The importance of maintaining adequate nutrition for child and adolescent females participating in sports.

Proper nutrition is especially important for young female athletes. Eating an adequate amount of calories and protein each day is essential in not only staying properly fueled to perform their best during games and practices but also is important in maintaining regular development. Low calorie or energy intake directly affects a young female athlete’s menstrual cycle and bone development. These three factors combine to make up a serious and very common medical condition, called the female athlete triad.

Low Energy Intake

The female athlete triad consists of low energy intake, menstrual cycle dysfunction, and low bone mineral density. Low energy intake is not consuming enough calories and protein to make up for the energy used for training, competition, and also everyday life. Low energy intake can be a result of unintentional practices or intentional practices, such as disordered eating. Unfortunately, disordered eating has become more common in adolescent female athletes, and can range from a wide variety of behaviors such as anorexia, bulimia, food avoidance, or binging and purging.  

Menstrual Dysfunction 

Menstrual cycle dysfunction is directly related to low energy intake and/or stress. Menstrual dysfunction is sometimes viewed as an indicator of being “skinny” or “fit” to the young athlete but should be more of a warning sign. The absence of your menstrual cycle, especially early on in adolescence can cause fertility and other hormonal imbalances later in life. The most common types of menstrual cycle dysfunctions are listed below.

Menstrual Status	Definition
Primary Amenorrhea	No menses by age 15 for normal sexual development
Secondary Amenorrhea	Loss of menses for >90 days after the start of menses
Oligomenorrhea	Menstrual cycles at intervals > 35 days

Low Bone Mineral Density 

Low bone mineral density can be especially detrimental to adolescent female athletes because the majority of your bone mass is acquired during puberty. Bone mineral density is related to bone strength, so low bone mineral density not only puts one at a greater risk for bone fractures and injuries during the sports season but also for conditions such as osteoporosis later in life. 

Preventing the Triad 

So now that you know how to identify the female athlete triad, what are some ways to prevent and/or decrease the effects? The best way to prevent low bone mineral density and menstrual dysfunction is to make sure your athlete is getting enough calories and protein to keep up with their rigorous training as well as normal everyday activities. Here are some tips for making sure your athlete is properly fueling: 

• Include nutrient-dense whole grains and lean protein sources in meals and snacks during the day. 
• Focus on proper timing of meals and snacks, making sure they are not only focusing on eating healthy meals prior to sporting events but also staying fueled during the event, as well as properly recovering after. 
• Try to have a wide variety of fruits and vegetables to help your athlete get a wide variety of vitamins and minerals daily. 
• Calcium and vitamin D are essential to bone health. Make sure to include fortified dairy products daily or other sources of calcium and vitamin D such as tofu and beans.
• Iron is also very important to young girls who are menstruating. Iron is found in foods such as meat products, poultry, seafood, spinach, bread, and cereal fortified with iron. 

Talking with your female athlete and coming up with a plan to optimize their nutrition on and off the court is important for helping them feel and play their best. Not only is it important to talk with your athlete about their energy levels, but you also want to be having those conversations about their menstrual health as well as how they are feeling about their bodies. Sports can be stressful, especially on top of everything else going on in a young female’s life. Sometimes just taking the extra time to check in and talk with your athlete can help in making a plan to better their menstrual, mental, and physical health. 

Here are some recipes tailored to young female athletes’ needs. 

Sumac Chicken Meatballs & Mini Potatoes

10 ingredients – 35 minutes – 4 servings

4 cups Mini Potatoes (halved)

2 tbsps Coconut Oil (melted, divided)

1 tsp Coriander

1 lb Extra Lean Ground Chicken

1/4 cup Bread Crumbs

2 tsp Ground Sumac

1/4 cup Shallot (minced)

1 Garlic Clove (minced)

1 tbsp Fresh Dill (chopped)

1/2 tsp Sea Saly (divided)

1. Preheat the oven to 375oF (190oC). Line a baking sheet with parchment paper.
2. Toss the potatoes with half the oil, half the sea salt, and coriander. Spread evenly onto the baking sheet and cook in the oven for 15 minutes. They will not be finished cooking yet.
3. Meanwhile, combine the chicken, breadcrumbs, sumac, shallot, and garlic in a large bowl. Scoop out the meat and roll it into balls roughly one teaspoon in size to create meatballs.
4. Add the meatballs to the baking sheet. Cook everything in the oven for 15 minutes more or until the meatballs are cooked through.
5. Divide the meatballs and potatoes evenly between plates and garnish with dill. Enjoy!