The Experts below are selected from a list of 1467 Experts worldwide ranked by ideXlab platform
Mary Jane De Souza - One of the best experts on this subject based on the ideXlab platform.
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Female Athlete Triad and relative energy deficiency in sport a focus on scientific rigor
Exercise and Sport Sciences Reviews, 2019Co-Authors: Nancy I. Williams, Kristen J. Koltun, Nicole C.a. Strock, Mary Jane De SouzaAbstract:We examine the scientific evidence supporting The Female Athlete Triad and Relative Energy Deficiency in Sport (RED-S) syndromes. More research is necessary to advance the understanding of both syndromes; however, it is premature to consider RED-S as an evidence-based syndrome. Future research should specifically define RED-S components, determine its clinical relevance, and establish the causality of relative energy deficiency on RED-S outcomes.
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Comparison of Female Athlete Triad Coalition and RED-S risk assessment tools
Journal of sports sciences, 2019Co-Authors: Kristen J. Koltun, Nancy I. Williams, Nicole C.a. Strock, Emily A. Southmayd, Andrew P. Oneglia, Mary Jane De SouzaAbstract:The Female Athlete Triad Coalition (Triad Coalition) and Relative Energy Deficiency in Sport (RED-S) consensus statements each include risk assessment tools to guide Athlete eligibility decisions. ...
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Rethinking the concept of an energy availability threshold and its role in the Female Athlete Triad
Current Opinion in Physiology, 2019Co-Authors: Mary Jane De Souza, Kristen J. Koltun, Nicole C.a. Strock, Nancy I. WilliamsAbstract:The scientific foundations of the Female Athlete Triad model include low energy availability (or energy deficiency) presenting with or without disordered eating, menstrual dysfunction, and poor bone health. Energy availability has been highlighted in the etiology of menstrual disorders and bone loss; a specific threshold of energy availability below which negative effects occur has been prominent in the framework of the Female Athlete Triad. This brief review will provide an overview of the Female Athlete Triad as represented by the scientifically rigorous evidence available to date. This review will focus on new findings regarding energy availability, specifically the validity of a particular energy availability threshold associated with menstrual disruption. Our findings to date do not support the use of an absolute energy availability threshold of 30 kcal/kg FFM/day as a strategy to prevent the occurrence of abnormal menstrual cycles. We propose that a sliding scale range should be considered for a given individual such that if energy availability decreases, the likelihood of a menstrual abnormality increases. We also caution against the use of self-report methods for assessing energy availability and encourage the use of repeated serial objective physiological assessments in free-living individuals. This review highlights the presence of individual variability in the level of energy availability at which the susceptibility to menstrual disruption is observed and calls for a reconceptualization of how best to utilize measures of energy availability in exercising women, and how to consider revisions to position stands and consensus statements utilizing new data on the Female Athlete Triad.
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Current Status of the Female Athlete Triad: Update and Future Directions
Current Osteoporosis Reports, 2017Co-Authors: Mary Jane De Souza, Kristen J. Koltun, Clara V. Etter, Emily A. SouthmaydAbstract:Purpose of Review This review provides an update on the primary clinical sequelae of the Female Athlete Triad. Recent Findings Scientific advancements have contributed to improve understanding of Triad-related conditions, including leptin’s role as a potential neuroendocrine link between energy status and reproductive function. Use of finite element analysis of HRpQCT imaging has provided a more accurate assessment of bone geometry and bone strength and may be clinically relevant. New perspectives aimed at developing and implementing a multi-disciplinary, personalized approach in the prevention and early treatment of Triad-related symptoms are provided. Summary The Female Athlete Triad is a multi-dimensional condition that affects active women across the lifespan. Energy availability impacts reproductive function and bone with implications for health and performance. Understanding the contributions of each individual component as well as their interconnected effects is necessary for progression and expansion of the Triad literature.
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Current Status of the Female Athlete Triad: Update and Future Directions.
