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Larrinaga B, Borrajo E, Muñoz-Perez I, Urquijo I, Garcia-Rodríguez A, Arbillaga-Etxarri A. Eating disorder symptoms and weight pressure in female rowers: associations between self-concept, psychological well-being and body composition. J Eat Disord 2024; 12:81. [PMID: 38877594 PMCID: PMC11177466 DOI: 10.1186/s40337-024-01033-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 05/28/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Female rowers may be at risk of eating disorders and high weight pressure. AIM The purpose of the study was to investigate the prevalence of disordered eating symptoms and weight-related pressure and the associations with self-concept, psychological well-being, socio-demographic data, experience, performance level and body composition in female fixed-bench rowers. METHODS Female rowers (n = 208; age ranged mean ± SD 23.6 ± 6.5 years) completed the SCOFF scale, Weight-Pressures in Sport-Females (WPS-F), Physical Self-Concept Questionnaire and the Ryff scales of psychological well-being and provided information on their experience and level of competition. In a subgroup of 115 athletes, body composition was assessed using bioimpedance. RESULTS It was found that 42.3% of the athletes scored ≥ 2 on SCOFF and mean ± SD value of WPS-F score was 3.65 ± 0.82. Stepwise regression analysis revealed that self-concept of strength and pressure from teammates and the uniform were associated with higher ED symptoms, whereas better psychological well-being in terms of autonomy, self-concept of attractiveness, and age were protective factors for ED symptoms. BMI, athletes' physical condition, strength, and experience were associated with more weight-related pressure and better self-concept of attractiveness and physical well-being of autonomy were significantly associated with less pressure. In body composition analysis, higher extra cellular water, self-acceptance, and physical condition were associated with more weight-related pressure in female rowers, being attractiveness and the environmental mastery protective elements. CONCLUSIONS The prevalence of ED symptomatology and weight-related pressure are high in female fixed bench rowing. The psychological factors of well-being and self-concept, team environment, body image concerns and body composition analysis should be considered to promote healthy eating behaviours in female rowers.
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Affiliation(s)
- Beñat Larrinaga
- Deusto Healh-PASS, Physical Activity and Sport Sciences Department, Faculty of Education and Sport, University of Deusto, Bilbao, Spain
| | - Erika Borrajo
- Deusto Sport and Society, Physical Activity and Sport Sciences Department, Faculty of Education and Sport, University of Deusto, Bilbao, Spain
| | - Iker Muñoz-Perez
- Deusto Healh-PASS, Physical Activity and Sport Sciences Department, Faculty of Education and Sport, University of Deusto, Bilbao, Spain
| | - Itziar Urquijo
- Deusto Sport and Society, Physical Activity and Sport Sciences Department, Faculty of Education and Sport, University of Deusto, Bilbao, Spain
| | - Ana Garcia-Rodríguez
- Deusto Physical TherapIker, Physical Therapy Department, Faculty of Health Sciences, University of Deusto, Donostia-San Sebastián, Spain
| | - Ane Arbillaga-Etxarri
- Deusto Physical TherapIker, Physical Therapy Department, Faculty of Health Sciences, University of Deusto, Donostia-San Sebastián, Spain.
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Thompson T, Kaplan S, Conway R, Miles C. Screening and Referral for Behavioral Health Symptoms in Collegiate Athletes. Clin J Sport Med 2024; 34:112-120. [PMID: 37589957 DOI: 10.1097/jsm.0000000000001185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 07/09/2023] [Indexed: 08/18/2023]
Abstract
OBJECTIVE We aim to investigate the prevalence of behavioral health symptoms in collegiate athletes and the frequency of referrals prompted by a preparticipation behavioral health screener. DESIGN Athletes completed a screening battery to detect behavioral health symptoms and sports psychology clinicians designed criteria for intervention based on the severity of symptoms reported. Data from the screener was retrospectively de-identified and analyzed. SETTING National Collegiate Athletic Association Division-I university. PARTICIPANTS All athletes on active rosters were required to complete the screener as a component of the preparticipation examination. INTERVENTIONS Sports psychology clinicians created a protocol for intervention based on the number and severity of symptoms reported on the screener. MAIN OUTCOME MEASURES Communication with athletes and referrals made to behavioral health services. RESULTS Of the 1126 surveys completed, 39% had behavioral health symptoms necessitating behavioral health referral. Twelve percent required a safety check-in, given the severity of their symptoms. Seven percent of the respondents were newly established with behavioral health services. CONCLUSIONS Symptoms of behavioral health disorders are common among athletes and yet, for a myriad of reasons, many choose to forgo treatment. By implementing a behavioral health screening battery, the prevalence of behavioral health symptoms among athletes at our institution was elucidated and many athletes were newly established with behavioral health services. The tiered intervention protocol in this study allowed for appropriate assessment and triage of high-risk individuals, while simultaneously providing lower-risk individuals with appropriate resources. Surveillance for behavioral health symptoms among college athletes using a screening battery with a tiered intervention protocol can ensure at-risk athletes are identified, contacted, and referred to behavioral health services, potentially improving their athletic performance and overall well-being, while averting poor outcomes.
