Objective:To estimate the prevalence of the female athlete triad(disordered eating,menstrual irregularity,and low bone mass)among high school athletes.D esign:Observational cross-sectional study.Setting:High school.Participants:Female athletes(n=170)representing 8 sports were recruited from 6 high school s in southern California.Main Outcome Measures:Disordered eating and menstrual status were determined by interviewer-assisted questionnaires.Bone mineral de nsity was measured by dual-energy x-ray absorptiometry of the hip,spine(L1-L4),and total body.Results:Among all athletes,18.2%,23.5%,and 21.8%met the criteria for disordered eating,menstrual irregularity,and low bone mass,r espectively.Ten girls(5.9%)met criteria for 2 components of the triad,and 2 girls(1.2%)met criteria for all 3 components.Oligomenorrheic/amenorrheic at hletes had higher mean ± SD eating restraint(1.55±1.60 vs 1.04±1.27;P=.02)-and Eating Disorder Exa mination Questionnaire global scores(1.68±1.20 vs 1.33±1.14;P=.03)than eume norrheic athletes.After controlling for age,age at menarche,body mass index,race/ethnicity,and sport type,athletes with oligomenorrhea/amenorrhea had sign ificantly lower mean ±SD bone mineral densities for the trochanter(0.884±0.09 0 g·cm-2)than eumenorrheic athletes(0.933±0.130 g·cm-2;P=0.04).Conclusi ons:The prevalence of the full female athlete triad was low in our sample;howe ver,a substantial percentage of the athletes may be at risk for long-term heal th consequences associated with disordered eating,menstrual irregularity,or lo w bone mass.Preparticipation screening to identify these components should be e ncouraged as a preventive approach to identify high-risk athletes.
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