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Kadın Sporcularda Yeme Bozuklukları ve Düşük Enerji Kullanılabilirliği: Prevelans, Risk ve Sportif Performansa Etkisi

Yıl 2025, Cilt: 47 Sayı: 5, 856 - 864, 04.09.2025
https://doi.org/10.20515/otd.1736525

Öz

Sağlıklı bir sporcunun besin alımı, vücudun enerji ihtiyacını ve fizyolojik fonksiyonlarını karşılayacak yeterlilikte olmalıdır. Ancak sporcularda, kısıtlayıcı diyetler, yeme bozuklukları (YB) veya fazla enerji harcaması nedeniyle düşük enerji kullanılabilirliği (LEA) ortaya çıktığında, bu durum vücudun temel fonksiyonlarında (hormonal dengesizlikler, kemik yoğunluğunun azalması ve psikolojik sorunlar gibi) multisistemik bozulmalara yol açabilmektedir. Kadın sporcular, YB ve LEA açısından yüksek risk altında olan gruplardan biridir. Bu araştırma, kadın sporcularda YB ve LEA’nın prevalansını, bu durumlara yol açan risk faktörlerini ve sportif performans üzerindeki etkilerini incelemektedir. Yapılan çalışmalar, kadın sporcuların erkek sporculara kıyasla daha yüksek oranda yeme bozuklukları yaşadığını ve özellikle estetik ve sıklet sporları gibi belirli branşlarda bu riskin daha fazla olduğunu göstermektedir. LEA’nın sportif performans üzerindeki etkileri arasında dayanıklılıkta azalma, koordinasyon kaybı, antrenman yanıtının azalması ve artan sakatlık riski yer almaktadır. Bu araştırmada, erken teşhisin önemi ve uygun tedavi yaklaşımları ele alınmıştır. Sonuç olarak, sağlıklı bir vücut ağırlığı yönetimi sağlanarak ve sporcuların beslenme bilgisi artırılarak hem sağlık hem de performans açısından olumlu sonuçlar elde edilebileceği önerilmektedir.

