{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:38:16Z","timestamp":1792791496481,"version":"4.5.0"},"reference-count":95,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,1,26]],"date-time":"2022-01-26T00:00:00Z","timestamp":1643155200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008899","name":"University of South Carolina","doi-asserted-by":"publisher","award":["SPARC Graduate Research Grant from the Office of the Vice President for Research at the University of South Carolina."],"award-info":[{"award-number":["SPARC Graduate Research Grant from the Office of the Vice President for Research at the University of South Carolina."]}],"id":[{"id":"10.13039\/100008899","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The purpose of this study was to examine individual and combined Female Athlete Triad components within collegiate cheerleaders, an at-risk group. Cheerleaders (n = 19; age: 20.3 \u00b1 1.2 years) completed anthropometric measurements, health history questionnaires, resting metabolic rate, the eating disorder inventory-3 and symptom checklist, blood sample, and DXA scan. Participants completed dietary and exercise logs for 7 days and used heart rate monitors to track daily and exercise energy expenditure. Proportions were calculated for low energy availability (LEA) risk, disordered eating risk, and pathogenic behaviors. Chi-square analysis was used to determine the difference between cheerleaders who experience low EA with or without disordered eating risk. All cheerleaders demonstrated LEA for the days they participated in cheerleading practice, 52.6% demonstrated LEA with eating disorder risk and 47.4% demonstrated LEA without eating disorder risk, 52.6% self-reported menstrual dysfunction, 14% experienced menstrual dysfunction via hormonal assessment, and 0% demonstrated low bone mineral density. Overall, 47.7% presented with one Triad component, 52.6% demonstrated two Triad components using self-reported menstrual data, and 10.5% demonstrated two Triad components using hormonal assessments. All cheerleaders displayed LEA. These findings support the need for increased education on the individual components of the Triad and their potential consequences by qualified personal.<\/jats:p>","DOI":"10.3390\/ijerph19031375","type":"journal-article","created":{"date-parts":[[2022,1,26]],"date-time":"2022-01-26T11:02:53Z","timestamp":1643194973000},"page":"1375","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Examination of the Prevalence of Female Athlete Triad Components among Competitive Cheerleaders"],"prefix":"10.3390","volume":"19","author":[{"given":"Allison B.","family":"Smith","sequence":"first","affiliation":[{"name":"School of Kinesiology, University of Louisiana at Lafayette, Lafayette, LA 70507, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Gay","sequence":"additional","affiliation":[{"name":"Department of Health Promotion & Behavior, University of Georgia, Athens, GA 30602, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0647-0591","authenticated-orcid":false,"given":"Shawn M.","family":"Arent","sequence":"additional","affiliation":[{"name":"Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6705-0668","authenticated-orcid":false,"given":"Mark A.","family":"Sarzynski","sequence":"additional","affiliation":[{"name":"Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0747-1193","authenticated-orcid":false,"given":"Dawn M.","family":"Emerson","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS 66160, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7963-5356","authenticated-orcid":false,"given":"Toni M.","family":"Torres-McGehee","sequence":"additional","affiliation":[{"name":"Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S19","DOI":"10.1016\/j.jadohealth.2008.10.046","article-title":"Competitive Sports, Eating Behaviors, and Menstrual Health in Female College Athletes","volume":"44","author":"Peebles","year":"2009","journal-title":"J. Adolesc. Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/j.1746-1561.2004.tb04209.x","article-title":"A Preliminary Survey of Dieting, Body Dissatisfaction, and Eating Problems Among High School Cheerleaders","volume":"74","author":"Thompson","year":"2004","journal-title":"J. Sch. Health"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1002\/(SICI)1098-108X(200005)27:4<371::AID-EAT1>3.0.CO;2-Y","article-title":"Female athletes and eating problems: A meta-analysis","volume":"27","author":"Smolak","year":"2000","journal-title":"Int. J. Eat. Disord."