[Energy balance, body composition and the female athlete triad syndrome]

With the rising participation of women in sports events, the prevalence of eating disorders and the female athlete triad (FTS), a syndrome of disordered eating, amenorrhea, and osteoporosis, have also increased in recent years. FTS is often seen in sports that emphasize thinness (e.g. gymnastics, figure skating and dancing) and also in endurance events. Elements of the FTS are pathophysiologically linked, leading to several disease risks and even to mortality. In spite of the considerable knowledge about sports nutrition, there is no consensus as to the correct nutrition regime for the female athlete. There is consensus that minimizing fluctuations in 'target-body-weight' is an indication of a long-term energy balance. Female athletes (e.g. in endurance events and gymnastics) are less likely to achieve the recommended carbohydrates (CHO) and fat consumption due to chronic or episodic constraints of total energy intake while struggling to achieve or maintain low levels of body fat. It is recommended that dietary CHO and fat content be increased to preserve fat-free mass thus enhancing health and performance. Energy balance should also be maintained during recesses. Furthermore, within-day episodes of energy deficits/surplus (measured by the frequency and/or magnitude of the episodes) should be monitored and treated closest to the time of the incidents.