Kaynakça

  • 1. Thomas DT, Erdman KA, Burke LM. Nutrition and athletic performance. Med Sci Sports Exerc. 2016;48(3):543-68.
  • 2. Ackerman KE, Holtzman B, Cooper KM, Flynn EF, Bruinvels G, Tenforde AS, et al. Low energy availability surrogates correlate with health and performance consequences of Relative Energy Deficiency in Sport. British journal of sports medicine. 2019;53(10):628-33.
  • 3. Mountjoy M, Sundgot-Borgen J, Burke L, Ackerman KE, Blauwet C, Constantini N, et al. International Olympic Committee (IOC) consensus statement on relative energy deficiency in sport (RED-S): 2018 update. International journal of sport nutrition and exercise metabolism. 2018;28(4):316-31.
  • 4. Sundgot-Borgen J, Torstveit MK. Aspects of disordered eating continuum in elite high-intensity sports. Scand J Med Sci Sports. 2010;20 Suppl 2:112-21.
  • 5. De Souza MJ, Nattiv A, Joy E, Misra M, Williams NI, Mallinson RJ, et al. 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, Indiana, May 2013. British journal of sports medicine. 2014;48(4):289-.
  • 6. APA. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. 5nd ed. Association AP, editor: American Psychiatric Association; 2013.
  • 7. Krentz EM, Warschburger P. A longitudinal investigation of sports‐related risk factors for disordered eating in aesthetic sports. Scandinavian journal of medicine & science in sports. 2013;23(3):303-10.
  • 8. Sundgot-Borgen J, Garthe I. Elite athletes in aesthetic and Olympic weight-class sports and the challenge of body weight and body composition. Food, Nutrition and Sports Performance III. 2013:101-14.
  • 9. Logue DM, Madigan SM, Melin A, Delahunt E, Heinen M, Donnell S-JM, et al. Low Energy Availability in Athletes 2020: An Updated Narrative Review of Prevalence, Risk, Within-Day Energy Balance, Knowledge, and Impact on Sports Performance. Nutrients. 2020;12(3):835.
  • 10. Gallant TL, Ong LF, Wong L, Sparks M, Wilson E, Puglisi JL, et al. Low Energy Availability and Relative Energy Deficiency in Sport: A Systematic Review and Meta-analysis. Sports Medicine. 2024:1-15.
  • 11. Torstveit M, Sundgot-Borgen J. Prevalence of eating disorders in elite athletes is higher than in the general population. Clin J Sport Med. 2004;14(1):25-32.
  • 12. Coelho AR, Cardoso G, Brito ME, Gomes IN, Cascais MJ. The female athlete triad/relative energy deficiency in sports (RED-S). Revista Brasileira de ginecología e obstetrícia. 2021;43(05):395-402.
  • 13. Martinsen M, Sundgot-Borgen J. Higher prevalence of eating disorders among adolescent elite athletes than controls. Medicine & Science in Sports & Exercise. 2013;45(6):1188-97.
  • 14. Soylu Y. Mücadele sporcularında duygusal yeme, bilinçli farkındalık ve psikolojik iyi oluş. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2021;10(3):542-9.
  • 15. Bratland-Sanda S, Sundgot-Borgen J. Eating disorders in athletes: overview of prevalence, risk factors and recommendations for prevention and treatment. European journal of sport science. 2013;13(5):499-508.
  • 16. Sundgot-Borgen J, Meyer NL, Lohman TG, Ackland TR, Maughan RJ, Stewart AD, et al. How to minimise the health risks to athletes who compete in weight-sensitive sports review and position statement on behalf of the Ad Hoc Research Working Group on Body Composition, Health and Performance, under the auspices of the IOC Medical Commission. British journal of sports medicine. 2013;47(16):1012-22.
  • 17. Bonci CM, Bonci LJ, Granger LR, Johnson CL, Malina RM, Milne LW, et al. National athletic trainers' association position statement: preventing, detecting, and managing disordered eating in athletes. Journal of athletic training. 2008;43(1):80-108.
  • 18. Aktaş BS. Elit Seviyedeki Sporcuların Beslenme Alışkanlıkları ve Bilgi Düzeylerinin İncelenmesi. Çanakkale Onsekiz Mart Üniversitesi Spor Bilimleri Dergisi.7(4):13-25.
  • 19. Shanmugam V, Jowett S, Meyer C. Interpersonal difficulties as a risk factor for athletes' eating psychopathology. Scandinavian Journal of Medicine & Science in Sports. 2014;24(2):469-76.
  • 20. Biesecker AC, Martz DM. Impact of coaching style on vulnerability for eating disorders: An analog study. Eating Disorders. 1999;7(3):235-44.
  • 21. Tan JOA, Calitri R, Bloodworth A, McNamee MJ. Understanding eating disorders in elite gymnastics: ethical and conceptual challenges. Clinics in sports medicine. 2016;35(2):275-92.
  • 22. Hopkinson R, Lock J. Athletics, perfectionism, and disordered eating. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity. 2004;9:99-106.