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"105","DOI":"10.2147\/OAJSM.S36528","article-title":"Prevention of eating disorders in female athletes","volume":"5","author":"Coelho","year":"2014","journal-title":"Open Access J. Sports Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1867","DOI":"10.1249\/mss.0b013e318149f111","article-title":"The female athlete triad","volume":"39","author":"STAND","year":"2007","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1136\/bjsports-2014-093502","article-title":"The IOC consensus statement: Beyond the Female Athlete Triad\u2014Relative Energy Deficiency in Sport (RED-S)","volume":"48","author":"Mountjoy","year":"2014","journal-title":"Br. J. Sports Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1136\/bjsports-2013-093218","article-title":"2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad: 1st International Conference held in San Francisco, California, May 2012 and 2nd International Conference held in Indianapolis, Indiana, May 2013","volume":"48","author":"Nattiv","year":"2014","journal-title":"Br. J. Sports Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S7","DOI":"10.1080\/02640414.2011.588958","article-title":"Energy availability in athletes","volume":"29","author":"Loucks","year":"2011","journal-title":"J. Sports Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1123\/ijsnem.2018-0136","article-title":"International Olympic Committee (IOC) Consensus Statement on Relative Energy Deficiency in Sport (RED-S): 2018 Update","volume":"28","author":"Mountjoy","year":"2018","journal-title":"Int. J. Sport Nutr. Exerc. Metab."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1007\/s40279-017-0790-3","article-title":"Low Energy Availability in Athletes: A Review of Prevalence, Dietary Patterns, Physiological Health, and Sports Performance","volume":"48","author":"Logue","year":"2018","journal-title":"Sports Med."},{"key":"ref_11","first-page":"E1","article-title":"Control of fertility by metabolic cues","volume":"270","author":"Wade","year":"1996","journal-title":"Am. J. Physiol. Metab."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1123\/ijsnem.20.3.245","article-title":"Comparison of strategies for assessing nutritional adequacy in elite female athletes\u2019 dietary intake","volume":"20","author":"Heaney","year":"2010","journal-title":"Int. J. Sport Nutr. Exerc. Metab."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1123\/ijsn.3.4.431","article-title":"Nutrient Intake of Female Elite Athletes Suffering from Eating Disorders","volume":"3","year":"1993","journal-title":"Int. J. Sport Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2014). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Publishing. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1002\/eat.22318","article-title":"Childhood anxiety trajectories and adolescent disordered eating: Findings from the NICHD Study of Early Child Care and Youth Development","volume":"47","author":"Zerwas","year":"2014","journal-title":"Int. J. Eat. Disord."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/S1471-0153(02)00093-4","article-title":"Examining gender, racial, and age differences in weight concern among third, fifth, eighth, and eleventh graders","volume":"3","author":"Thompson","year":"2003","journal-title":"Eat. Behav."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Practice Committee of the American Society for Reproductive Medicine (2008). Current evaluation of amenorrhea. Fertil. Steril., 90, S219\u2013S225.","DOI":"10.1016\/j.fertnstert.2008.08.038"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1210\/jcem-68-2-402","article-title":"Alterations in the Hypothalamic-Pituitary-Ovarian and the Hypothalamic-Pituitary-Adrenal Axes in Athletic Women*","volume":"68","author":"Loucks","year":"1989","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_19","unstructured":"NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy (2000). Osteoporosis prevention, diagnosis, and therapy. NIH Consens. Statement, 17, 1\u201345."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/8756-3282(95)00171-9","article-title":"A comparison of bone mineral densities among female athletes in impact loading and active loading sports","volume":"17","author":"Fehling","year":"1995","journal-title":"Bone"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1249\/00005768-199010000-00005","article-title":"Bone density in eumenorrheic female college athletes","volume":"22","author":"Risser","year":"1990","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1002\/jbmr.5650100107","article-title":"Gymnasts exhibit higher bone mass than runners despite similar prevalence of amenorrhea and oligomenorrhea","volume":"10","author":"Robinson","year":"1995","journal-title":"J. Bone Miner. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2015","DOI":"10.1249\/MSS.0b013e3181822ea0","article-title":"Prevalence of and Traits Associated with Low BMD among Female Adolescent Runners","volume":"40","author":"Barrack","year":"2008","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1080\/02640410601129714","article-title":"The components of the female athlete triad do not identify all physically active females at risk","volume":"25","author":"Burrows","year":"2007","journal-title":"J. Sports Sci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1097\/JSM.0b013e3181b8c136","article-title":"Prevalence of the Female Athlete Triad in High School Athletes and Sedentary Students","volume":"19","author":"Hoch","year":"2009","journal-title":"Clin. J. Sport Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1001\/archpedi.160.2.137","article-title":"Prevalence of the Female Athlete Triad Syndrome among High School Athletes","volume":"160","author":"Nichols","year":"2006","journal-title":"Arch. Pediatr. Adolesc. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1007\/s002239900589","article-title":"Low Bone Mass Density at Multiple Skeletal Sites, Including the Appendicular Skeleton in Amenorrheic Runners","volume":"64","author":"Pettersson","year":"1999","journal-title":"Calcif. Tissue Int."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1123\/ijsnem.20.5.418","article-title":"Bone-mineral density and other features of the female athlete triad in elite endurance runners: A longitudinal and cross-sectional observational study","volume":"20","author":"Pollock","year":"2010","journal-title":"Int. J. Sport Nutr. Exerc. Metab."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"243","DOI":"10.4085\/1062-6050-45.3.243","article-title":"Relationships among Injury and Disordered Eating, Menstrual Dysfunction, and Low Bone Mineral Density in High School Athletes: A Prospective Study","volume":"45","author":"Rauh","year":"2010","journal-title":"J. Athl. Train."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2904","DOI":"10.1152\/jappl.1993.74.6.2904","article-title":"Spine and total body bone mineral density in amenorrheic endurance athletes","volume":"74","author":"Rutherford","year":"1993","journal-title":"J. Appl. Physiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1016\/j.nut.2008.11.029","article-title":"Female athlete triad in elite swimmers of the city of Rio de Janeiro, Brazil","volume":"25","author":"Schtscherbyna","year":"2009","journal-title":"Nutrition"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"541","DOI":"10.4085\/1062-6050-47.5.03","article-title":"Eating Disorder Risk and the Role of Clothing in Collegiate Cheerleaders\u2019 Body Images","volume":"47","author":"Monsma","year":"2012","journal-title":"J. Athl. Train."},{"key":"ref_33","first-page":"71","article-title":"Body Image, Maturation, and Psychological Functioning in College Cheerleaders: A Matter of Position?","volume":"1","author":"Monsma","year":"2016","journal-title":"Transl. J. Am. Coll. Sports Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"993","DOI":"10.4085\/JAT0502-20","article-title":"Energy Availability With or Without Eating Disorder Risk in Collegiate Female Athletes and Performing Artists","volume":"56","author":"Emerson","year":"2021","journal-title":"J. Athl. Train."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1080\/07315724.2007.10719639","article-title":"Do Hand-Held Calorimeters Provide Reliable and Accurate Estimates of Resting Metabolic Rate?","volume":"26","year":"2007","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1001\/jama.285.6.785","article-title":"Osteoporosis prevention, diagnosis, and therapy","volume":"285","author":"Klibanski","year":"2001","journal-title":"JAMA"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1123\/ijsnem.17.5.491","article-title":"A Systematic Review on Use of a Handheld Indirect Calorimeter to Assess Energy Needs in Adults and Children","volume":"17","author":"McDoniel","year":"2007","journal-title":"Int. J. Sport Nutr. Exerc. Metab."},{"key":"ref_38","unstructured":"Garner, D.M. (2021, December 13). EDI-3, Eating Disorder Inventory-3: Professional Manual: Psychological Assessment Resources. Available online: https:\/\/www.parinc.com\/Products\/Pkey\/103."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Gibson, A.L., Wagner, D., and Heyward, V. (2018). Advanced Fitness Assessment and Exercise Prescription, Human Kinetics.","DOI":"10.5040\/9781718220966"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"S498","DOI":"10.1097\/00005768-200009001-00009","article-title":"Compendium of Physical Activities: An update of activity codes and MET intensities","volume":"32","author":"Ainsworth","year":"2000","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1080\/17461391.2011.635707","article-title":"Differences in energy expenditure between high- and low-volume training","volume":"13","author":"Drenowatz","year":"2013","journal-title":"Eur. J. Sport Sci."