Current osteoporosis reports, 2017Co-Authors: Mary Jane De Souza, Kristen J. Koltun, Clara V. Etter, Emily A. SouthmaydAbstract:This review provides an update on the primary clinical sequelae of the Female Athlete Triad. Scientific advancements have contributed to improve understanding of Triad-related conditions, including leptin’s role as a potential neuroendocrine link between energy status and reproductive function. Use of finite element analysis of HRpQCT imaging has provided a more accurate assessment of bone geometry and bone strength and may be clinically relevant. New perspectives aimed at developing and implementing a multi-disciplinary, personalized approach in the prevention and early treatment of Triad-related symptoms are provided. The Female Athlete Triad is a multi-dimensional condition that affects active women across the lifespan. Energy availability impacts reproductive function and bone with implications for health and performance. Understanding the contributions of each individual component as well as their interconnected effects is necessary for progression and expansion of the Triad literature.
Nancy I. Williams - One of the best experts on this subject based on the ideXlab platform.
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Female Athlete Triad and relative energy deficiency in sport a focus on scientific rigor
Exercise and Sport Sciences Reviews, 2019Co-Authors: Nancy I. Williams, Kristen J. Koltun, Nicole C.a. Strock, Mary Jane De SouzaAbstract:We examine the scientific evidence supporting The Female Athlete Triad and Relative Energy Deficiency in Sport (RED-S) syndromes. More research is necessary to advance the understanding of both syndromes; however, it is premature to consider RED-S as an evidence-based syndrome. Future research should specifically define RED-S components, determine its clinical relevance, and establish the causality of relative energy deficiency on RED-S outcomes.
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Comparison of Female Athlete Triad Coalition and RED-S risk assessment tools
Journal of sports sciences, 2019Co-Authors: Kristen J. Koltun, Nancy I. Williams, Nicole C.a. Strock, Emily A. Southmayd, Andrew P. Oneglia, Mary Jane De SouzaAbstract:The Female Athlete Triad Coalition (Triad Coalition) and Relative Energy Deficiency in Sport (RED-S) consensus statements each include risk assessment tools to guide Athlete eligibility decisions. ...
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Rethinking the concept of an energy availability threshold and its role in the Female Athlete Triad
Current Opinion in Physiology, 2019Co-Authors: Mary Jane De Souza, Kristen J. Koltun, Nicole C.a. Strock, Nancy I. WilliamsAbstract:The scientific foundations of the Female Athlete Triad model include low energy availability (or energy deficiency) presenting with or without disordered eating, menstrual dysfunction, and poor bone health. Energy availability has been highlighted in the etiology of menstrual disorders and bone loss; a specific threshold of energy availability below which negative effects occur has been prominent in the framework of the Female Athlete Triad. This brief review will provide an overview of the Female Athlete Triad as represented by the scientifically rigorous evidence available to date. This review will focus on new findings regarding energy availability, specifically the validity of a particular energy availability threshold associated with menstrual disruption. Our findings to date do not support the use of an absolute energy availability threshold of 30 kcal/kg FFM/day as a strategy to prevent the occurrence of abnormal menstrual cycles. We propose that a sliding scale range should be considered for a given individual such that if energy availability decreases, the likelihood of a menstrual abnormality increases. We also caution against the use of self-report methods for assessing energy availability and encourage the use of repeated serial objective physiological assessments in free-living individuals. This review highlights the presence of individual variability in the level of energy availability at which the susceptibility to menstrual disruption is observed and calls for a reconceptualization of how best to utilize measures of energy availability in exercising women, and how to consider revisions to position stands and consensus statements utilizing new data on the Female Athlete Triad.
