Knowledge of the female athlete triad and relative energy deficiency in sport among female cross-country athletes and support staff
Open accessAbstract
Context: Female endurance athletes exhibit an increased risk of the female athlete triad (Triad) and relative energy deficiency in sport (RED-S). The triad and RED-S are conditions that involve the health and performance consequences of low energy availability. Few authors of studies to date have assessed the knowledge that athletes, coaches, and athletic trainers (ATs) have regarding the Triad or RED-S. Proper education has been shown to be effective in increasing knowledge of sports medicine concerns for athletes, yet no known continuing education programs for the Triad or RED-S exist at collegiate institutions. Objective: To assess the knowledge, confidence, and educational impact of identifying, screening, treating, and preventing the Triad or RED-S. Design: Cross-sectional study. Setting: An evidence-based online survey was developed and administered via Qualtrics. Patients or Other Participants: Female collegiate cross-country athletes (n = 275, age = 20 ± 1 years), collegiate cross-country coaches (n = 55, age = 34 ± 9 years), and ATs working with cross-country teams (n = 30, age = 36 ± 11 years). Main Outcome Measure(s): Knowledge, confidence, and educational impact scores were assessed among groups using analysis of variance. Independent t tests were calculated to determine differences in impact scores between people who had or had not received education on the topic. Results: Female cross-country athletes' total knowledge, confidence, and educational impact scores (mean scores = 25.00 ± 5.27, 95.42 ± 28.83, and 18.81 ± 7.05, respectively) were different from those of coaches (mean scores = 26.92 ± 5.02, 111.35 ± 24.14, and 22.41 ± 6.33, respectively) and ATs (mean scores = 28.66 ± 4.02, 117.67 ± 22.53, and 23.93 ± 5.69, respectively; P < .05). Conclusions: Knowledge, confidence, and educational impact scores regarding Triad or RED-S were lowest in female cross-country athletes and highest in ATs. These findings support the call for education, which should be regarded as the primary tool for increasing knowledge, to improve the prevention and treatment of the Triad or RED-S.
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Other studies reported similar knowledge gaps among physiotherapists and athletic trainers.
“other studies reported similar knowledge gaps among physiotherapists and athletic trainers.142 145”
From 2023 international olympic committee's (IOC) consensus statement on relative energy deficiency in sport (REDs) (2023) · cites this paper as [145]
The introduction (page unavailable) reports prior assessments finding gaps in athletic trainers’ knowledge of the female athlete triad, and the Discussion (page unavailable) describes a prior survey in which few trainers identified a key component correctly. The paper does not report a comparable finding about physiotherapists, so it supports only the athletic-trainer part of the claim. (LLM, conf=0.87)
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- Authors
- Lodge, M. T., Ackerman, K. E., & Garay, J.
- Affiliations
- Syracuse University (US)
- Boston Children's Hospital (US)
- Venue
- Journal of Athletic Training
- Published
- 2021-07-30
- Volume
- 57
- Issue
- 4
- Pages
- 385-392
- ISSN
- 1062-6050 (ISSN-L)
- 1938-162X
- PMC
- PMC9020605
- OpenAlex
- W3183967214
- Cited by
- 45
- References
- 19
- Citations by year
- 2026: 11 · 2025: 15 · 2024: 8 · 2023: 9 · 2022: 2
- FWCI
- 3.24
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Journal of Athletic Training (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- female athlete triad, relative energy deficiency in sport, low energy availability, cross-country athletes, female endurance athletes, coaches, athletic trainers, sports medicine education, knowledge and confidence, screening and prevention, college athletics, continuing education, eating disorders, menstrual disorders, bone health, injury risk, gender differences in health knowledge, nutrition education
- MeSH terms
- Relative Energy Deficiency in Sport, Adult, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Sports, Female Athlete Triad Syndrome, Young Adult, Athletes
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