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1136\/bjsm.2008.048868","article-title":"Validity of physical activity monitors in adults participating in free-living activities","volume":"44","author":"Berntsen","year":"2008","journal-title":"Br. J. Sports Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3758\/BF03193146","article-title":"G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences","volume":"39","author":"Faul","year":"2007","journal-title":"Behav. Res. Methods"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1123\/ijsnem.2018-0127","article-title":"Endocrine Effects of Relative Energy Deficiency in Sport","volume":"28","author":"Tenforde","year":"2018","journal-title":"Int. J. Sport Nutr. Exerc. Metab."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1080\/17461391.2014.969323","article-title":"Low energy availability and low body fat of female gymnasts before an international competition","volume":"15","author":"Silva","year":"2015","journal-title":"Eur. J. Sport Sci."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1123\/ijsnem.23.1.24","article-title":"Energy Availability of Female Varsity Volleyball Players","volume":"23","author":"Woodruff","year":"2013","journal-title":"Int. J. Sport Nutr. Exerc. Metab."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1080\/02640414.2014.908321","article-title":"Nutritional practices associated with low energy availability in Division I female soccer players","volume":"32","author":"Reed","year":"2014","journal-title":"J. Sports Sci."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"136","DOI":"10.3389\/fnut.2018.00136","article-title":"Assessment of Dietary Intake, Energy Status, and Factors Associated With RED-S in Vocational Female Ballet Students","volume":"5","author":"Civil","year":"2019","journal-title":"Front. Nutr."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1111\/sms.12716","article-title":"Elite synchronized swimmers display decreased energy availability during intensified training","volume":"27","author":"Schaal","year":"2016","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/j.csm.2017.05.003","article-title":"Female Athlete Triad: Future Directions for Energy Availability and Eating Disorder Research and Practice","volume":"36","author":"Williams","year":"2017","journal-title":"Clin. Sports Med."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"489","DOI":"10.3200\/JACH.57.5.489-496","article-title":"Female Collegiate Athletes: Prevalence of Eating Disorders and Disordered Eating Behaviors","volume":"57","author":"Greenleaf","year":"2009","journal-title":"J. Am. Coll. Health"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"431","DOI":"10.4085\/1062-6050-46.4.431","article-title":"Prevalence of Eating Disorder Risk and Body Image Distortion Among National Collegiate Athletic Association Division I Varsity Equestrian Athletes","volume":"46","author":"Monsma","year":"2011","journal-title":"J. Athl. Train."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Condo, D., Lohman, R., Kelly, M., and Carr, A. (2019). Nutritional Intake, Sports Nutrition Knowledge and Energy Availability in Female Australian Rules Football Players. Nutrients, 11.","DOI":"10.3390\/nu11050971"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12970-015-0082-y","article-title":"Nutritional knowledge and eating habits of professional rugby league players: Does knowledge translate into practice?","volume":"12","author":"Alaunyte","year":"2015","journal-title":"J. Int. Soc. Sports Nutr."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1007\/s40279-015-0372-1","article-title":"A Review of Factors Influencing Athletes\u2019 Food Choices","volume":"45","author":"Birkenhead","year":"2015","journal-title":"Sports Med."},{"key":"ref_56","first-page":"180","article-title":"Knowledge and Practice of Top Level Coaches about Weight Control and Eating Disorders","volume":"5","year":"1993","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1097\/00042752-200401000-00005","article-title":"Prevalence of Eating Disorders in Elite Athletes Is Higher Than in the General Population","volume":"14","author":"Torstveit","year":"2004","journal-title":"Clin. J. Sport Med."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40337-021-00388-7","article-title":"Examination of eating disorder risk among university marching band artists","volume":"9","author":"Uriegas","year":"2021","journal-title":"J. Eat. Disord."