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misunderstanding the Female Athlete Triad refuting the ioc consensus statement on relative energy deficiency in sport red s
British Journal of Sports Medicine, 2014Co-Authors: Mary Jane De Souza, Aurelia Nattiv, Elizabeth Joy, Madhusmita Misra, Nancy I. Williams, Marion P. Olmsted, Gordon O. Matheson, Anne B. Loucks, Michelle T Barrack, Rebecca J. MallinsonAbstract:An IOC consensus group has recently introduced a new umbrella term, that is, ‘Relative Energy Deficiency in Sport’ (RED-S) to describe the physiological and pathophysiological effects of energy deficiency in male and Female Athletes.1 The authors assert that “new terminology is required to more accurately describe the clinical syndrome originally known as the Female Athlete Triad” that is a “more comprehensive, broader term for the overall syndrome, which includes what has so far been called the ‘Female Athlete Triad’.”1 This new terminology (RED-S) is insufficiently supported by scientific research to warrant adoption at this time. The Female Athlete Triad has more than 30 years of published evidence to support its existence in the scientific literature with strong evidence for its clinical sequelae and should remain a focus of scientific inquiry and translation.2–6 Moreover, several major concerns and errors with the IOC consensus statement should give researchers and practitioners great pause before adopting the IOC's new terminology, its theoretical construct and its proposed recommendations for screening and return to play. As stated by the IOC authors, the science of energy deficiency in the male Athlete and in other groups is still in its ‘infancy’.1 In contrast, research on the Triad has been published since the early 1990s4 and, in fact, even earlier. Reports of menstrual and other problems in Athletes were becoming prevalent in the literature as early as the 1960s, but particularly in the 1970s and 1980s.7–10 The first symposium related to the topic at the American College of Sports Medicine (ACSM) Annual Meeting was organised by Barbara Drinkwater in 1981 and was entitled ‘Menstrual Irregularities in Female Athletes’. The term ‘Female Athlete Triad’ was introduced at a workshop in 1992.4 The first position stand from the ACSM was published in 1997,2 and …
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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, India
British journal of sports medicine, 2014Co-Authors: Mary Jane De Souza, Aurelia Nattiv, Elizabeth Joy, Madhusmita Misra, Nancy I. Williams, Rebecca J. Mallinson, Jenna C. Gibbs, Marion P. Olmsted, Marci Goolsby, Gordon O. MathesonAbstract:The Female Athlete Triad is a medical condition often observed in physically active girls and women, and involves three components: (1) low energy availability with or without disordered eating, (2) menstrual dysfunction and (3) low bone mineral density. Female Athletes often present with one or more of the three Triad components, and an early intervention is essential to prevent its progression to serious endpoints that include clinical eating disorders, amenorrhoea and osteoporosis. This consensus statement represents a set of recommendations developed following the 1st (San Francisco, California, USA) and 2nd (Indianapolis, Indiana, USA) International Symposia on the Female Athlete Triad. It is intended to provide clinical guidelines for physicians, athletic trainers and other healthcare providers for the screening, diagnosis and treatment of the Female Athlete Triad and to provide clear recommendations for return to play. The 2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad expert panel has proposed a risk stratification point system that takes into account magnitude of risk to assist the physician in decision-making regarding sport participation, clearance and return to play. Guidelines are offered for clearance categories, management by a multidisciplinary team and implementation of treatment contracts. This consensus paper has been endorsed by the Female Athlete Triad Coalition, an International Consortium of leading Triad researchers, physicians and other healthcare professionals, the American College of Sports Medicine and the American Medical Society for Sports Medicine.
Jenna C. Gibbs - One of the best experts on this subject based on the ideXlab platform.
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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, India
British journal of sports medicine, 2014Co-Authors: Mary Jane De Souza, Aurelia Nattiv, Elizabeth Joy, Madhusmita Misra, Nancy I. Williams, Rebecca J. Mallinson, Jenna C. Gibbs, Marion P. Olmsted, Marci Goolsby, Gordon O. MathesonAbstract:The Female Athlete Triad is a medical condition often observed in physically active girls and women, and involves three components: (1) low energy availability with or without disordered eating, (2) menstrual dysfunction and (3) low bone mineral density. Female Athletes often present with one or more of the three Triad components, and an early intervention is essential to prevent its progression to serious endpoints that include clinical eating disorders, amenorrhoea and osteoporosis. This consensus statement represents a set of recommendations developed following the 1st (San Francisco, California, USA) and 2nd (Indianapolis, Indiana, USA) International Symposia on the Female Athlete Triad. It is intended to provide clinical guidelines for physicians, athletic trainers and other healthcare providers for the screening, diagnosis and treatment of the Female Athlete Triad and to provide clear recommendations for return to play. The 2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad expert panel has proposed a risk stratification point system that takes into account magnitude of risk to assist the physician in decision-making regarding sport participation, clearance and return to play. Guidelines are offered for clearance categories, management by a multidisciplinary team and implementation of treatment contracts. This consensus paper has been endorsed by the Female Athlete Triad Coalition, an International Consortium of leading Triad researchers, physicians and other healthcare professionals, the American College of Sports Medicine and the American Medical Society for Sports Medicine.