  • 23. Loucks AB. Energy balance and body composition in sports and exercise. Journal of sports sciences. 2004;22(1):1-14.
  • 24. Merkel DL. Youth sport: positive and negative impact on young athletes. Open access journal of sports medicine. 2013:151-60.
  • 25. Vardardottir B, Gudmundsdottir SL, Olafsdottir AS. Health and performance consequences of Relative Energy Deficiency in Sport (RED-s). Laeknabladid. 2020;106(9):406-13.
  • 26. Frings-Meuthen P, Henkel S, Boschmann M, Chilibeck PD, Alvero Cruz JR, Hoffmann F, et al. Resting energy expenditure of master athletes: accuracy of predictive equations and primary determinants. Frontiers in physiology. 2021;12:641455.
  • 27. Wasserfurth P, Palmowski J, Hahn A, Krüger K. Reasons for and consequences of low energy availability in female and male athletes: social environment, adaptations, and prevention. Sports medicine-open. 2020;6(1):44.
  • 28. Ihle R, Loucks AB. Dose‐response relationships between energy availability and bone turnover in young exercising women. Journal of bone and mineral research. 2004;19(8):1231-40.
  • 29. Nattiv A, Loucks AB, Manore MM, Sanborn CF, Sundgot-Borgen J, Warren MP. American College of Sports Medicine position stand. The female athlete triad. Med Sci Sports Exerc. 2007;39(10):1867-82.
  • 30. Mountjoy M, Sundgot-Borgen J, Burke L, Carter S, Constantini N, Lebrun C, et al. The IOC consensus statement: beyond the Female Athlete Triad—Relative Energy Deficiency in Sport (RED-S). British Journal of Sports Medicine. 2014;48(7):491-7.
  • 31. Cabre H, Moore S, Smith-Ryan A, Hackney A. Relative energy deficiency in sport (RED-S): scientific, clinical, and practical implications for the female athlete. Deutsche Zeitschrift fur Sportmedizin. 2022;73(7):225.
  • 32. Noirrit-Esclassan E, Valera M-C, Tremollieres F, Arnal J-F, Lenfant F, Fontaine C, et al. Critical Role of Estrogens on Bone Homeostasis in Both Male and Female: From Physiology to Medical Implications. International Journal of Molecular Sciences. 2021;22(4):1568.
  • 33. Gibson MES, Fleming N, Zuijdwijk C, Dumont T. Where have the periods gone? The evaluation and management of functional hypothalamic amenorrhea. Journal of clinical research in pediatric endocrinology. 2020;12(Suppl 1):18.
  • 34. Khosla S, Monroe DG. Regulation of bone metabolism by sex steroids. Cold Spring Harbor perspectives in medicine. 2018;8(1):a031211.
  • 35. Pensgaard AM, Sundgot-Borgen J, Edwards C, Jacobsen AU, Mountjoy M. Intersection of mental health issues and Relative Energy Deficiency in Sport (REDs): a narrative review by a subgroup of the IOC consensus on REDs. British Journal of Sports Medicine. 2023;57(17):1127-35.
  • 36. Sim A, Burns SF. questionnaires as measures for low energy availability (LEA) and relative energy deficiency in sport (RED-S) in athletes. Journal of Eating Disorders. 2021;9:1-13.
  • 37. Schaal K, VanLoan MD, Hausswirth C, Casazza GA. Decreased energy availability during training overload is associated with non-functional overreaching and suppressed ovarian function in female runners. Applied Physiology, Nutrition, and Metabolism. 2021;46(10):1179-88.
  • 38. Melin AK, Heikura IA, Tenforde A, Mountjoy M. Energy availability in athletics: health, performance, and physique. International journal of sport nutrition and exercise metabolism. 2019;29(2):152-64.
  • 39. Logue DM, Madigan SM, Heinen M, McDonnell S-J, Delahunt E, Corish CA. Screening for risk of low energy availability in athletic and recreationally active females in Ireland. European Journal of Sport Science. 2019;19(1):112-22.
  • 40. Ljungqvist A, Jenoure PJ, Engebretsen L, Alonso JM, Bahr R, Clough AF, et al. The International Olympic Committee (IOC) Consensus Statement on Periodic Health Evaluation of Elite Athletes, March 2009. Clinical Journal of Sport Medicine. 2009;19(5):347-65.
  • 41. DeJong Lempke AF, Reece LM, Whitney KE. Nutrition educational interventions for athletes related to low energy availability: A systematic review. PLoS One. 2025;20(2):e0314506.
  • 42. Koreshe E, Paxton S, Miskovic-Wheatley J, Bryant E, Le A, Maloney D, et al. Prevention and early intervention in eating disorders: findings from a rapid review. Journal of Eating Disorders. 2023;11(1):38.
  • 43. Joy E, Kussman A, Nattiv A. 2016 update on eating disorders in athletes: A comprehensive narrative review with a focus on clinical assessment and management. British journal of sports medicine. 2016;50(3):154-62.
  • 44. Stand P. The female athlete triad. Med Sci Sports Exerc. 2007;39(10):1867-82.

