Female athlete triad in elite swimmers of the city of Rio de Janeiro, Brazil.
ABSTRACT Female athlete triad (FAT) is a syndrome characterized by the simultaneous presence of disordered eating, amenorrhea, and osteopenia or osteoporosis. The aim of this study was to assess the prevalence of FAT in adolescent elite women swimmers.
The sample was composed of 78 athletes in the age range of 11-19 y from Rio de Janeiro (Brazil). The presence of disordered eating was assessed through three questionnaires (Eating Attitudes Test, Bulimic Investigatory Test Edinburgh, and Body Shape Questionnaire); the presence of menstrual dysfunctions, through a validated questionnaire; and bone dysfunctions, through assessment of bone mineral density by applying the method of dual-energy X-ray absorptiometry. The t test was used to compare means. The chi-square test was used to evaluate the association among categorical variables (P < 0.05). Pearson's coefficients of simple linear correlation between the variables of lean body mass and body mineral density at the spine (L1-L4) and overall in the body were calculated. Kaplan-Meier survival curves to estimate mean menarche age were obtained. All analyses were conducted in SPSS 13.0.
The athletes' mean age at menarche was 12.38 +/- 0.2 y. It was verified that 44.9%, 19.2%, and 15.4% of the athletes met the criteria for disordered eating, menstrual irregularity, and low bone mass, respectively. Among participants, 47.4% (37 of 78) met one criterion of FAT, 15.4% (12 of 78) met two criteria, and 1.3% (1 of 78) met all three criteria, corresponding with the development of the syndrome. Only 35.9% (28 of 78) of the athletes did not present positive results for any of the criteria assessed.
The prevalence of FAT was low. However, a significant number of athletes presented a partial status of FAT, especially of disordered eating. The present study suggests the need to monitor the causes of these disorders to create preventive actions that will reverse or avoid the development of the syndrome, thus preserving the athletes' health.
- SourceAvailable from: highwire.orgArchives of Disease in Childhood 07/1969; 44(235):291-303. · 3.05 Impact Factor
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ABSTRACT: This study considered the concordance of self-assessment and physician assessment of sexual maturity status; breasts, and pubic hair in girls, and genitals and pubic hair in boys. The subjects were Brazilian children, youth and young adults, 174 females and 178 males, 6–26 years of age. Each subject evaluated his/her level of sexual maturation and then was examined by a physician. The sexual maturity ratings of the subjects and physicians were compared. Overall, the results showed moderate to high concordance (60.9–71.3%) for both assessments of secondary sex characteristics; better concordance was found for pubic hair (69.7–71.3%) than for the breasts or genitals (60%). Age did not appear to influence the accuracy of self-evaluation; rather, accuracy was more dependent on stage of maturation of the subject. Correlations between self- and physician assessments, and replicate self- and physician assessments were relatively high. © 1994 Wiley-Liss, Inc.American Journal of Human Biology 06/2005; 6(4):451 - 455. · 2.34 Impact Factor
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ABSTRACT: To link annual changes of bone mineral density (BMD) over 12 consecutive years to pharmacological intervention and to fluctuations of body mass and body composition in an amenorrheic athlete. BMD of the lumbar spine (LS) and total proximal femur (PF) were measured using dual energy x-ray absorptiometry (DXA), every 11-13 months between ages 24.8 and 36.9 yr. Body composition was assessed every 3-4 yr from a whole body DXA scan. Body mass was recorded every 3 months. For the first 5 yr of study, the subject used oral contraceptives (OC). For the subsequent 7 yr, she used estradiol skin patches (EP) with oral norethisterone. The first DXA scan (age 24.8 yr) revealed a low BMD at both LS and PF, with T-scores of -1.4 and -2.8, respectively. During the next 5 yr, while adhering to OC, the BMD of her LS and PF declined by 9.8% and 12.1%, respectively. Concomitantly, her body mass fell from 45.1 to 41.4 kg, her body mass index (BMI) from 16.4 to 15.0 kg.m-2, and her percent body fat from 8.3 to <4.0%. While treated with EP and norethisterone (age 29.8-33.5 yr), her LS BMD gradually increased by 9.4%, despite a further 0.8 kg decline of body mass. From age 33.8 to 36.9 yr, voluntary weight gain (2-3 kg.yr-1; total: 8.1 kg) was accompanied by an increase of her PF BMD (16.9%), with no further increase at the LS. Changes of BMD at the total proximal femur reflected changes of body mass in this subject. At the lumbar spine, BMD declined with weight loss but increased in association with transdermal estradiol treatment in the absence of weight gain.Medicine & Science in Sports & Exercise 02/2004; 36(1):137-42. · 4.48 Impact Factor