KIRSTEN WAGNER, M.A., C.S.C.S.
Program Manager at the Center for Health and Wellness
Saint Barnabas Ambulatory Care Center
 Many teenage girls believe that excessive training or exercise
and a strict diet will improve their athletic performance.
In reality, the opposite is true. They may hinder their performance
and cause short-term and/or long-term damage to their bodies.
Young female athletes who eat erratically and experience irregular
menstrual periods may have a common condition known
as the Female Athlete Triad. This condition is a combination
of three serious health issues: disordered eating, amenorrhea
and osteoporosis.
Many young female athletes participate in quirky diets or
restrict certain foods in order to meet their goals. They
often end up with diets that barely satisfy their ability
to function, and certainly do not prepare them for intense
exercise. Sports such as gymnastics, swimming, figure skating,
long distance running and rowing require female athletes
to sustain a particular weight or carry a specific “lean
look” to impress the judges or make the grade. Some
athletes even show symptoms of anorexia nervosa or bulimia
and experiment with dangerous diet pill and laxatives as
well.
How many calories does a young athlete really need? It depends
on the
young woman and the sports in which she is participating.
We all need a
certain number of calories to survive and to grow into young
adults. Known as our Resting Metabolic Rate, this is usually
in the area of 1500 calories. On top of that we need additional
calories for our Activities of Daily Living (walk the dog,
go to work, grocery shop, etc…), which can require
an additional 300 to 500 calories. An athlete needs additional
calories to sprint, twist, throw, jump and propel herself
around the field, court or pool. This can add up to several
hundred or several thousand additional calories per day. It
is not uncommon for a 130 lb high school soccer player to
use 2,750 to 3,000 calories per day.
 In order to satisfy these calorie needs an athlete should
acquire approximately 60 percent of her calories from simple
and complex carbohydrates, such as fruit, vegetables, whole
grain pastas and breads. The rule of thumb is 3 to 5 grams
of carbohydrate per pound of body weight. Ten to 15 percent
of her calories should come from lean protein sources such
as fish, poultry, peanut butter, eggs, milk and beans. Usually
.8 to .9 grams of protein per pound of body weight is enough
to repair and restore muscle and build strong bones. Contrary
to popular belief, excess protein cannot turn itself into
muscle.
The final building block is dietary fat from sources such
as olive, canola, peanut and fish. Twenty to 30 percent of
an athlete's calories can come from these “healthy” dietary
fats, which are necessary for many biological processes.
Do not forget about proper hydration. Typically, you drink
one liter of water for
every 1,000 calories you expend. Drinking water continuously
throughout the day and monitoring the frequency and color
of urine output is a simple way to stay hydrated. About two
hours before a game or practice, drink two cups of water.
Add another two cups of water 15 minutes before the activity
and 1/2-cup of water every 15 to 20 minutes of your workout.
Monitor post workout urine as well. If it is dark and sparse,
you are dehydrated.
Amenorrhea can be primary, where a young woman has never had
a period, or secondary, where a young woman has missed three
to six consecutive menstrual periods. Missed periods occur
when hormones that regulate
menstrual periods decrease as result of intense exercise and
disordered eating habits. However, the primary cause of a
missed period is pregnancy, and should be ruled out first.
Young athletes who miss more than one period, consecutively,
should inform their physician immediately. If hormone levels
remain low, irreversible loss of bone mass may occur.
Osteoporosis is a condition in which bones are weak and easily
broken without excessive trauma. This results from inadequate
amounts of bone mass. We often do not associate young, active
women with osteoporosis;
however, our bones are built throughout our lives. If we do
not build the proper
foundation for them when we are young, we will be at a greater
risk for osteoporosis later in life.
Our largest gains in bone mass occur between the ages of
10 and 20, thanks in large part to the hormone estrogen. Bone
that is not gained at this time cannot be regained later in
life and will result in a lower peak bone mass. A young woman
who has poor nutrition, exercises excessively and experiences
primary or secondary amenorrhea will not develop strong bones.
There are more opportunities than ever before for young women
who want to play sports. From high school to club teams it
is possible for a young woman to play one sport competitively
year round in addition to other sports during their regular
seasons. It can be hard to determine when exercise becomes
too much exercise.
In the training routine, the missing variable for many young
women is rest. While there are no strict guidelines on rest,
it is reasonable to say that within any given week a young
athlete should have at least one day without competition or
practice. The most recent exploration in the field of exercise
science relates to the proper methods of recovery, after and
between workouts. When our bodies are at rest they are actually
rebuilding themselves to become stronger, faster and more
coordinated.
For anyone struggling with one or all of the components of
the Female Athlete Triad, there are several options. First,
consult a medical professional such as your primary care
physician or OB/GYN. They can also refer you to sports nutritionists
and/or a sports psychologist who can become invaluable members
of your health care team.
Secondly, take time out in your training schedule. At least
one full day of rest every week is necessary for all athletes.
In severe cases extended rest will be necessary to get the
body's equilibrium back in line.
All athletes need to learn how to listen to their bodies
in order to compete successfully and, more importantly, to
lead well-rounded, healthy lives beyond their days of competitive
sports.
For more information, please call the Athlete Training Center
at the
Saint Barnabas Ambulatory Care Center at 973-322-7488.
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