Eating Disorders and Low Energy Availability in Female Athletes: Prevalence, Risk, and Impact on Athletic Performance

Yıl 2025, Cilt: 47 Sayı: 5, 856 - 864, 04.09.2025
https://doi.org/10.20515/otd.1736525

Öz

A healthy athlete’s nutrient intake should be sufficient to meet energy demands and support essential physiological functions. However, when athletes follow restrictive diets, experience eating disorders, or expend excessive energy, low energy availability may occur. This condition disrupts multiple physiological systems, leading to hormonal imbalances, decreased bone mineral density, and psychological disturbances. Female athletes are particularly vulnerable, facing a heightened risk for both eating disorders and low energy availability. This review explores the prevalence of these issues among female athletes, identifies contributing risk factors, and evaluates their impact on athletic performance. Existing literature highlights a notably increased risk in sports that emphasize aesthetics or weight classification. Performance-related consequences of low energy availability include reduced endurance, impaired coordination, and a higher incidence of injuries. Early identification and the implementation of appropriate nutritional strategies may significantly enhance both health outcomes and athletic performance.

Kaynakça

  • 1. Thomas DT, Erdman KA, Burke LM. Nutrition and athletic performance. Med Sci Sports Exerc. 2016;48(3):543-68.
  • 2. Ackerman KE, Holtzman B, Cooper KM, Flynn EF, Bruinvels G, Tenforde AS, et al. Low energy availability surrogates correlate with health and performance consequences of Relative Energy Deficiency in Sport. British journal of sports medicine. 2019;53(10):628-33.
  • 3. Mountjoy M, Sundgot-Borgen J, Burke L, Ackerman KE, Blauwet C, Constantini N, et al. International Olympic Committee (IOC) consensus statement on relative energy deficiency in sport (RED-S): 2018 update. International journal of sport nutrition and exercise metabolism. 2018;28(4):316-31.
  • 4. Sundgot-Borgen J, Torstveit MK. Aspects of disordered eating continuum in elite high-intensity sports. Scand J Med Sci Sports. 2010;20 Suppl 2:112-21.
  • 5. De Souza MJ, Nattiv A, Joy E, Misra M, Williams NI, Mallinson RJ, et al. 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, Indiana, May 2013. British journal of sports medicine. 2014;48(4):289-.
  • 6. APA. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. 5nd ed. Association AP, editor: American Psychiatric Association; 2013.
  • 7. Krentz EM, Warschburger P. A longitudinal investigation of sports‐related risk factors for disordered eating in aesthetic sports. Scandinavian journal of medicine & science in sports. 2013;23(3):303-10.
  • 8. Sundgot-Borgen J, Garthe I. Elite athletes in aesthetic and Olympic weight-class sports and the challenge of body weight and body composition. Food, Nutrition and Sports Performance III. 2013:101-14.
  • 9. Logue DM, Madigan SM, Melin A, Delahunt E, Heinen M, Donnell S-JM, et al. Low Energy Availability in Athletes 2020: An Updated Narrative Review of Prevalence, Risk, Within-Day Energy Balance, Knowledge, and Impact on Sports Performance. Nutrients. 2020;12(3):835.
  • 10. Gallant TL, Ong LF, Wong L, Sparks M, Wilson E, Puglisi JL, et al. Low Energy Availability and Relative Energy Deficiency in Sport: A Systematic Review and Meta-analysis. Sports Medicine. 2024:1-15.
  • 11. Torstveit M, Sundgot-Borgen J. Prevalence of eating disorders in elite athletes is higher than in the general population. Clin J Sport Med. 2004;14(1):25-32.
