Dr. Vicki Harber of the University of Alberta describes the kind of nutrition female athletes build strong, resilient bodies and stave off the Female Triad: disordered eating, bone loss and dysmenorrhoea.

2. Fueling the female athlete
Vicki Harber, PhD
V k H b
Faculty of Physical Education &
Recreation
University of Alberta

3. Components of Performance
Nutrition
Physical Technical
Tactical Mental
Sleep/Rest/Recovery

4. Athletic Performance
NUTRITION
Smith DJ

6. …changing
g g
participation rate
More sports…
More opportunities…

7. Female‐ p
Female‐specific issues
Musculoskeletal issues:
Musculoskeletal issues:
Mechanical Medical conditions
Medical conditions:
Medical conditions:
conditions:
Energetic
• disordered eating
• anterior cruciate
• menstrual irregularities
menstrual irregularities
ligament (ACL) injuries
• patellofemoral joint • bone health
(iliotibial band; IT band)
(ili tibi l b d IT b d) – stress fractures
stress fractures
• shoulder conditions – osteopenia
• concussion – osteoporosis

8. “Injury” model
Elliot et al

10. Major issues for female athletes
Major issues for female athletes
Maintaining adequate:
Maintaining adequate:
1. Energy balance
2. Carbohydrate (CHO)
2 C b h d (C O)
3. Calcium
4. Iron
American College of Sports Medicine/American Dietetic Association of Canada
Joint Position Statement (2009) Nutrition and athletic performance.
Joint Position Statement (2009) Nutrition and athletic performance

11. What do we know about energy intake of
athletes?
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Challenge to match energy intake with
demands of training and requirements for
daily living
• li i i
limitations to data collection (under‐reporting,
d ll i ( d i
under eating, deception, measurement error)
• energy intake of female athletes may be 35%‐
70% of recommended intake

12. Energy intake: female vs
Energy intake: female vs male

13. Problems asst’d with negative
g
energy balance?
Numerous adverse consequences
(physiological, psychological,
medical):
d l)
poor recovery and adaptation to
training
reduced lean body mass (muscle)
increased risk of injury
reduced ability to fight infection/illness
reduced ability to fight infection/illness
reduced restorative sleep
poor performance

14. Reproductive disturbances
✒delayed menarche
✒primary amenorrhea
✒secondary amenorrhea
✒oligomenorrhea
✒ li h
✒subclinical (anovulation, luteal phase defects)

15. Bone health
Drinkwater (1990) JAMA

16. The impact of menstrual function on bone mass and size. Menstrual function was defined as normal (≥ 10 cycles/year) versus
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)
Ruffing et al (2007) Nutrition & Metabolism

17. When do problems arise??
When do problems arise??
Severity and duration of deficit determines
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consequence
Impact may be immediate or take time to emerge

18. 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 limiting
dietary restraint (perception of constant monitoring and/or limiting
intake to control body weight)
disordered eating (food avoidance/restriction, laxatives, etc)
eating disorder (anorexia, bulimia)

19. Fat phobia
Fat 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 range
g
Abramovitz 2000, Boyce 2008, Patton 1999

20. Energy balance
Energy balance
Training and
Training and
competing at
your very best
requires good
nutrition
Athletes need to
make smart
choices about
choices about
type, timing and
quantity of food
quantity of food

21. Avoid the avoidable!!
Avoid the avoidable!!

22. Resources
International Olympic Committee Medical Commission
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Position Stand on the Female Athlete Triad:
http://www.olympic.org/uk/organisation/commissions/medical/index_uk.asp
Bonci CM et al (2008) National Athletic Trainers’
B i CM t l (2008) N ti l Athl ti T i ’
Association Position Statement: Preventing,
Detecting and Managing Disordered Eating in
g g g g
Athletes. J Athletic Training 43:80‐108.
Female Athlete Triad Coalition:
http://www.femaleathletetriad.org/