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Dietary intakes of 24 female athletes in various sports were compared inseason and postseason to those reported by 24 nonathletes during the same time period. Diets were analyzed for energy, carbohydrate, fat, protein, vitamins A and C, thiamin, riboflavin, niacin, folacin, calcium, and iron. During the study, the athletes' and nonathletes' diets were similar. Their energy intakes were lower than recommended while their iron and calcium intakes were marginal (less than 70% of the recommended dietary allowance). Although few dietary changes were observed, the nonathletes' diets changed more than those of the athletes during the study. Both groups reduced their energy intakes but only the nonathletes' reduction was significant. Initially many subjects were dieting. More subjects reported dieting during the second recording period. These results suggest that the desire to be thin may influence dietary intakes of female athletes more than changes in exercise training.

Some of the nutritional concerns of female athletes are highlighted in this case study of a 20-year-old woman who wants to lose 16% of her body weight to qualify for the position of coxswain on a national crew team. These concerns include adequacy of vitamin, mineral, protein, and carbohydrate intake as well as amenorrhea and pathogenic eating behaviors.

This paper presents an overview of eating disorders, including definitions, clinical criteria for appropriate diagnosis, and a discussion of the potential for increased risk for eating disorders in special populations of female athletes. This is followed by a discussion of the prevalence of eating disorders in normal and athletic populations. From this discussion, it seems clear that female athletes in endurance or appearance sports are at an increased risk for disordered eating. Finally, the paper focuses on related disorders—a triad associating eating disorders, menstrual dysfunction, and bone mineral disorders. It is clear that secondary amenorrhea is associated with malnutrition and disordered eating. Further, bone mineral disorders are related to menstrual dysfunction. Disordered eating may represent the initiating factor of this triad.

The aim of this study was to establish whether extremely low serum ferritin values in female athletes were associated with indications of iron deficiency anemia and whether serum ferritin values were influenced by the type of training or participants' body size. Hematological data collected during 6 years at the Australian Institute of Sport were reviewed to quantify changes in serum ferritin concentration associated with training and to establish whether decrements in serum ferritin were associated with any change in hemoglobin concentration, mean corpuscular volume, or mean corpuscular hemoglobin concentration. Mean serum ferritin concentrations of 7.5 μg ⋅ L⁻¹ were not associated with any indication of iron-deficiency anemia. Serum ferritin declined by approximately 25% with the onset of rigorous daily training (p <.01) whether training was predominantly weight-bearing or non-weight-bearing. Rowers had significantly higher ferritin concentrations than basketball players of similar stature (p = .02). We conclude that considerable background information such as the stage of training, specific sport, and previous blood results should be sought when interpreting serum ferritin concentrations in female athletes.

Female athletes experience a high incidence of menstrual abnormalities. This has critical health consequences because amenorrhea athletes are at greater risk of developing osteopenia and bone injury compared to normally menstruating athletes or nonathletic normally cycling females. Female performers and athletes are also at risk for developing disordered eating behaviors. There appears to be a connection between menstrual dysfunction, athletic training, and disordered eating, but how they relate is not fully understood. In this paper we explore how low calorie intakes, nutritional inadequacies, vegetarianism, low body fat stores, and specific training behaviors may contribute to the abnormal menstrual patterns seen in this population. Recommendations for the detection and prevention of eating and training problems and consequent menstrual abnormalities are included.

A growing body of evidence suggests that the prevalence of eating disorders and excessive concerns regarding body weight in certain subpopulations of female athletes are increasing. The pressure on female athletes to improve their performances and physiques, coupled with the general sociocultural demand placed on all women to be thin, often results in attempts to achieve unrealistic body size and body weight goals. For some female athletes the pressure to achieve and maintain a low body weight leads to potentially harmful patterns of restrictive eating or chronic dieting. This paper seeks to further delineate the characteristics of a recently identified subclinical eating disorder in female athletes: anorexia athletica. Research studies that support the existence of subclinical eating disorders will be reviewed. In addition, the possible physiological and psychological consequences of subclinical eating disorders will be explored.