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Affiliation(s)
- Tyler Thompson
- Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston Salem, North Carolina
| | - Sebastian Kaplan
- Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston Salem, North Carolina
| | - Rachel Conway
- Department Sport Psychology, Wake Forest University Athletics, Winston Salem, North Carolina; and
| | - Christopher Miles
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston Salem, North Carolina
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Torres-McGehee TM, Uriegas NA, Hauge M, Monsma EV, Emerson DM, Smith AB. Eating Disorder Risk and Pathogenic Behaviors Among Collegiate Student-Athletes. J Athl Train 2023; 58:803-812. [PMID: 37459386 DOI: 10.4085/1062-6050-0539.22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
CONTEXT Eating disorders (EDs) are a cluster of behavioral conditions characterized by uneasy thoughts and behaviors that grow into severe or persistent eating disturbances. The demands on student-athletes may create mental and physical stressors that increase the likelihood of EDs and disordered eating. OBJECTIVE To examine the ED risk through eating attitudes and behaviors in male and female student-athletes and across various sport types (endurance, aesthetic, power, ball or team, or technical sports). DESIGN Cross-sectional study. SETTING Collegiate athletics. PATIENTS OR OTHER PARTICIPANTS National Collegiate Athletic Association Division I and II student-athletes (n = 2054; males = 631; females = 1423) from 40 institutions. MAIN OUTCOME MEASURE(S) Participants completed a web-based demographic survey and the Eating Attitudes Test-26 (EAT-26). Multiple χ2 analyses examined participants classified as at risk for EDs. Independent-samples t tests and a 1-way analyses of variance compared sex and sport type across EAT-26 totals and subscale (Dieting, Bulimia, and Oral Control) scores. RESULTS Overall, 25.3% (n = 520/2054) of student-athletes were classified as at risk for EDs. Differences were found between sex and ED risk (χ21,2054 = 32.9, P ≤ .01; 17.3% [n = 109/631] males, 28.9% [n = 411/1423] females) and across ED risk and sport type (χ24,2054 = 13.4, P = .01). When examining females only, we observed differences across ED risk and sport type (χ24,1423 = 13.4, P ≤ .01). No differences were evident across ED risk and sport type for males. Differences were seen between sex and binge eating (χ21,2054 = 6.8, P = .009), sex and diet pill use (χ21,2054 = 19.6, P ≤ .01), and sport type and diet pill use (χ24,2054= 12.2, P = .016), excessive exercise (χ24,2054 = 32.1, P ≤ .01), and losing more than 20 lb (9 kg) in the last 6 months (χ24,2054 = 10.2, P ≤ .037). CONCLUSIONS Student-athletes in the collegiate setting are at risk for EDs. Medical professionals, such as athletic trainers, need to be educated on the potential risk factors that may lead to EDs. Protocols for prevention, screening and recognition, and referral should be developed for student-athletes at risk for EDs.
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Zaccagni L, Gualdi-Russo E. The Impact of Sports Involvement on Body Image Perception and Ideals: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20065228. [PMID: 36982136 PMCID: PMC10049477 DOI: 10.3390/ijerph20065228] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/16/2023] [Accepted: 03/16/2023] [Indexed: 05/31/2023]
Abstract
Concerns about body image may affect athletes, mainly because of specific sports models to achieve successful performance. This systematic review reports on body image dissatisfaction (BID) in athletes following the guidelines for systematic reviews and meta-analyses. From a total of 887 articles identified through a systematic search of electronic databases, 15 articles conducted on 2412 athletes were included in this review. To be eligible for inclusion, the studies must have been published in the last ten years up until September 2022 and analyze body image perception using body figure drawings and anthropometric profiles. The quality of the included studies was evaluated using the adapted Newcastle-Ottawa Scale for observational studies. These studies were compared through thematic analysis of BID to develop four general issues, including gender, sport type and level, and weight status. According to the meta-analyses, the significant medium and small effect sizes found for gender and weight status, respectively, indicated that male athletes had lower BID than females and that, among the latter, normal-weight athletes had a higher BID than underweight ones. The implications and limitations of the included studies are discussed extensively in this review, highlighting the need for further research on BID examined both in the social and the sports contexts. Sports activity should be carried out following healthy lifestyles, and promoting positive BI.
