The female athlete triad refers to three distinct and interrelated health concerns sometimes seen in women driven to excel in athletics. Those health concerns include disordered eating of some sort (such as eating far too little or binging and purging), amenorrhea (irregular menstrual periods or lack of menstruation) and osteoporosis (low bone density due to excessive exercise and lack of nutrients like calcium and vitamin D). Women that participate in activities like gymnastics, ballet and figuring skating are at increased risk for the female athlete triad, just as they are at increased risk for eating disorders like anorexia nervosa. Early recognition and treatment is imperative to prevent life-threatening complications.
Many athletes use dietary supplements as part of their regular training or competition routine, including about 85% of elite track and field athletes. Supplements commonly used include vitamins, minerals, protein, creatine, and various "ergogenic" compounds. These supplements are often used without a full understanding or evaluation of the potential benefits and risks associated with their use, and without consultation with a sports nutrition professional. A few supplements may be helpful to athletes in specific circumstances, especially where food intake or food choice is restricted. Vitamin and mineral supplements should be used only when a food-based solution is not available. Sports drinks, energy bars, and protein-carbohydrate shakes may all be useful and convenient at specific times. There are well-documented roles for creatine, caffeine, and alkalinizing agents in enhancing performance in high-intensity exercise, although much of the evidence does not relate to specific athletic events. There are potential costs associated with all dietary supplements, including the risk of a positive doping result as a consequence of the presence of prohibited substances that are not declared on the label.
These things collectively represent a perfect storm. There are no easy answers here. The system of youth sports is set up to cater to more elite players as they approach high school, leaving average kids with fewer opportunities. Our culture encourages specialization and achievement, which actively discourages kids from trying new things or just playing for fun. And all of this converges at a time when they’re going through major physical, emotional and social changes as well as facing pressure to pare down their interests and focus on school.