The Eating Disorder Examination Questionnaire and Future Menstrual Function, Bone Mass Change in Adolescent Runners

Abstract

PURPOSE: We aimed to assess if adolescent runners' baseline eating attitude and behavior scores were associated with future menstrual function or changes in bone mass. METHODS: Following a baseline data collection period, 39 female runners (age at baseline 15.9 ± 0.17y) underwent a 3-y follow-up DXA scan to measure bone mineral density (BMD) of the lumbar spine, total hip, and total body. At baseline and follow-up, runners completed the Eating Disorder Examination Questionnaire (EDE-Q) and reported information about menstrual function, sports participation, and training volume. Runners with ≥1 EDE-Q subscale score(s) or a global score >4.0 or who reported >1 pathologic behavior in the past 28 days were classified with disordered eating (DE). RESULTS: Runners' baseline age, menstrual function, and bone mass did not significantly differ between those with DE or normal EDE-Q scores, while BMI was higher in those with DE (22.1 ± 0.8 vs. 20.2 ± 0.4, P= 0.05). Runners with DE at baseline, when compared to those with normal EDE-Q scores at baseline, had a lower mean number of menstrual cycles each year (6.0 ± 1.2 vs. 10.2 ± 0.6, P=0.002) and more years of secondary amenorrhea (1.9 ± 0.3 vs. 0.3 ± 0.1, P=0.001) during the 3 years between assessments. Runners with normal menses at baseline who developed oligo- or amenorrhea compared to those with normal menses at both time points had significantly higher baseline shape concern (3.08 ± 0.38 vs. 1.53 ± 0.22, P=0.002), eating concern (0.81 ± 0.19 vs. 0.32 ± 0.11, P=0.03), a higher global score (1.78 ± 0.26 vs. 0.88 ± 0.15, P=0.005), and a trend toward higher EDE-Q weight concern (1.86 + 0.40 vs. 0.96 + 0.23; P < 0.06). The BMI-adjusted 3-y change in lumbar spine Z-score (-0.50 ± 0.23 vs. 0.14 ± 0.11, P=0.02) was lower among runners with baseline DE. CONCLUSIONS: These findings support the potential use of the EDE-Q to identify female adolescent runners at risk of developing oligo- or amenorrhea or low bone mass.