TRIAD Prevalence in Female Austrian University Sport Students

Abstract

Adequate nutrition is essential for performance and health. Low energy availability can lead to menstrual dysfunction and increased risk for low bone density and stress fractures. These associated disorders are known as the Female Athlete Triad (TRIAD). European university sport students are an underrepresented subject group in the TRIAD literature. Although there are no collegiate athletic teams, acceptance into European university sport institutes is highly competitive, requiring talent and stamina in several sports. The sport program's curriculum includes a range of practical courses with vigorous training schedules. PURPOSE: To describe the prevalence of the TRIAD in Austrian sport students in comparison with non-sport students. METHODS: Participants were female Austrian University students from four Austrian Universities, majoring in sport (n = 183), and non-sport controls (n = 123), aged 18–33 y. Eating behaviors, menstrual dysfunction, musculoskeletal injuries, including stress fractures, were assessed using a self-developed questionnaire on training, dietary, weight, menstrual, and injury history, along with the Eating Disorder Inventory (EDI) body dissatisfaction (BD), bulimia (BUL), and drive for thinness (DT) subscales. RESULTS: Independent t-test comparisons revealed higher training volumes (9.2 ± 4.3 vs. 3.9 ± 3.1 hrs per week, p < 0.001) and later age at menarche (13.4 ± 1.3 vs. 12.9 ± 1.2 y; p < 0.05) in sport students than controls. More non-sport students than sport students were “at risk” for an eating disorder using EDI-BD ≥ 14 (14.6 vs.7.1%, p < 0.05; Mann Witney-U test). Fasting (14.9 vs. 5.5%) and skipping meals (50.4 vs. 34.6%) for weight control were higher in the controls than in sport students. More sport students than non-sport students used additional exercise beyond regular training for weight control (42.9 vs. 31.4%), and there were more stress fractures (3.3% vs. 0) and current menstrual dysfunction (32.9 vs. 16.7%) in sport students compared with controls (p < 0.05; CHI square tests). CONCLUSION: Both sport and non-sport students were identified with disordered eating behaviors, menstrual dysfunction, and musculoskeletal injuries. However, clear medical signs, such as menstrual dysfunction and stress fractures, were more common in the athletic population, indicating that clinical manifestation of the TRIAD are more prevalent in University sport students than controls. This study was funded by grants from Land Tirol and the University of Innsbruck.