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Nancy I. Williams, Clara V. Etter and Jay L. Lieberman

An understanding of the health consequences of abnormal menstrual function is an important consideration for all exercising women. Menstrual disturbances in exercising women are quite common and range in severity from mild to severe and are often associated with bone loss, low energy availability, stress fractures, eating disorders, and poor performance. The key factor that causes menstrual disturbances is low energy availability created by an imbalance of energy intake and energy expenditure that leads to an energy deficit and compensatory metabolic adaptations to maintain energy balance. Practical guidelines for preventing and treating amenorrhea in exercising women include evidence-based dietary practices designed to achieve optimal energy availability. Other factors such as gynecological age, genetics, and one’s susceptibility to psychological stress can modify an individual’s susceptibility to menstrual disturbances caused by low energy availability. Future research should explore the magnitude of these effects in an effort to move toward more individualized prevention and treatment approaches.

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Laurie Stickler, Trisha Armstrong, Alyssa Polso and Melissa Smith

Context:

Low energy availability has been identified through research as the cornerstone of the female athlete triad, yet reasons for nutritional choices among female collegiate athletes are poorly understood.

Objective:

To explore the perspectives of female collegiate cross country runners on eating behaviors and attitudes toward health.

Design:

Phenomenologic qualitative study with individual, semistructured interviews.

Methods:

Ten collegiate female cross country runners, ages 18–22, participated in the study. All interviews were audiotaped then transcribed. Three researchers independently coded data and developed themes and subthemes before meeting and negotiating findings.

Results:

The following four themes were identified: health behaviors, nutritional knowledge, internal and external factors, and health attitudes.

Conclusions:

This study contributes to understanding “the why” behind health behaviors of female collegiate cross country runners. This developmental understanding may assist in interpreting the behavioral causes of low energy availability; thus, both management and prevention of the triad may be aided by this information.

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contraceptive pill or pharmaceutical agents for treating low bone density in female athletes. Rather, increasing energy availability and weight gain are more effective strategies, with bone strength improvements reported over one to six years. There is scant evidence on the long-term bone health in female