The triad of sportswomen

The first time they talked about triad It was in the 90s of the last century. At present, due to the large number of women who practice sports at a high level, it is increasingly common to find it. Therefore, to know detect it in time and know how it can be solved will avoid health problems. Let's learn more about the Triad.

What is understood by the athlete's triad?

The Female Athlete Triad is a medical condition that includes the following symptoms:

• Low energy availability with or without Eating Disorder (Eating Disorder).
• Altered menstrual function.
• Low bone mineral density (BMD).

The athlete does not have to show simultaneously the three clinical manifestations at the same time, but they can also present individually. They are all in risk of suffering the triad, regardless of the complexion they have or the sport practiced. For this reason, it is important to pay attention to its three components, and above all, in the case of girls or young people who practice sports intensively and in federated sports disciplines, there must be continuous ones.

What symptoms develop in the triad?

There are many symptoms that can give the warning of a possible Triad before it triggers:

• Fatigue
• Anemia
• Depression
• Stress fractures
• Decreased ability to concentrate
• Cold intolerance, hypothermia, cold and loss of color in feet and hands
• Increased parotid glands
• Throat pain
• Erosion of tooth enamel
• Bloating, abdominal pain, and constipation
• Dry skin, edema of the face and extremities
• Dizziness, bradycardia, hypotension
• Chest pain

Energy availability

When the energy available is very low, physiological mechanisms reduce the energy used to perform vital functions such as cell maintenance, thermoregulation, growth and reproduction, affecting health. Among the athletes who practice sports in which weight is influential, such as gymnasts, long distance runners, sports by weight category (judo, karate ...), etc. is more common than low energy availability, that is, not eating enough, is related to problems of eating disorder (eating disorder). On the contrary, in many other athletes the affectations do not present pathological eating behaviors, but it may be that their low intake is unintentional and the training is very intense. As risk factors we could find inadequate or insufficient rest, excessive worship of the body, low self-esteem, etc. Depending on the origin of the low intake, one treatment or another will be carried out.

Menstrual function

When we talk about alterations in menstrual function we talk about those situations that occur between the normal menstrual cycle (eumenorrhea) and absence of menstrual cycle (amenorrhea). In young girls there may be a delay in the first menstruation (menarche) which is considered a primary amenorrhea. There are documented cases, such as that of a British athlete who did not have her first menstruation until after 20 years, or there may be secondary amenorrhea, which is defined as the absence of a menstrual cycle for more than three months.

Bone mineral density (BMD)

When we talk about a low bone mineral density, we refer to the spectrum between optimal bone health and osteoporosis is defined as a skeletal disorder characterized by lower bone mass and, therefore, with a higher risk of fracture. Bone mass and the increased risk of fracture depend on the density of the internal bone mineral structure, but also on the quality of the protein. Osteoporosis is caused not only by accelerated bone loss in adulthood but also by not accumulating adequate BMD during childhood and adolescence. The acquisition of bone mass occurs between fourteen and fifteen years and the maximum peak of bone mass is located in the twenty - thirty years. At the end of adolescence the 90% of adult bone mass. Although genetics play a crucial role, participation in impact sports and diet have a very important influence on bone health in childhood.

Consequences for health

Sustained low energy availability, with or without TCA, can lead to health problems. Medical problems include disturbances in the cardiovascular, endocrine, reproductive, skeletal, gastrointestinal, renal, and central nervous systems. Alterations in eating behavior are associated with low BMD in athletes, so a low BMD is a good predictor of low BMD. Athletes with a low percentage of body fat or low dietary intake have increased risk of having lower BMD or injury, in addition to the serious psychological consequences that can accompany EDs.

Prevention

Low energy availability (with or without eating disorders), amenorrhea, and osteoporosis are risk factors for women's health. The consequences of these potentially irreversible clinical conditions make prevention very necessary, and here food education is key. It is important establish and promote healthy eating habits, highlight the importance of strength, muscle percentage and fat for optimal sports performance and not only give importance to body weight. In addition, make the athlete aware of the short and long-term health consequences of an inadequate diet.

• The Sportswoman Triad is a medical condition which includes: low energy availability, impaired menstrual function and low bone mineral density.
• All sportswomen They are at risk of suffering from the triad, regardless of their complexion or the sport they play.
• The consequences of these clinical conditions, potentially irreversible, make prevention very necessary, where food education is key.

Diploma in Human Nutrition and Dietetics Sports nutrition specialist