| dc.description.abstract | Adolescents regularly participating in sports and do not meet their energy intake
may develop several medical conditions, such as disordered eating, menstrual
dysfunction, and decreased bone mineral density, collectively referred to as the
Female Athlete Triad (FAT). Limited data is available on components of FAT in
adolescent athletes of African descent. This study’s aim was to investigate the
presence of the components of the female athlete triad amongst a group of junior
long female distance runners and non-athletes in Kenya. One hundred and ten
students randomly selected from secondary schools in Iten, Elgeyo-Marakwet
County, took part in this cross-sectional comparative study. Students completed
demographic, health, sport and menstrual history questionnaires as well as a 5-day
weighed dietary record and exercise log to calculate energy availability (EA). Heel
bone mineral density was assessed with ultrasound. Subscales of the Eating Disorder
Inventory and the cognitive dietary restraint subscale of the Three-Factor Eating
Questionnaire measured disordered eating. Dietary intake was analysed with Nutrisurvey and dietary diversity determined by the Individual Dietary Diversity Score
(IDDS) using 5-day dietary records. Fewer mothers (19 vs. 40%, χ2=12.9, p=0.02)
and fathers (28 vs. 50%, χ2=11.8, p=0.06) from athletes had tertiary education than
non-athletes, and more mothers from non-athletes had formal employment than
athletes (54 vs.13%, χ2=22, p<0.001). Energy availability was significantly lower in
athletes than non-athletes (36.5 ± 4.5 vs. 39.5 ± 5.7 kcal/kg/FFM/day, p=0.003).
More athletes than non-athletes were identified with clinical low EA (17.9 vs. 2 %,
[OR = 9.5, 95% CI (1.17, 77), p=0.021). Subclinical (75.4 vs. 71.4%) and clinical
DE behaviour was similar between athletes and non-athletes, (4.9 vs. 10.2%,
respectively, χ
2=1.1, p=0.56). More athletes than non-athletes had a body mass index
of < 17.5 kg/m2
[16.1 vs. 0%, OR= 0.8, 95% CI (0.7, 0.9), p=0.004]. No significant
differences were noted for carbohydrate, fat, calcium, magnesium, B2 and zinc intake
between groups. IDDS was higher in students in day schools than in boarding
schools (4.36±0.7 vs. 3.8±0.6, χ2 =13.4, p=0.001). More athletes (72.1% vs. 32.7%
χ
2 =17, p=0.000) reported restricting the types of food eaten and the amount to
control weight (68.9% vs. 32.7%, χ2 =14, p=0.000). More athletes reported clinical
menstrual dysfunction in comparison to non-athletes (32.7% vs. 18.3%, χ
2=7.1
p=0.02); primary amenorrhea (13.1% vs. 2.0%) and secondary amenorrhea (19.7%
vs. 10.2%). BMD tended to be higher in athletes compared to non-athletes
(0.629±0.1 vs. 0.592±0.1 g/cm2
, p=0.06). Kenyan adolescent athletes and non athletes present with low energy availability and menstrual disturbances which are
key components of the female athlete triad. Energy intakes should be increased in
the student population to match the energy expended and menstrual disturbances
closely monitored in athletic adolescent girls since exercise induced amenorrhea
signals energy drain. | en_US |
