In case you haven’t seen the most recent news in the sports world I’ll provide a little update. Recently former professional runner Mary Cain who ran for the Oregon Project published an opinion piece with The New York Times. Cain describes her experience with the team as a “systemic crisis in women’s sports and at Nike.’ She describes how she was constantly being monitored for her weight, was told in order to be better she had to be thinner and was publicly shamed if she did not maintain the weight her coach wanted her too. Her story reaches a climax when she developed RED-S syndrome (Relative Energy Deficiency in Sports), also known as the female athlete triad, and ended up with five broken bones. If you want to watch her full story click here.
According to an article published in Sports Health the female athlete triad consist of: menstrual dysfunction + low energy (with or without an eating disorder) + decreased bone mineral density. While there are many ways menstrual dysfunction can be described it is most often discussed as amenorrhea, or the absence of your period. Amenorrhea can be caused by many things but a few of the most common ones include energy deficiency (think consuming less calories than your body needs), stress (over exercising, life stressors ect..) and decreased body fat. All these factors can put the body in a state where it does not feel that it has the capability to reproduce thus no cycle occurs. Some women may be okay with this however the side effects can be detrimental to health in the long run.
Lets chat about bone health. I feel that this side effect of amenorrhea is one that many are not monitoring, especially with athletes or active females. Maximal increases in bone mass occur anywhere from 11-14 years old in females with approximately 92% of total body bone mineral content by 18 years of age and 99% by 26 years old*. However, these statistics look much different for those who fall under the athlete triad. Amenorrhea can put an individual in a hypoestrogenic state (decreased estrogen levels). Estrogen is bone protective and inhibits osteoclast (bone breakdown) thus a lack of estrogen disrupts proper bone development and health. A few other effects of the athlete triad are endothelial dysfunction, elevated LDL cholesterol and decreased immune function*.
From an energy level standpoint female athletes are often at a higher risk of developing an eating disorder with the pressure to maintain a specific body composition for their sport which can come from the athlete themselves, a coach or even the media/society. Unfortunately, disorder eating behaviors or active eating disorders do go undiagnosed in college athletes especially if the athlete is performing well because why fix something that’s not broken?
Disclaimer: I’m no eating disorder expert but there can be different levels of ‘extremeness’ when it comes to disordered eating behaviors. It could be as simple as lowering your daily calories or as extreme as skipping meals, binging and purging, fasting or using laxatives and diet pills. That is exactly what Cain describes in her video as she was forced to take birth control and laxatives by her coach to help loose weight. Not only is this scary from a weight perspective but also from a physiological standpoint as frequent bowel movements can cause loss of electrolytes and dehydration which is not ideal for any athlete!
Something else to note is that the Oregon Project did not have a dietitian on staff. Could some of these things been prevented had they had a nutrition expert on staff? Possibly but unfortunately that answer will never be known.
Yes, this short video blasted Nike but let’s not be naïve and think this doesn’t happen anywhere else because it does! Telling women and girls how they should look has gone on for far too long and it is mentally, emotionally and physically damaging. It is time we start praising young athletes and females for their performance and accomplishments rather than their looks.
I could write much more but I’ll end with this…
Periods may be a taboo topic to talk about but it shouldn’t be and it can’t be. Our generation is so okay with brushing under the rug a young female athlete, growing teenager or young active female not getting their period and this is NOT okay. Our health care field does not do a good enough job educating young girls and adults about the side effects of amenorrhea. Treatment of the athlete triad or simply just amenorrhea requires a multidisciplinary approach, or multiple health care providers, therefore it is important for health care providers and coaches to be trained to recognize the signs and symptoms so they can refer out to the right person. If your unsure where to start finding a registered dietitian would be a great place to begin. But for now I want you to think about the following…
A thinner athlete does not equal a better athlete.
A thinner young adult does not equal a healthier adult.
Please take those words to heart and put your health first.
*Source: Nazem, Taraneh, and Kathryn Ackerman. “The Female Athlete Triad.” Sports Health, vol. 4, no. 4, July 2012, pp. 302–311.