  • 12. Coelho AR, Cardoso G, Brito ME, Gomes IN, Cascais MJ. The female athlete triad/relative energy deficiency in sports (RED-S). Revista Brasileira de ginecología e obstetrícia. 2021;43(05):395-402.
  • 13. Martinsen M, Sundgot-Borgen J. Higher prevalence of eating disorders among adolescent elite athletes than controls. Medicine & Science in Sports & Exercise. 2013;45(6):1188-97.
  • 14. Soylu Y. Mücadele sporcularında duygusal yeme, bilinçli farkındalık ve psikolojik iyi oluş. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2021;10(3):542-9.
  • 15. Bratland-Sanda S, Sundgot-Borgen J. Eating disorders in athletes: overview of prevalence, risk factors and recommendations for prevention and treatment. European journal of sport science. 2013;13(5):499-508.
  • 16. Sundgot-Borgen J, Meyer NL, Lohman TG, Ackland TR, Maughan RJ, Stewart AD, et al. How to minimise the health risks to athletes who compete in weight-sensitive sports review and position statement on behalf of the Ad Hoc Research Working Group on Body Composition, Health and Performance, under the auspices of the IOC Medical Commission. British journal of sports medicine. 2013;47(16):1012-22.
  • 17. Bonci CM, Bonci LJ, Granger LR, Johnson CL, Malina RM, Milne LW, et al. National athletic trainers' association position statement: preventing, detecting, and managing disordered eating in athletes. Journal of athletic training. 2008;43(1):80-108.
  • 18. Aktaş BS. Elit Seviyedeki Sporcuların Beslenme Alışkanlıkları ve Bilgi Düzeylerinin İncelenmesi. Çanakkale Onsekiz Mart Üniversitesi Spor Bilimleri Dergisi.7(4):13-25.
  • 19. Shanmugam V, Jowett S, Meyer C. Interpersonal difficulties as a risk factor for athletes' eating psychopathology. Scandinavian Journal of Medicine & Science in Sports. 2014;24(2):469-76.
  • 20. Biesecker AC, Martz DM. Impact of coaching style on vulnerability for eating disorders: An analog study. Eating Disorders. 1999;7(3):235-44.
  • 21. Tan JOA, Calitri R, Bloodworth A, McNamee MJ. Understanding eating disorders in elite gymnastics: ethical and conceptual challenges. Clinics in sports medicine. 2016;35(2):275-92.
  • 22. Hopkinson R, Lock J. Athletics, perfectionism, and disordered eating. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity. 2004;9:99-106.
  • 23. Loucks AB. Energy balance and body composition in sports and exercise. Journal of sports sciences. 2004;22(1):1-14.
  • 24. Merkel DL. Youth sport: positive and negative impact on young athletes. Open access journal of sports medicine. 2013:151-60.
  • 25. Vardardottir B, Gudmundsdottir SL, Olafsdottir AS. Health and performance consequences of Relative Energy Deficiency in Sport (RED-s). Laeknabladid. 2020;106(9):406-13.
  • 26. Frings-Meuthen P, Henkel S, Boschmann M, Chilibeck PD, Alvero Cruz JR, Hoffmann F, et al. Resting energy expenditure of master athletes: accuracy of predictive equations and primary determinants. Frontiers in physiology. 2021;12:641455.
  • 27. Wasserfurth P, Palmowski J, Hahn A, Krüger K. Reasons for and consequences of low energy availability in female and male athletes: social environment, adaptations, and prevention. Sports medicine-open. 2020;6(1):44.
  • 28. Ihle R, Loucks AB. Dose‐response relationships between energy availability and bone turnover in young exercising women. Journal of bone and mineral research. 2004;19(8):1231-40.
  • 29. Nattiv A, Loucks AB, Manore MM, Sanborn CF, Sundgot-Borgen J, Warren MP. American College of Sports Medicine position stand. The female athlete triad. Med Sci Sports Exerc. 2007;39(10):1867-82.
  • 30. Mountjoy M, Sundgot-Borgen J, Burke L, Carter S, Constantini N, Lebrun C, et al. The IOC consensus statement: beyond the Female Athlete Triad—Relative Energy Deficiency in Sport (RED-S). British Journal of Sports Medicine. 2014;48(7):491-7.
