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Cited by 26Eating Disorders and BehaviorsNutrition, Health and Food BehaviorHealth and Lifestyle Studies

Examination of the Prevalence of Female Athlete Triad Components among Competitive Cheerleaders

Open access
Smith, Allison B., Gay, Jennifer L., Arent, Shawn M., Sarzynski, Mark A., Emerson, Dawn M., Torres-McGehee, Toni M.·2022·International Journal of Environmental Research and Public Health
DOI 10.3390/ijerph19031375PMC PMC8835590
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Abstract

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 ± 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.

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Crossref · 10.3390/ijerph19031375

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  • High energy expenditure, high stress, and caloric needs often occur in the pre-season and again during high travel and competition blocks.

    “high energy expenditure, high stress, and caloric needs often occur in the pre-season (lower fitness) and again during high travel and competition blocks [143–145].”

    From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [144]

    Results §3.2 reports exercise energy expenditure and low energy availability in competitive cheerleaders, and Discussion §4.1 says data were collected while they prepared for a national competition. The paper does not establish that high expenditure, high stress, and caloric needs often coincide in the pre-season or during travel and competition blocks; Discussion §4.4 describes the measured expenditure as lower than in several other sports. Page numbers were not available in our copy. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Continuous workload monitoring throughout the season plays an important role in assessing stress and recovery needs.

    “Continuous workload monitoring throughout the season also plays an important role in assessing stress and recovery needs”

    From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [144]

    The Methods, §2.2.10 (page unavailable), says participants wore watches continuously during the study to monitor energy expenditure. It does not say monitoring continued throughout a season or that it was used to assess stress and recovery needs. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Two studies on cheerleaders (n = 19) and young athletic males (n = 14) found that no athletes had low BMD, although the majority of subjects in both studies had LEA.

    “Two of the studies on cheerleaders (n = 19) [33] and young athletic males (n = 14) [34] found that no athletes had low BMD, although the majority of subjects in both studies had LEA.”

    From Low Energy Availability and Relative Energy Deficiency in Sport: A Systematic Review and Meta-analysis (2025) · cites this paper as [33]

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Cites

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Research works printed but not linked: 1

  1. [19]NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy Osteoporosis prevention, diagnosis, and therapy NIH Consens. Statement 2000 17 1 45 11525451

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Authors
Smith, A. B., Gay, J. L., Arent, S. M., Sarzynski, M. A., Emerson, D. M., & Torres-McGehee, T. M.
Affiliations
  • University of Louisiana at Lafayette (US)
  • University of Georgia (US)
  • University of South Carolina (US)
  • University of Kansas Medical Center (US)
Corresponding author
Smith, Allison B.
ORCID
Venue
International Journal of Environmental Research and Public Health
Publisher
MDPI AG
Published
2022-01-26
Volume
19
Issue
3
Pages
1375
ISSN
1660-4601 (ISSN-L)
DOI
10.3390/ijerph19031375
PMC
PMC8835590
OpenAlex
W4210393469
Cited by
26
References
92
Citations by year
2026: 7 · 2025: 6 · 2024: 6 · 2023: 5 · 2022: 2
FWCI
4.33
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Scholar Commons (University of South Carolina) (submittedVersion, cc-by)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
University of South Carolina (SPARC Graduate Research Grant from the Office of the Vice President for Research at the University of South Carolina.)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
  • Health Sciences › Health Professions › General Health Professions › Health and Lifestyle Studies
Keywords
female athlete triad, cheerleading, low energy availability, disordered eating, menstrual disorders, bone mineral density, eating disorders, energy expenditure, female athletes
MeSH terms
Adult, Feeding and Eating Disorders, Female, Humans, Surveys and Questionnaires, Absorptiometry, Photon, Bone Density, Prevalence, Female Athlete Triad Syndrome, Young Adult

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