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(17) PARAMETERS OF THE ATHLETE TRIAD IN MALE NCAA DIVISION I ATHLETES


Authors:

Chelsie M. Zajac – Student, Southern Illinois University Edwardsville

Jose M. Moris – undergraduate student, Southern Illinois University Edwardsville

Bharath S. Selvaraj – student, Southern Illinois University Edwardsville

Andrea M. Frerker – student, Southern Illinois University Edwardsville

Aubrey Kamp – student, Southern Illinois University Edwardsville

Jennifer L. Zuercher – Assistant Professor, Southern Illinois University Edwardsville

Bryan Smith – Associate Professor, Southern Illinois University Edwardsville

Maria Fernandez-del-Valle – Assistant Professor, Southern Illinois University Edwardsville

Brianne L. Guilford – Graduate Student, Southern Illinois University Edwardsville

Abstract:

 

 

PURPOSE: The female athlete triad is defined as having one of the following: low energy availability (EA), abnormal menstrual cycle, or decreased bone mineral density (BMD). Although male athletes are also at risk of developing a similar condition characterized by low BMD, low EA, and reduced reproductive hormones, the triad has not been well studied in male athletes. The purpose of this study was to assess BMD and EA in male NCAA division I athletes participating in a leanness emphasized sport (cross country) and a non-leanness emphasized sport (soccer). We hypothesized that cross country (XC) runners would have both lower BMD and EA compared to soccer players.

METHODS: Participants included 12 NCAA division I male athletes (20.6 ± 1.4 yrs) participating in soccer (n = 5) or cross country (XC, n = 7) at Southern Illinois University Edwardsville. Following a 12 hr fast and abstinence from physical activity, a resting metabolic rate (RMR) test, dual energy X-ray absorptiometry scan, and 24-hour food intake recall interview was performed during an early morning testing session. Two unannounced follow-up food intake recall interviews were performed over the phone and used to determine mean daily energy intake. Activity energy expenditure was assessed using an Actigraph activity monitor for 7 days. EA was calculated by subtracting mean daily activity energy expenditure from mean daily energy intake. Low EA was defined as EA < RMR. Group means were compared using an independent samples T-test.

RESULTS: XC athletes had significantly lower BMI (20.4 ± 1.0 vs. 25.1 ± 0.9; p < 0.01), total BMD (1.2 ± 0.6 vs. 1.4 ± 0.0 g/cm3; p < 0.05), lumbar spine BMD (1.2 ± 0.7 vs. 1.4 ± 0.1 g/cm3; p < 0.05) and dual femur BMD (1.1 ± 0.0 vs. 1.4 ± 0.0 g/cm3; p < 0.01). In addition, dual femur T-scores (0.6 ± 0.3 vs. 2.3 ± 0.3; p < 0.01) and Z-scores (0.5 ± 0.2 vs. 1.8 ± 0.2; p < 0.01) were lower in XC compared to soccer athletes. There were no significant differences between sports for body fat percentage, total BMD or lumbar spine T and Z scores, RMR, energy intake, activity energy expenditure, or EA. None of the athletes met the American College of Sports Medicine criterion for low total BMD (Z score = < -1.0). Although there were no significant differences in EA between XC and soccer, 20% of XC athletes had low EA whereas 83% of soccer athletes had low EA.

CONCLUSION: In support of our hypothesis, BMD was lower in athletes participating in XC, a leanness emphasized sport, compared to soccer athletes. In contrast, a higher percentage of soccer athletes had low EA compared to XC runners. Only one parameter of the triad must be present to diagnose an athlete with the triad, thus 50% of the athletes in this study exhibited the athlete triad.

PRACTICAL APPLICATIONS: Despite the small sample size, these data suggest that male athletes may be at similar risk for the triad as female athletes. Although none of the athletes had low total BMD, chronic low EA can lead to low BMD. It is important to ensure that coaches and athletes are made aware of the risk for the male athlete triad and the potential long term health consequences.  In order to thoroughly assess the prevalence of the triad in male athletes, future research that includes a larger and more diverse sample size and reproductive hormone measurements is warranted.

 

 

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