  • 31. Cabre H, Moore S, Smith-Ryan A, Hackney A. Relative energy deficiency in sport (RED-S): scientific, clinical, and practical implications for the female athlete. Deutsche Zeitschrift fur Sportmedizin. 2022;73(7):225.
  • 32. Noirrit-Esclassan E, Valera M-C, Tremollieres F, Arnal J-F, Lenfant F, Fontaine C, et al. Critical Role of Estrogens on Bone Homeostasis in Both Male and Female: From Physiology to Medical Implications. International Journal of Molecular Sciences. 2021;22(4):1568.
  • 33. Gibson MES, Fleming N, Zuijdwijk C, Dumont T. Where have the periods gone? The evaluation and management of functional hypothalamic amenorrhea. Journal of clinical research in pediatric endocrinology. 2020;12(Suppl 1):18.
  • 34. Khosla S, Monroe DG. Regulation of bone metabolism by sex steroids. Cold Spring Harbor perspectives in medicine. 2018;8(1):a031211.
  • 35. Pensgaard AM, Sundgot-Borgen J, Edwards C, Jacobsen AU, Mountjoy M. Intersection of mental health issues and Relative Energy Deficiency in Sport (REDs): a narrative review by a subgroup of the IOC consensus on REDs. British Journal of Sports Medicine. 2023;57(17):1127-35.
  • 36. Sim A, Burns SF. questionnaires as measures for low energy availability (LEA) and relative energy deficiency in sport (RED-S) in athletes. Journal of Eating Disorders. 2021;9:1-13.
  • 37. Schaal K, VanLoan MD, Hausswirth C, Casazza GA. Decreased energy availability during training overload is associated with non-functional overreaching and suppressed ovarian function in female runners. Applied Physiology, Nutrition, and Metabolism. 2021;46(10):1179-88.
  • 38. Melin AK, Heikura IA, Tenforde A, Mountjoy M. Energy availability in athletics: health, performance, and physique. International journal of sport nutrition and exercise metabolism. 2019;29(2):152-64.
  • 39. Logue DM, Madigan SM, Heinen M, McDonnell S-J, Delahunt E, Corish CA. Screening for risk of low energy availability in athletic and recreationally active females in Ireland. European Journal of Sport Science. 2019;19(1):112-22.
  • 40. Ljungqvist A, Jenoure PJ, Engebretsen L, Alonso JM, Bahr R, Clough AF, et al. The International Olympic Committee (IOC) Consensus Statement on Periodic Health Evaluation of Elite Athletes, March 2009. Clinical Journal of Sport Medicine. 2009;19(5):347-65.
  • 41. DeJong Lempke AF, Reece LM, Whitney KE. Nutrition educational interventions for athletes related to low energy availability: A systematic review. PLoS One. 2025;20(2):e0314506.
  • 42. Koreshe E, Paxton S, Miskovic-Wheatley J, Bryant E, Le A, Maloney D, et al. Prevention and early intervention in eating disorders: findings from a rapid review. Journal of Eating Disorders. 2023;11(1):38.
  • 43. Joy E, Kussman A, Nattiv A. 2016 update on eating disorders in athletes: A comprehensive narrative review with a focus on clinical assessment and management. British journal of sports medicine. 2016;50(3):154-62.
  • 44. Stand P. The female athlete triad. Med Sci Sports Exerc. 2007;39(10):1867-82.
Toplam 44 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Spor ve Egzersiz Beslenmesi
Bölüm DERLEMELER / REVIEWS
Yazarlar

Nur Sueda Boyraz 0000-0003-4760-8892

Pınar Göbel 0000-0001-7152-1581

Yayımlanma Tarihi 4 Eylül 2025
Gönderilme Tarihi 7 Temmuz 2025
Kabul Tarihi 18 Ağustos 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 47 Sayı: 5

Kaynak Göster

Vancouver Boyraz NS, Göbel P. Eating Disorders and Low Energy Availability in Female Athletes: Prevalence, Risk, and Impact on Athletic Performance. Osmangazi Tıp Dergisi. 2025;47(5):856-64.


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