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2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad
Current sports medicine reports, 2014Co-Authors: Elizabeth Joy, Aurelia Nattiv, Mary Jane De Souza, Madhusmita Misra, Nancy I. Williams, Rebecca J. Mallinson, Jenna C. Gibbs, Marion P. Olmsted, Marci Goolsby, Gordon O. MathesonAbstract:The Female Athlete Triad is a medical condition often observed in physically active girls and women and involves three components: (1) low energy availability with or without disordered eating, (2) menstrual dysfunction, and (3) low bone mineral density. Female Athletes often present with one or more of the three Triad components, and early intervention is essential to prevent its progression to serious end points that include clinical eating disorders, amenorrhea, and osteoporosis. This consensus statement presents a set of recommendations developed following the first (San Francisco, CA) and second (Indianapolis, IN) International Symposia on the Female Athlete Triad. This consensus statement was intended to provide clinical guidelines for physicians, athletic trainers, and other health care providers for the screening, diagnosis, and treatment of the Female Athlete Triad and to provide clear recommendations for return to play. The expert panel has proposed a risk stratification point system that takes into account magnitude of risk to assist the physician in decision making regarding sport participation, clearance, and return to play. Guidelines are offered for clearance categories, management by a multidisciplinary team, and implementation of treatment contracts.
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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, CA, May 2012, and 2nd International Conference Held in Indianapolis, IN, May 2013
Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine, 2014Co-Authors: Mary Jane De Souza, Aurelia Nattiv, Madhusmita Misra, Nancy I. Williams, Rebecca J. Mallinson, Jenna C. Gibbs, Marion P. Olmsted, Marci Goolsby, Elizabeth A. Joy, Gordon O. MathesonAbstract:The Female Athlete Triad is a medical condition often observed in physically active girls and women, and involves 3 components: (1) low energy availability with or without disordered eating, (2) menstrual dysfunction, and (3) low bone mineral density. Female Athletes often present with 1 or more of the 3 Triad components, and an early intervention is essential to prevent its progression to serious endpoints that include clinical eating disorders, amenorrhea, and osteoporosis. This consensus statement represents a set of recommendations developed following the first (San Francisco, California) and second (Indianapolis, Indianna) International Symposia on the Female Athlete Triad. It is intended to provide clinical guidelines for physicians, athletic trainers, and other health care providers for the screening, diagnosis, and treatment of the Female Athlete Triad and to provide clear recommendations for return to play. The 2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad Expert Panel has proposed a risk stratification point system that takes into account magnitude of risk to assist the physician in decision-making regarding sport participation, clearance, and return to play. Guidelines are offered for clearance categories, management by a multidisciplinary team, and implementation of treatment contracts. This consensus paper has been endorsed by The Female Athlete Triad Coalition, an International Consortium of leading Triad researchers, physicians, and other health care professionals, the American College of Sports Medicine, and the American Medical Society for Sports Medicine.
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Update on the Female Athlete Triad
Current reviews in musculoskeletal medicine, 2013Co-Authors: Michelle T Barrack, Kathryn E. Ackerman, Jenna C. GibbsAbstract:Updated prevalence estimates of all 3 components of the Female Athlete Triad, a syndrome characterized by low energy availability, functional hypothalamic amenorrhea, and osteoporosis, is low (0 %–16 %), however, estimates of 1 or 2 concurrent components approach 50 %–60 % among certain Athlete groups. Recent research identifies components of the Triad among Female adolescent Athletes, particularly those participating in leanness sports, such as endurance running. This is alarming, as adolescents require adequate nutrition and normal hormone function to optimize bone mineral gains during this critical developmental period. Current literature highlights new assessments, such as measurements of bone microarchitecture and hormone levels to better evaluate bone strength and the hormonal and metabolic profile of Athletes with and at risk for the Triad. Recent data also provides support for additional potential consequences of the Triad, such as endothelial dysfunction and related cardiovascular effects, stress fractures, and musculoskeletal injuries. Additional prospective research is needed to evaluate long-term indicators and consequences of the Triad and identify effective behavioral treatment strategies.
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Prevalence of individual and combined components of the Female Athlete Triad.
Medicine and science in sports and exercise, 2013Co-Authors: Jenna C. Gibbs, Nancy I. Williams, Mary Jane De SouzaAbstract:ABSTRACTPurposeThe Female Athlete Triad (Triad) is a syndrome linking low energy availability (EA) with or without disordered eating (DE), menstrual disturbances (MD), and low bone mineral density (BMD) in exercising women. The prevalence of Triad conditions (both clinical and subclinical) has not b
Gordon O. Matheson - One of the best experts on this subject based on the ideXlab platform.
