Novas abordagens dos componentes da tríade do atleta em adolescentes

Abstract

The athlete triad comprises the spectrum of low energy availability (EA), disordered eating (DE), problems in reproductive function and low bone mineral density (BMD). Adolescents can be considered more vulnerable to these components, as this is a phase marked by intense biopsychosocial growth and development. Recently, the triad has been recognized as a syndrome that also affects males. However, there are gaps in the understanding and identification of these components in the male population, especially in adolescents. In this thesis, two original manuscripts are presented, which are cross-sectional studies with adolescent athletes from a municipal school dedicated to sport. The manuscript I evaluated the relationship between the disordered eating, phase angle (AngF) and BIVA questionnaire scores in female adolescent athletes (n=103). Participants were divided into groups according to DE (+EAT-26, +BSQ and control). The DE was investigated using the EAT-26 and BSQ questionnaires. The raw states of bioelectrical impedance (BIA) and AngF were determined by a tetrapolar frequency analyzer. The tolerance ellipses were processed by the BIVA-software. Differences between groups were tested by Kruskal-Wallis with Dunn's post-hoc. To identify the association between the variables, adjusted partial correlation was used. The significance level was 5%. The groups were similar in terms of energy expenditure, body composition, DE questionnaire scores, raw BIA and AngF data. A correlation was observed between body mass and BSQ score (r= 0.353; p< 0.01) and between phase angle and BSQ score (r= -0.233) and EAT-26 (-0.225; p< 0.05). BIVA did not distinguish a distribution pattern between the groups. AngF and BIVA may be promising tools for use in adolescent athletes at risk of DE. Longitudinal studies with larger sample sizes should be developed to confirm the findings demonstrated in the present study. The II manuscript investigated the application of lower limb height as a proxy for a triad component in male adolescent athletes (n=61). Participants were classified according to the spectra of the triad components - energy availability, DE, BMD and lower leg length (LL) percentile. The LL was obtained by subtracting the sitting height from the total height. Body composition was determined by dual emission X-ray absorptiometry (DXA). Food consumption was estimated using a 24-hour recall. The DE identified by validated questionnaires and the EA was calculated by subtracting the energy consumed in the diet by the energy spent on exercise and normalized by the fat-free mass. The triad was identified by the traditional model (EA/DE and low BMD). and the modified model (EA/DE, %LL, and low BMD (< -1.0 SD). The variables were presented as median and interquartile range. The Mann-Whitney test was used for comparison between groups. The significance level was 5%. Participants had carbohydrate insufficiency (22.9%), proteins (30%), calcium (98.4%) Low EA was identified in 80% of the athletes and 44% were positive for the DE questionnaires. Eighteen percent of the athletes presented low BMD, and of these, seven practiced sports risk for DE. Regarding the %LL, 19.7% of the participants were below the value of – 0.136. There was no difference between the groups (EA, DE, BMD and LL percentile) and 8% were positive in the traditional model and no athlete was identified in the adapted model. The use of LL% as component of the athlete's triad may be promising in future studies.