Prevalência de Tríade da Mulher Atleta em adolescentes de escola municipal vocacionada para o esporte

Abstract

Adolescence is the period most susceptible to the development of eating disorders (ED), and adolescents are more exposed to this condition, especially those who practice sports as a risk factor for ED. The greater energy demand generated by the growth and sports practice associated with the energy restriction can trigger low energy availability (EA), with or without ED, which causes important health damages, such as changes in the menstrual cycle and bone homeostasis. The interrelation of these modifications or even the indication of change in one of these components may characterize the triad of the female athlete (TFA). The objective of the present study was to estimate the prevalence of TMA in adolescents of different sports modalities considered to be at risk for ED and by level of competition in a sports-oriented school. This is a cross-sectional study in which bone maturation and body composition were determined by x-ray emission double-absorptiometry, dietary components by 24-hour recall, eating disorders by EAT-26 (Eating Attitude Test), BITE (Bulimic Investigatory Test Edinburgh), BSQ (Body Image Questionnaire), and menstrual status by questionnaire. The groups were divided by risk for ED and by level of competition. The Shapiro-Wilk test was used to confirm the normality of the data, Student's t-test for numerical variables and the chi-square test for categorical variables using SPSS 17.0 software with a significance level of p <0.05. Thirty-five adolescents participated in the study, among which there was no difference between groups regarding chronological age, age of menarche and body composition (p> 0.05). Overall, 71% and 55% of the athletes consumed protein and carbohydrates below the recommended level, respectively, 42% of the athletes presented excessive lipid intake, 84% of which exceeded the saturated fat limit and more than 70% of the athletes presented ingestion insufficient iron and zinc, and no participant reached the calcium recommendation. Considering the lower cut-off point, 45% and 37% of the athletes in the group at higher risk for ED and higher level of competition had a lower EA, respectively. The overall prevalence of ED was 57%, and for the EAT, BITE symptoms, BITE severity and BSQ the positivity was 15%, 17%, 4% and 42%, respectively. 30% of the group at higher risk for ED and higher level of competition presented irregular menstruation and athletes from the higher level of competition had a higher proportion of secondary amenorrhea (p = 0.05). The mean values of bone mineral density did not differ between groups, however, 9% of the group with the highest level of competition had the lowest values of bone mineral density (Z-score <-1 SD). Concerning TFM, 85% of the athletes presented at least one component of the triad. Already considering two components, the group without risk for ED and higher level of competition had prevalences above 40%. Two (4%) athletes already presented general triad. These findings indicate the need for preventive actions to TFM, especially in adolescence, where lack of energy and nutrients for growth can lead to serious consequences in adult life