Assessment and identification of health problems of female athletes

Date
2005-01-01
Authors
Westberg, Karin
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Altmetrics
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Abstract

Female athletes are susceptible to health problems related to the physical stress of exercise and suboptimal nutrition habits. In 1992, The American College of Sport Medicine identified the Female Athlete Triad (disordered eating, amenorrhea, osteoporosis) as an increasing health problem among female athletes. Weight-bearing exercise stimulates bone formation, which in a healthy state exceeds bone breakdown and increases the bone mass density and bone mineral content. However, bone breakdown from excessive exercise may exceed bone formation, thus contributing to bone loss. Bone loss may be accelerated by the physical impact of sports; higher impact sports have greater bone turnover and risk for bone loss. In addition to the triad, many female athletes suffer from iron deficiency. Iron is essential for iron-dependent enzymes in collagen formation, thus may play a role in bone health. Decreased bone mass can result in stress fractures and place the athlete at risk for osteoporosis later in life. This study examined sport impact and bone status in 117 collegiate female athletes while developing a model to predict stress fracture risk. Secondly, it examined the relationship between iron status and bone health in collegiate female athletes. Data from this study suggest that bone resorption is greater (P<0.05) in high impact sports than low impact sports. It also introduces a model, which suggests that high impact sports and a low bone formation to breakdown ratio (<8) are predictive of increased probability of stress fractures (P<0.05). The data also suggest that iron status is negatively associated with bone formation (P<0.05) and positively associated with bone breakdown (P<0.05). Subjects with iron depletion have significantly higher bone breakdown and subjects with iron deficiency have significantly higher bone formation than other categories of iron status. Thus, this study contradicts a previously postulated theory that adequate iron promotes bone formation. It is recommended that sport impact be included when assessing bone status and stress fractures in female athletes. The negative relationship between tissue iron status indicators and bone turnover warrants further research. Future research needs to identify valid and reliable bone markers with standardized reference values to facilitate the comparison among studies.

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Food science and human nutrition, Nutrition
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