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misunderstanding the Female Athlete Triad refuting the ioc consensus statement on relative energy deficiency in sport red s
British Journal of Sports Medicine, 2014Co-Authors: Mary Jane De Souza, Aurelia Nattiv, Elizabeth Joy, Madhusmita Misra, Nancy I. Williams, Marion P. Olmsted, Gordon O. Matheson, Anne B. Loucks, Michelle T Barrack, Rebecca J. MallinsonAbstract:An IOC consensus group has recently introduced a new umbrella term, that is, ‘Relative Energy Deficiency in Sport’ (RED-S) to describe the physiological and pathophysiological effects of energy deficiency in male and Female Athletes.1 The authors assert that “new terminology is required to more accurately describe the clinical syndrome originally known as the Female Athlete Triad” that is a “more comprehensive, broader term for the overall syndrome, which includes what has so far been called the ‘Female Athlete Triad’.”1 This new terminology (RED-S) is insufficiently supported by scientific research to warrant adoption at this time. The Female Athlete Triad has more than 30 years of published evidence to support its existence in the scientific literature with strong evidence for its clinical sequelae and should remain a focus of scientific inquiry and translation.2–6 Moreover, several major concerns and errors with the IOC consensus statement should give researchers and practitioners great pause before adopting the IOC's new terminology, its theoretical construct and its proposed recommendations for screening and return to play. As stated by the IOC authors, the science of energy deficiency in the male Athlete and in other groups is still in its ‘infancy’.1 In contrast, research on the Triad has been published since the early 1990s4 and, in fact, even earlier. Reports of menstrual and other problems in Athletes were becoming prevalent in the literature as early as the 1960s, but particularly in the 1970s and 1980s.7–10 The first symposium related to the topic at the American College of Sports Medicine (ACSM) Annual Meeting was organised by Barbara Drinkwater in 1981 and was entitled ‘Menstrual Irregularities in Female Athletes’. The term ‘Female Athlete Triad’ was introduced at a workshop in 1992.4 The first position stand from the ACSM was published in 1997,2 and …
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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, India
British journal of sports medicine, 2014Co-Authors: Mary Jane De Souza, Aurelia Nattiv, Elizabeth Joy, Madhusmita Misra, Nancy I. Williams, Rebecca J. Mallinson, Jenna C. Gibbs, Marion P. Olmsted, Marci Goolsby, Gordon O. MathesonAbstract:The Female Athlete Triad is a medical condition often observed in physically active girls and women, and involves three components: (1) low energy availability with or without disordered eating, (2) menstrual dysfunction and (3) low bone mineral density. Female Athletes often present with one or more of the three Triad components, and an early intervention is essential to prevent its progression to serious endpoints that include clinical eating disorders, amenorrhoea and osteoporosis. This consensus statement represents a set of recommendations developed following the 1st (San Francisco, California, USA) and 2nd (Indianapolis, Indiana, USA) International Symposia on the Female Athlete Triad. It is intended to provide clinical guidelines for physicians, athletic trainers and other healthcare providers for the screening, diagnosis and treatment of the Female Athlete Triad and to provide clear recommendations for return to play. The 2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad expert panel has proposed a risk stratification point system that takes into account magnitude of risk to assist the physician in decision-making regarding sport participation, clearance and return to play. Guidelines are offered for clearance categories, management by a multidisciplinary team and implementation of treatment contracts. This consensus paper has been endorsed by the Female Athlete Triad Coalition, an International Consortium of leading Triad researchers, physicians and other healthcare professionals, the American College of Sports Medicine and the American Medical Society for Sports Medicine.
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2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad
Current sports medicine reports, 2014Co-Authors: Elizabeth Joy, Aurelia Nattiv, Mary Jane De Souza, Madhusmita Misra, Nancy I. Williams, Rebecca J. Mallinson, Jenna C. Gibbs, Marion P. Olmsted, Marci Goolsby, Gordon O. MathesonAbstract:The Female Athlete Triad is a medical condition often observed in physically active girls and women and involves three components: (1) low energy availability with or without disordered eating, (2) menstrual dysfunction, and (3) low bone mineral density. Female Athletes often present with one or more of the three Triad components, and early intervention is essential to prevent its progression to serious end points that include clinical eating disorders, amenorrhea, and osteoporosis. This consensus statement presents a set of recommendations developed following the first (San Francisco, CA) and second (Indianapolis, IN) International Symposia on the Female Athlete Triad. This consensus statement was intended to provide clinical guidelines for physicians, athletic trainers, and other health care providers for the screening, diagnosis, and treatment of the Female Athlete Triad and to provide clear recommendations for return to play. The expert panel has proposed a risk stratification point system that takes into account magnitude of risk to assist the physician in decision making regarding sport participation, clearance, and return to play. Guidelines are offered for clearance categories, management by a multidisciplinary team, and implementation of treatment contracts.
