TY - JOUR
T1 - Female athlete triad coalition cumulative risk assessment tool
T2 - Proposed alternative scoring strategies
AU - Koltun, Kristen J.
AU - Williams, Nancy I.
AU - De Souza, Mary Jane
N1 - Funding Information:
This study was partially supported by the U.S. Department of Defense, U.S. Army Medical Research and Materiel Command (grant no. PR054531), and the Pennsylvania State University Childhood Obesity Prevention Training Program.
Publisher Copyright:
© 2020, Canadian Science Publishing. All rights reserved.
PY - 2020
Y1 - 2020
N2 - We (i) identified alternative scoring strategies for the Female Athlete Triad Coalition cumulative risk assessment (CRA) tool to be utilized when particular risk factors (bone mineral density (BMD), oligomenorrhea/amenorrhea) cannot be deter-mined; (ii) objectively defined dietary restriction for use in the CRA tool; and (iii) explored proxy measures of energy deficiency. This cross-sectional investigation of exercising women (n=166) utilized an existing database derived from multiple studies designed to assess health, exercise, and menstrual function. Data from the screening/baseline period of each study included: Anthropometrics, dual-energy X-ray absorptiometry, disordered eating questionnaires, descriptive data, and proxy measures of energy deficiency (total triiodothyronine (TT3) and ratio of measured-to-predicted resting metabolic rate (mRMR/pRMR)). Substituting delayed menarche for BMD was the best-fit replacement resulting in 15 (9%) participants being categorized in different clearance categories. When menstrual status cannot be assessed, such as during hormonal contraceptive use, low energy availability (EA) determined using self-report and disordered eating questionnaires was the best substitution, resulting in 34 (20%) participants being categorized in different clearance categories. Based on original clearance categorizations, the provisional group had lower TT3 (78.3±2.2 ng/dL; 92.7±2.7 ng/dL) and Harris-Benedict mRMR/pRMR (0.85±0.01; 0.90±0.01) than the full group. Until an updated risk assessment tool is developed, delayed menarche can substitute for low BMD and low EA for oligomenorrhea/amenorrhea. Novelty • This investigation addresses previous limitations of the Triad CRA tool. • Disordered eating questionnaires can be used to objectively identify dietary restriction for the low EA risk factor. • When a risk factor cannot be assessed, delayed menarche can substitute for low BMD and low EA for oligomenorrhea/amenorrhea.
AB - We (i) identified alternative scoring strategies for the Female Athlete Triad Coalition cumulative risk assessment (CRA) tool to be utilized when particular risk factors (bone mineral density (BMD), oligomenorrhea/amenorrhea) cannot be deter-mined; (ii) objectively defined dietary restriction for use in the CRA tool; and (iii) explored proxy measures of energy deficiency. This cross-sectional investigation of exercising women (n=166) utilized an existing database derived from multiple studies designed to assess health, exercise, and menstrual function. Data from the screening/baseline period of each study included: Anthropometrics, dual-energy X-ray absorptiometry, disordered eating questionnaires, descriptive data, and proxy measures of energy deficiency (total triiodothyronine (TT3) and ratio of measured-to-predicted resting metabolic rate (mRMR/pRMR)). Substituting delayed menarche for BMD was the best-fit replacement resulting in 15 (9%) participants being categorized in different clearance categories. When menstrual status cannot be assessed, such as during hormonal contraceptive use, low energy availability (EA) determined using self-report and disordered eating questionnaires was the best substitution, resulting in 34 (20%) participants being categorized in different clearance categories. Based on original clearance categorizations, the provisional group had lower TT3 (78.3±2.2 ng/dL; 92.7±2.7 ng/dL) and Harris-Benedict mRMR/pRMR (0.85±0.01; 0.90±0.01) than the full group. Until an updated risk assessment tool is developed, delayed menarche can substitute for low BMD and low EA for oligomenorrhea/amenorrhea. Novelty • This investigation addresses previous limitations of the Triad CRA tool. • Disordered eating questionnaires can be used to objectively identify dietary restriction for the low EA risk factor. • When a risk factor cannot be assessed, delayed menarche can substitute for low BMD and low EA for oligomenorrhea/amenorrhea.
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U2 - 10.1139/apnm-2020-0131
DO - 10.1139/apnm-2020-0131
M3 - Article
C2 - 32502379
AN - SCOPUS:85097003205
SN - 1715-5312
VL - 45
SP - 1324
EP - 1331
JO - Applied Physiology, Nutrition and Metabolism
JF - Applied Physiology, Nutrition and Metabolism
IS - 12
ER -
