Fueling the female athleteFueling the female athleteFueling the female athleteFueling the female athlete

V k H b PhDV k H b PhDVicki Harber, PhDVicki Harber, PhDFaculty of Physical Education & Faculty of Physical Education &

RecreationRecreationRecreationRecreationUniversity of AlbertaUniversity of Alberta

Components of Performance

Nutrition

PhysicalPhysical TechnicalTechnical

TacticalTactical MentalMental

Sleep/Rest/Recovery

Athletic Performance

NUTRITIONNUTRITIONNUTRITIONNUTRITION

Smith DJ

…changing …changing g gg gparticipation rateparticipation rate

More sports…More sports…More opportunities…More opportunities…

FemaleFemale‐‐specific issuesspecific issuespp

Musculoskeletal issuesMusculoskeletal issues:: Medical conditionsMedical conditions::Mechanical Energetic

•• anterior cruciate anterior cruciate 

Medical conditionsMedical conditions::

•• disordered eatingdisordered eating

•• menstrual irregularitiesmenstrual irregularities

Mechanical Energetic

ligament (ACL) injuriesligament (ACL) injuries•• patellofemoral joint patellofemoral joint (ili tibi l b d IT b d)(ili tibi l b d IT b d)

•• menstrual irregularitiesmenstrual irregularities

•• bone healthbone healthstress fracturesstress fractures(iliotibial band; IT band)(iliotibial band; IT band)

•• shoulder conditionsshoulder conditions•• concussionconcussion

–– stress fracturesstress fractures

–– osteopeniaosteopenia

–– osteoporosisosteoporosis•• concussionconcussion osteoporosisosteoporosis

“Injury” model

Elliot et al

Major issues for female athletesMajor issues for female athletesMajor issues for female athletesMajor issues for female athletes

Maintaining adequate:Maintaining adequate:

1. Energy balance

2 C b h d (C O)2. Carbohydrate (CHO)

3. Calcium

4. Iron

American College of Sports Medicine/American Dietetic Association of Canada American College of Sports Medicine/American Dietetic Association of Canada Joint Position Statement (2009) Nutrition and athletic performanceJoint Position Statement (2009) Nutrition and athletic performanceJoint Position Statement (2009) Nutrition and athletic performance.Joint Position Statement (2009) Nutrition and athletic performance.

What do we know about energy intake of What do we know about energy intake of hl ?hl ?athletes?athletes?

Challenge to match energy intake withChallenge to match energy intake with demands of training and requirements for daily livingdaily living

li i i d ll i ( d i• limitations to data collection (under‐reporting, under eating, deception, measurement error)

• energy intake of female athletes may be 35%‐70% of recommended intake

Energy intake: female vs maleEnergy intake: female vs male

Problems asst’d with negative genergy balance?

Numerous adverse consequences (physiological, psychological, 

d l)medical):poor recovery and adaptation to trainingreduced lean body mass (muscle)increased risk of injuryreduced ability to fight infection/illnessreduced ability to fight infection/illnessreduced restorative sleeppoor performance

Reproductive disturbancesReproductive disturbances

✒delayed menarche

✒primary amenorrhea

✒secondary amenorrhea

✒ li h✒oligomenorrhea

✒subclinical (anovulation, luteal phase defects)

Bone healthBone health

Drinkwater (1990) JAMA

The impact of menstrual function on bone mass and size Menstrual function was defined as normal (≥ 10 cycles/year) versus

Ruffing et al (2007) Nutrition & Metabolism

The impact of menstrual function on bone mass and size. Menstrual function was defined as normal (≥ 10 cycles/year) versus oligomenorrhea/amenorrhea (≤ 9 cycles/year). Bone mineral density was measured at the spine, hip and heel; and at the tibia, bone mineral content, cortical thickness and endosteal circumference were determined. All values are mean ± standard errors. Subjects were military cadets (n=135)

When do problems arise??When do problems arise??

Severity and duration of deficit determines yconsequence

Impact may be immediate or take time to emerge

Why does this happen?Why does this happen?Why does this happen?Why does this happen?

Not always deliberate (busy schedule, $$, travel, etc)Not always deliberate (busy schedule, $$, travel, etc)

Sometimes deliberate, sometimes other stressors:dietary restraint (perception of constant monitoring and/or limitingdietary restraint (perception of constant monitoring and/or limiting intake to control body weight)

disordered eating (food avoidance/restriction, laxatives, etc)

eating disorder (anorexia, bulimia)

Fat phobiaFat phobia

Grade 3 girls

30% think they should be thinner

40% have tried to lose weight

Grade 6 girls

60% have tried to lose weight

80% think they should be thinner

9% are in the anorexia nervosa rangeg

Abramovitz 2000, Boyce 2008, Patton 1999

Energy balanceEnergy balance

Training andTraining andTraining and Training and competing at competing at your very best your very best requires good requires good nutritionnutrition

Athletes need to Athletes need to make smart make smart choices aboutchoices aboutchoices about choices about type, timing and type, timing and quantity of foodquantity of foodquantity of foodquantity of food

Avoid the avoidable!!Avoid the avoidable!!

ResourcesResourcesResourcesResources

International Olympic Committee Medical Commission y pPosition Stand on the Female Athlete Triad:

http://www.olympic.org/uk/organisation/commissions/medical/index_uk.asp

B i CM t l (2008) N ti l Athl ti T i ’Bonci CM et al (2008) National Athletic Trainers’ Association Position Statement: Preventing, Detecting and Managing Disordered Eating in g g g gAthletes. J Athletic Training 43:80‐108.

Female Athlete Triad Coalition:http://www.femaleathletetriad.org/