{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T03:02:34Z","timestamp":1773802954092,"version":"3.50.1"},"reference-count":70,"publisher":"National Athletic Trainers' Association","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,4]]},"abstract":"<jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Adolescence is a critical period for bone development. Due to an elevated risk for low body mass index (BMI) and\/or low energy availability, certain adolescent athletes are at increased risk of bone stress injury (BSI) and eating disorders (EDs). Despite this risk, the incidence of EDs in patients with BSI is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the incidence of a premorbid drop in BMI percentile in a sample of adolescent athletes diagnosed with a BSI between 2005 and 2016. We also evaluated the relative risk of developing an ED for this sample, compared with a sex-matched, age-matched (\u00b16 months), and time-matched (\u00b12 years) sample of active adolescents with knee pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Data collected through the Rochester Epidemiology Project.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients or Other Participants<\/jats:title>\n                    <jats:p>One hundred eighty-seven adolescent (aged 13\u201318) athletes with BSI and 187 active adolescents with knee pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>Conditional logistic regression was used to assess whether premorbid weight loss was a risk factor for BSI. A stratified log-rank test was used to evaluate the association between ED diagnosis and case-control status up to 5 years postinjury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients with a BSI had 1.53 times the odds of premorbid BMI percentile drop compared with controls (95% CI = 0.83, 2.12;\n                      <jats:italic>P<\/jats:italic>\n                      = .17). A total of 14 patients with a BSI had ED diagnoses after injury compared with 8 controls (\n                      <jats:italic>P<\/jats:italic>\n                      = .13). Patients from weight-based or aesthetic sports had 1.93 times the odds of a BSI compared with controls (95% CI = 1.23, 3.02;\n                      <jats:italic>P<\/jats:italic>\n                      = .0040). The Kaplan-Meier estimates indicate that the case group had a greater risk of ED diagnosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Results suggest a trend toward a greater drop in BMI percentile and increased frequency of ED diagnoses in the BSI group compared with controls. The documented co-occurrence of weight loss, stress fractures, and EDs in adolescent athletes should inform guidelines for screening and treatment of adolescent athletes with BSIs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4085\/1062-6050-0160.25","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:31:04Z","timestamp":1755045064000},"page":"239-245","source":"Crossref","is-referenced-by-count":0,"title":["The Association of Bone Stress Injuries With Body Mass Index Percentile Drop and Eating Disorder Diagnoses in Adolescent Athletes"],"prefix":"10.4085","volume":"61","author":[{"given":"Audrey","family":"Potts","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Mayo Clinic School of Graduate Medical Education, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Soma","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN"},{"name":"Department of Orthopedics and Sports Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leslie","family":"Sim","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jocelyn","family":"Lebow","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN"},{"name":"Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roland","family":"Henz","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN"},{"name":"Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel","family":"Hickman","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN"},{"name":"Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2557","reference":[{"issue":"1","key":"i1938-162X-61-3-239-b01","series-title":"Phys Sportsmed","first-page":"17","article-title":"Part I: epidemiology and risk factors for stress fractures in female athletes","volume":"48","author":"Abbott","year":"2020","unstructured":"Abbott A,\nBird ML,\nWild E,\nBrown SM,\nStewart G,\nMulcahey MK. Part I: epidemiology and risk factors for stress fractures in female athletes. Phys Sportsmed. 2020;48(1):17\u201324. doi:10.1080\/00913847.2019.1632158"},{"issue":"7","key":"i1938-162X-61-3-239-b02","series-title":"Dtsch Z Sportmed","first-page":"225","article-title":"Relative Energy Deficiency in Sport (RED-S): scientific, clinical, and practical implications for the female athlete","volume":"73","author":"Cabre","year":"2022","unstructured":"Cabre HE,\nMoore SR,\nSmith-Ryan AE,\nHackney AC. Relative Energy Deficiency in Sport (RED-S): scientific, clinical, and practical implications for the female athlete. 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Neuroendocrine alterations in the exercising human: implications for energy homeostasis. Metabolism. 2013;62(7):911\u2013921. doi:10.1016\/j.metabol.2013.01.016"},{"issue":"2","key":"i1938-162X-61-3-239-b07","series-title":"Spartan Med Res J","first-page":"11595","article-title":"Disordered eating and eating disorders in adolescent athletes","volume":"4","author":"Mancine","year":"2020","unstructured":"Mancine R,\nKennedy S,\nStephan P,\nLey A. Disordered eating and eating disorders in adolescent athletes. Spartan Med Res J. 2020;4(2):11595. doi:10.51894\/001c.11595"},{"issue":"10","key":"i1938-162X-61-3-239-b08","series-title":"Scand J Med Sci Sports","first-page":"1501","article-title":"Risk factors of stress fractures due to the Female Athlete Triad: differences in teens and twenties","volume":"29","author":"Nose-Ogura","year":"2019","unstructured":"Nose-Ogura S,\nYoshino O,\nDohi M, et al. 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Part I: epidemiology and risk factors for stress fractures in female athletes. Phys Sportsmed. 2020;48(1):17\u201324. doi:10.1080\/00913847.2019.1632158"},{"issue":"7","key":"i1938-162X-61-3-239-b02","series-title":"Dtsch Z Sportmed","first-page":"225","article-title":"Relative Energy Deficiency in Sport (RED-S): scientific, clinical, and practical implications for the female athlete","volume":"73","author":"Cabre","year":"2022","unstructured":"Cabre HE,\nMoore SR,\nSmith-Ryan AE,\nHackney AC. Relative Energy Deficiency in Sport (RED-S): scientific, clinical, and practical implications for the female athlete. 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