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1111\/j.1600-0838.2007.00657.x","article-title":"Prevalence of eating disorders and the predictive power of risk models in female elite athletes: A controlled study","volume":"18","author":"Torstveit","year":"2007","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1123\/ijsn.3.1.29","article-title":"Prevalence of Eating Disorders in Elite Female Athletes","volume":"3","year":"1993","journal-title":"Int. J. Sport Nutr."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1111\/j.1600-0838.2010.01190.x","article-title":"Aspects of disordered eating continuum in elite high-intensity sports","volume":"20","author":"Torstveit","year":"2010","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_62","first-page":"286","article-title":"Physiologic Screening Test for Eating Disorders\/Disordered Eating Among Female Collegiate Athletes","volume":"38","author":"Black","year":"2003","journal-title":"J. Athl. Train."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"418","DOI":"10.4085\/1062-6050-44.4.418","article-title":"Body Image, Anthropometric Measures, and Eating-Disorder Prevalence in Auxiliary Unit Members","volume":"44","author":"Green","year":"2009","journal-title":"J. Athl. Train."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Prnjak, K., Jukic, I., and Tufano, J.J. (2019). Perfectionism, Body Satisfaction and Dieting in Athletes: The Role of Gender and Sport Type. Sports, 7.","DOI":"10.3390\/sports7080181"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1080\/10640266.2013.797822","article-title":"Prevalence of Disordered Eating and Pathogenic Weight Control Behaviors among Male Collegiate Athletes","volume":"21","author":"Chatterton","year":"2013","journal-title":"Eat. Disord."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1037\/a0013178","article-title":"Prevalence of eating disorders and disordered eating behaviors among male collegiate athletes","volume":"9","author":"Petrie","year":"2008","journal-title":"Psychol. Men Masc."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1080\/10640260902848485","article-title":"Body Image, Disordered Eating and Anabolic Steroid Use in Female Bodybuilders","volume":"17","author":"Goldfield","year":"2009","journal-title":"Eat. Disord."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"711","DOI":"10.2466\/06.PMS.112.3.711-725","article-title":"Attitude and Knowledge Changes in Collegiate Dancers following a Short-Term, Team-Centered Prevention Program on Eating Disorders","volume":"112","author":"Green","year":"2011","journal-title":"Percept. Mot. Ski."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1177\/1089313X1001400403","article-title":"Energetic efficiency, menstrual irregularity, and bone mineral density in elite professional female ballet dancers","volume":"14","author":"Akers","year":"2010","journal-title":"J. Dance Med. Sci."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1097\/00006250-197907000-00013","article-title":"Menstrual Dysfunction in Distance Runners","volume":"54","author":"Dale","year":"1979","journal-title":"Obstet. Gynecol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1016\/S0140-6736(78)92294-8","article-title":"SECONDARY AMENORRH\u0152A IN ATHLETES","volume":"312","author":"Feicht","year":"1978","journal-title":"Lancet"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1016\/S0015-0282(16)59522-3","article-title":"Amenorrhea in Olympic marathon runners","volume":"48","author":"Glass","year":"1987","journal-title":"Fertil. Steril."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1016\/0002-9378(82)90463-X","article-title":"Is athletic amenorrhea specific to runners?","volume":"143","author":"Sanborn","year":"1982","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1016\/0002-9378(82)90464-1","article-title":"The effect of marathon training upon menstrual function","volume":"143","author":"Shangold","year":"1982","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1249\/00005768-198204000-00002","article-title":"Reproductive system function in women cross-country runners","volume":"14","author":"Wakat","year":"1982","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/0002-9378(81)90277-5","article-title":"Menstrual disorders in college students","volume":"140","author":"Singh","year":"1981","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/0002-9378(73)90732-1","article-title":"Epidemiology of secondary amenorrhea","volume":"117","author":"Pettersson","year":"1973","journal-title":"I. Incid. Preval. Rates. Am. J. Obs. Gynecol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1123\/ijsnem.16.1.1","article-title":"The Prevalence of Disordered Eating, Menstrual Dysfunction, and Low Bone Mineral Density among US Collegiate Athletes","volume":"16","author":"Beals","year":"2006","journal-title":"Int. J. Sport Nutr. Exerc. Metab."