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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, CA, May 2012, and 2nd International Conference Held in Indianapolis, IN, May 2013
Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine, 2014Co-Authors: Mary Jane De Souza, Aurelia Nattiv, Madhusmita Misra, Nancy I. Williams, Rebecca J. Mallinson, Jenna C. Gibbs, Marion P. Olmsted, Marci Goolsby, Elizabeth A. Joy, Gordon O. MathesonAbstract:The Female Athlete Triad is a medical condition often observed in physically active girls and women, and involves 3 components: (1) low energy availability with or without disordered eating, (2) menstrual dysfunction, and (3) low bone mineral density. Female Athletes often present with 1 or more of the 3 Triad components, and an early intervention is essential to prevent its progression to serious endpoints that include clinical eating disorders, amenorrhea, and osteoporosis. This consensus statement represents a set of recommendations developed following the first (San Francisco, California) and second (Indianapolis, Indianna) International Symposia on the Female Athlete Triad. It is intended to provide clinical guidelines for physicians, athletic trainers, and other health care providers for the screening, diagnosis, and treatment of the Female Athlete Triad and to provide clear recommendations for return to play. The 2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad Expert Panel has proposed a risk stratification point system that takes into account magnitude of risk to assist the physician in decision-making regarding sport participation, clearance, and return to play. Guidelines are offered for clearance categories, management by a multidisciplinary team, and implementation of treatment contracts. This consensus paper has been endorsed by The Female Athlete Triad Coalition, an International Consortium of leading Triad researchers, physicians, and other health care professionals, the American College of Sports Medicine, and the American Medical Society for Sports Medicine.
Aurelia Nattiv - One of the best experts on this subject based on the ideXlab platform.
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Clearance and Return to Play for the Female Athlete Triad: Clinical Guidelines, Clinical Judgment, and Evolving Evidence.
Current sports medicine reports, 2017Co-Authors: Elizabeth A. Joy, Aurelia NattivAbstract:The Female Athlete Triad (Triad) was first defined by a group of clinical and scientific experts in 1992 (28). Since then, two American College of Sports Medicine (ACSM) Position Stands have been published (1997, 2007) (21,22), and more recently, the Female Athlete Triad Coalition Consensus on Clear
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Team Management of the Female Athlete Triad
The Physician and Sportsmedicine, 2015Co-Authors: Elizabeth A. Joy, Aurelia Nattiv, Nancy Clark, Mary Lloyd Ireland, Joseph R. Martire, Steve VarechokAbstract:Multidisciplinary management of the Female Athlete Triad (disordered eating, amenorrhea, and osteoporosis) is optimal, but what exactly does it entail? With the primary care physician as the point person, the healthcare team addresses the underlying causes of disordered eating through such measures as drawing up a contract for returning to play, resolving nutrition issues, exploring psychotherapy options, and, sometimes, prescribing antidepressants. Hormone replacement therapy and conservative or orthopedic intervention for stress fractures may also be required. Communication among the members of the treatment team is crucial, and athletic trainers especially can provide valuable input. Prevention strategies need to involve education of coaches, teachers, trainers, parents, and others who work closely with Female Athletes.
