torstveit MK, Sundgot-Borgen J: The female athlete triad exists in both elite athletes and controls. Med Sci Sport Exerc 2005, 37:1449–1459.

    Article  Google Scholar 

  14. Reinking MF, Alexander LE: Prevalence of disorderedeating behaviors in undergraduate female collegiate athletes and nonathletes. J Athl Train 2005, 40:47–51.

    PubMed Central  PubMed  Google Scholar 

  15. Warren MP, Perlroth NE: The effects of intense exercise on the female reproductive system. J Endocrinol 2001, 170:3–11.

    Article  CAS  PubMed  Google Scholar 

  16. Stafford DEJ: Altered hypothalamic-pituitary-ovarian axis function in young female athlete: Implications and recommendations for management. Treat Endocrinol 2005, 4:147–154. This review addresses the hypothalamic-pituitary-ovarian axis as central to menstrual irregularities in young female athletes and therapeutic recommendations to correct the irregularity. Treatment is aimed at restoring normal menstrual function by increasing energy intake.

    Article  PubMed  Google Scholar 

  17. Eliakim A, Beyth Y: Exercise training, menstrual irregularities and bone development in children and adolescents. J Pediatr Adolesc Gynecol 2003, 16:201–206.

    Article  PubMed  Google Scholar 

  18. Gibson JH, Mitchell A, Harries MG, Reeve J: Nutritional and exercise-related determinants of bone density in elite female runners. Osteopos Int 2004, 15:611–618.

    Google Scholar 

  19. Rencken M, Chestnut III CH, Drinkwater BL: Decreased bone density at multiple skeletal sites in amenorrheic athletes. JAMA 1996, 276:238–240.

    Article  CAS  PubMed  Google Scholar 

  20. Burrows M, Nevill AM, Bird S, Simpson D: Physiological factors associated with low bone mineral density in female endurance runners. Br J Sport Med 2003, 37:67–71.

    Article  CAS  Google Scholar 

  21. Miller KK: Mechanisms by which nutritional disorders cause reduced bone mass in adults. J Womens Health (Larchmt) 2003, 12:145–150.

    Article  Google Scholar 

  22. Cobb KL, Bachrach LK, Greendale G, et al.: Disordered eating, menstrual irregularity, and bone mineral density in female runners. Med Sci Sports Exerc 2003, 35:711–719.

    Article  PubMed  Google Scholar 

  23. Fredericson M, Kent K: Normalization of bone density in a previously amenorrheic runner with osteoporosis. Med Sci Sports Exerc 2005, 37:1481–1486. Interesting case report of athlete returning to normal bone levels after missing the window for bone growth. Emphasizes the importance of energy intake in recovery.

    Article  PubMed  Google Scholar 

  24. Joy EA, Campbell D: Stress fractures in the female athlete. Curr Sports Med Rep 2005, 4:323–328.

    Article  PubMed  Google Scholar 

  25. Bemben DA, Buchanan TD, Bemben MG, Knehans AW: Influence of type of mechanical loading, menstrual status, and training season on bone density in young women athletes. J Strength Cond Res 2004, 18:220–226.

    PubMed  Google Scholar 

  26. Prather H, Hunt D: Issues unique to the female runner. Phys Med Rehabil Clin N Am 2005, 16:691–709.

    Article  PubMed  Google Scholar 

  27. Zeni Hoch A, Dempsey RL, Carrera GF, et al.: Is there an association between athletic amenorrhea and endothelial cell dysfunction? Med Sci Sports Exerc 2003, 35:377–383.

    Article  Google Scholar 

  28. Jorgensen L, Joakimsen O, Rosvold-Bernstsen GK, et al.: Low bone mineral density is related to echogenic carotid artery plaques: a population-based study. Amer J Epidemiol 2004, 160:549–556.

    Article  Google Scholar 

  29. Leone JE, Gray KA, Massie JE, Rossi JM: Celiac disease symptoms in a female collegiate tennis player: Case report. J Athl Train 2005, 40:365–369.

    PubMed Central  PubMed  Google Scholar 

  30. Eberman LE, Cleary MA: Celiac disease in an elite female collegiate volleyball athlete: case report. J Athl Train 2005, 40:360–364.

    PubMed Central  PubMed  Google Scholar 

  31. Sherman RT, Thompson RA: Practical use of the International Olympic Committee Medical Commission position stand on the female athlete triad: a case example. Int J Eat Disord 2006, 39:193–201. Implications of the International Olympic Committee Medical Commission position stand on the female athlete triad are discussed in terms of the athlete’s health being primary to her performance.

    Article  PubMed  Google Scholar 

  32. Loucks AB, Nattiv A: Essay: the female athlete triad. Lancet 2005, 366:S49-S50.

    Article  PubMed  Google Scholar 

  33. Waldrop J: Early identification and interventions for female athlete triad. J Pediatr Health Care 2005, 19:213–220.

    Article  PubMed  Google Scholar 

  34. Ziegler PJ, Kannan S, Jonnalagadda SS, et al.: Dietary intake, body image perceptions, and weight concerns of female US International synchronized figure skating teams. Int J Sport Nutr Exerc Metab 2005, 15:550–566.

    PubMed  Google Scholar 

  35. American Academy of Pediatrics: Committee on sports medicine and fitness. Medical concerns in female athletes. Pediatrics 2000, 106:610–613.

  36. Winters-Stone KM, Snow CM: One year of oral calcium supplementation maintains cortical bone density in young adult female distance runners. Int J Sport Nutr Exerc Metab 2004, 14:7–17.

    CAS  PubMed  Google Scholar 

  37. Zeigler PJ, Jonnalagadda SS, Nelson JA, et al.: Contribution of meals and snacks to nutrient intake of male and female elite figure skaters during peak competitive season. J Am Coll Nutr 2002, 21:114–119.

    Article  Google Scholar 

  38. Bass M, Turner L, Hunt S: Counseling female athletes: application of the stages of change model to avoid disordered eating, amenorrhea, and osteoporosis. Psychol Rep. 2001, 88:1153–1160.

    Article  CAS  PubMed  Google Scholar 

  39. Elliot DL, Moe EL, Goldberg L, et al.: Definition and outcome of a curriculum to prevent disordered eating and body-shaping drug use. J Sch Health 2006, 76:67–73. This program holds promise as a preventive program for disordered eating and related behaviors in athletes. Programs for females (ATHENA) and males (ATLAS, prevention of steroid use) are presented.

    Article  PubMed  Google Scholar 

  40. De La Torre DM, Snell, BJ: Use of the preparticipation physical exam in screening for the female athlete triad among high school athletes. J School Nurs 2005, 21:340–345.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kathe A. Gabel PhD, RD, LD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gabel, K.A. Special nutritional concerns for the female athlete. Curr Sports Med Rep 5, 187–191 (2006). https://doi.org/10.1007/s11932-006-0045-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11932-006-0045-9

Keywords

Navigation