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1111\/j.1471-0528.1982.tb03649.x","article-title":"Body weight, exercise and menstrual status among ballet dancers in training","volume":"89","author":"Abraham","year":"1982","journal-title":"BJOG: Int. J. Obstet. Gynaecol."},{"key":"ref_80","first-page":"79","article-title":"Influence of high intensity training on menstrual cycle disorders in athletes","volume":"42","author":"Dusek","year":"2001","journal-title":"Croat. Med. J."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/0002-9378(82)90402-1","article-title":"Prevalence of oligomenorrhea and amenorrhea in a college population","volume":"144","author":"Bachmann","year":"1982","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1123\/ijsn.9.1.70","article-title":"Energy and Nutrient Status of Amenorrheic Athletes Participating in a Diet and Exercise Training Intervention Program","volume":"9","author":"Manore","year":"1999","journal-title":"Int. J. Sport Nutr."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1001\/jama.1990.03440040084033","article-title":"Menstrual history as a determinant of current bone density in young athletes","volume":"263","author":"Drinkwater","year":"1990","journal-title":"JAMA"},{"key":"ref_84","first-page":"639","article-title":"Collegiate women athletes with irregular menses during adolescence have decreased bone density","volume":"72","author":"Lloyd","year":"1988","journal-title":"Obstet. Gynecol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1007\/BF01623770","article-title":"Irreversible bone loss in former amenorrheic athletes","volume":"7","author":"Keen","year":"1997","journal-title":"Osteoporos. Int."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"3162","DOI":"10.1210\/jcem.87.7.8637","article-title":"Osteopenia in exercise-associated amenorrhea using ballet dancers as a model: A longitudinal study","volume":"87","author":"Warren","year":"2002","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"91","DOI":"10.2165\/00007256-199928020-00004","article-title":"Risk Factors for Stress Fractures","volume":"28","author":"Bennell","year":"1999","journal-title":"Sports Med."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/S0278-5919(05)70016-8","article-title":"EPIDEMIOLOGY AND SITE SPECIFICITY OF STRESS FRACTURES","volume":"16","author":"Bennell","year":"1997","journal-title":"Clin. Sports Med."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1177\/036354659602400617","article-title":"Risk factors for stress fractures in track and field athletes. A twelve-month prospective study","volume":"24","author":"Bennell","year":"1996","journal-title":"Am. J. Sports Med."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/S0003-9993(00)90225-9","article-title":"The relation between stress fractures and bone mineral density: Evidence from active-duty Army women","volume":"81","author":"Lauder","year":"2000","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"754","DOI":"10.7326\/0003-4819-113-10-754","article-title":"Low Bone Density Is an Etiologic Factor for Stress Fractures in Athletes","volume":"113","author":"Myburgh","year":"1990","journal-title":"Ann. Intern. Med."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1348","DOI":"10.1056\/NEJM198605223142104","article-title":"Scoliosis and Fractures in Young Ballet Dancers","volume":"314","author":"Warren","year":"1986","journal-title":"N. Engl. J. Med."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1093\/milmed\/162.10.698","article-title":"Risk factors associated with stress reactions in female Marines","volume":"162","author":"Winfield","year":"1997","journal-title":"Mil. Med."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1249\/MSS.0b013e31827e1bdc","article-title":"Prevalence of Individual and Combined Components of the Female Athlete Triad","volume":"45","author":"Gibbs","year":"2013","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1249\/01.mss.0000177678.73041.38","article-title":"The Female Athlete Triad Exists in Both Elite Athletes and Controls","volume":"37","author":"Torstveit","year":"2005","journal-title":"Med. Sci. Sports Exerc."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/3\/1375\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:08:07Z","timestamp":1760134087000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/3\/1375"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,26]]},"references-count":95,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["ijerph19031375"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19031375","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,26]]}}}