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misunderstanding the Female Athlete Triad refuting the ioc consensus statement on relative energy deficiency in sport red s
British Journal of Sports Medicine, 2014Co-Authors: Mary Jane De Souza, Aurelia Nattiv, Elizabeth Joy, Madhusmita Misra, Nancy I. Williams, Marion P. Olmsted, Gordon O. Matheson, Anne B. Loucks, Michelle T Barrack, Rebecca J. MallinsonAbstract:An IOC consensus group has recently introduced a new umbrella term, that is, ‘Relative Energy Deficiency in Sport’ (RED-S) to describe the physiological and pathophysiological effects of energy deficiency in male and Female Athletes.1 The authors assert that “new terminology is required to more accurately describe the clinical syndrome originally known as the Female Athlete Triad” that is a “more comprehensive, broader term for the overall syndrome, which includes what has so far been called the ‘Female Athlete Triad’.”1 This new terminology (RED-S) is insufficiently supported by scientific research to warrant adoption at this time. The Female Athlete Triad has more than 30 years of published evidence to support its existence in the scientific literature with strong evidence for its clinical sequelae and should remain a focus of scientific inquiry and translation.2–6 Moreover, several major concerns and errors with the IOC consensus statement should give researchers and practitioners great pause before adopting the IOC's new terminology, its theoretical construct and its proposed recommendations for screening and return to play. As stated by the IOC authors, the science of energy deficiency in the male Athlete and in other groups is still in its ‘infancy’.1 In contrast, research on the Triad has been published since the early 1990s4 and, in fact, even earlier. Reports of menstrual and other problems in Athletes were becoming prevalent in the literature as early as the 1960s, but particularly in the 1970s and 1980s.7–10 The first symposium related to the topic at the American College of Sports Medicine (ACSM) Annual Meeting was organised by Barbara Drinkwater in 1981 and was entitled ‘Menstrual Irregularities in Female Athletes’. The term ‘Female Athlete Triad’ was introduced at a workshop in 1992.4 The first position stand from the ACSM was published in 1997,2 and …
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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, India
British journal of sports medicine, 2014Co-Authors: Mary Jane De Souza, Aurelia Nattiv, Elizabeth Joy, Madhusmita Misra, Nancy I. Williams, Rebecca J. Mallinson, Jenna C. Gibbs, Marion P. Olmsted, Marci Goolsby, Gordon O. MathesonAbstract:The Female Athlete Triad is a medical condition often observed in physically active girls and women, and involves three components: (1) low energy availability with or without disordered eating, (2) menstrual dysfunction and (3) low bone mineral density. Female Athletes often present with one or more of the three Triad components, and an early intervention is essential to prevent its progression to serious endpoints that include clinical eating disorders, amenorrhoea and osteoporosis. This consensus statement represents a set of recommendations developed following the 1st (San Francisco, California, USA) and 2nd (Indianapolis, Indiana, USA) International Symposia on the Female Athlete Triad. It is intended to provide clinical guidelines for physicians, athletic trainers and other healthcare providers for the screening, diagnosis and treatment of the Female Athlete Triad and to provide clear recommendations for return to play. The 2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad expert panel has proposed a risk stratification point system that takes into account magnitude of risk to assist the physician in decision-making regarding sport participation, clearance and return to play. Guidelines are offered for clearance categories, management by a multidisciplinary team and implementation of treatment contracts. This consensus paper has been endorsed by the Female Athlete Triad Coalition, an International Consortium of leading Triad researchers, physicians and other healthcare professionals, the American College of Sports Medicine and the American Medical Society for Sports Medicine.
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2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad
Current sports medicine reports, 2014Co-Authors: Elizabeth Joy, Aurelia Nattiv, Mary Jane De Souza, Madhusmita Misra, Nancy I. Williams, Rebecca J. Mallinson, Jenna C. Gibbs, Marion P. Olmsted, Marci Goolsby, Gordon O. MathesonAbstract:The Female Athlete Triad is a medical condition often observed in physically active girls and women and involves three components: (1) low energy availability with or without disordered eating, (2) menstrual dysfunction, and (3) low bone mineral density. Female Athletes often present with one or more of the three Triad components, and early intervention is essential to prevent its progression to serious end points that include clinical eating disorders, amenorrhea, and osteoporosis. This consensus statement presents a set of recommendations developed following the first (San Francisco, CA) and second (Indianapolis, IN) International Symposia on the Female Athlete Triad. This consensus statement was intended to provide clinical guidelines for physicians, athletic trainers, and other health care providers for the screening, diagnosis, and treatment of the Female Athlete Triad and to provide clear recommendations for return to play. The expert panel has proposed a risk stratification point system that takes into account magnitude of risk to assist the physician in decision making regarding sport participation, clearance, and return to play. Guidelines are offered for clearance categories, management by a multidisciplinary team, and implementation of treatment contracts.