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Affiliation(s)
- Luciana Zaccagni
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, 44121 Ferrara, Italy
- Center for Exercise Science and Sports, University of Ferrara, 44123 Ferrara, Italy
| | - Emanuela Gualdi-Russo
- Department of Neuroscience and Rehabilitation, Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, 44121 Ferrara, Italy
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Palermo M, Rancourt D, Juarascio A. Athlete-specific risk factors for the development of disordered eating behaviors in first-year college athletes. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-10. [PMID: 36595568 DOI: 10.1080/07448481.2022.2151842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 10/04/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE The current study tested whether proposed sport-related risk factors for disordered eating behaviors were associated with increases in disordered eating over first-year college athletes' first four months of collegiate sport participation. PARTICIPANTS Participants included a sample of first-year college athletes (N = 59, 45% female) from a Division I National Collegiate Athletics Association (DI) university. METHOD This follow-up study tested whether 1) wearing a uniform that emphasizes body concerns, 2) participating in a lean sport, and 3) perceived pressure for thinness from coaches and teammates would lead to increases in weight/shape concerns and disordered eating behaviors over the first four months of collegiate sport participation. RESULTS Wearing a uniform that emphasizes body concerns and perceived coach pressure for thinness predicted increases in weight/shape concern. Both teammate and coach pressure for thinness predicted increases in restrained eating behaviors. CONCLUSION Findings suggest that there are identifiable, athlete-specific risk factors for the development of disordered eating behaviors among first-year college athletes.
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Affiliation(s)
- Madeline Palermo
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Diana Rancourt
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Adrienne Juarascio
- Department of Psychology, Drexel University, Philadelphia, Pennsylvania, USA
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Chapa DAN, Johnson SN, Richson BN, Bjorlie K, Won YQ, Nelson SV, Ayres J, Jun D, Forbush KT, Christensen KA, Perko VL. Eating-disorder psychopathology in female athletes and non-athletes: A meta-analysis. Int J Eat Disord 2022; 55:861-885. [PMID: 35665528 PMCID: PMC9303059 DOI: 10.1002/eat.23748] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 05/10/2022] [Accepted: 05/10/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE There is ongoing discussion about whether sports participation is a risk or protective factor for eating disorders (EDs). Research is mixed, with some studies suggesting that athletes have higher mean levels of ED psychopathology compared to nonathletes, while other studies suggest the opposite effect or no differences. The purpose of the current meta-analysis was to identify whether female athletes reported higher mean levels of ED psychopathology compared to nonathletes. METHOD Following PRISMA guidelines, we identified 56 studies that reported ED psychopathology for female athletes and nonathletes. A three-level random-effects model of between- and within-study variance was completed for the following outcome variables: overall ED psychopathology, body dissatisfaction, drive for thinness, restricting, and loss-of-control eating. RESULTS Athletes reported lower levels of body dissatisfaction compared to nonathletes (g = -.21, p < .0001). Athletes and nonathletes reported similar levels of overall ED psychopathology, drive for thinness, restricting, and loss-of-control eating on average. Sport type significantly moderated standardized mean difference effect sizes of ED psychopathology in athletes versus nonathletes. Effect sizes comparing levels of drive for thinness, restricting, and loss-of-control eating in athletes versus nonathletes were larger for studies with athletes participating in aesthetic/lean sports compared to nonaesthetic/nonlean sports. DISCUSSION Findings from this meta-analysis could inform future ED prevention and treatment in female athletes by providing further evidence that athletes in aesthetic/lean sports may report higher levels of ED psychopathology. Participating in nonaesthetic/nonlean sports may be a protective factor for experiencing less body dissatisfaction. PUBLIC SIGNIFICANCE STATEMENT The current meta-analysis summarized findings from 56 studies that assessed levels of disordered eating, body dissatisfaction, dietary restricting, and loss-of-control eating in female athletes and nonathletes. Athletes reported lower levels of body dissatisfaction compared to nonathletes, highlighting that participation in sport could have some protective factors. Athletes participating in sports that require weight categories (e.g., judo) and sports that emphasize thinness/leanness (e.g., gymnastics and distance running) had higher levels of disordered eating relative to athletes participating in other types of sports that do not emphasize thinness/leanness (e.g., volleyball and basketball).
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Affiliation(s)
| | | | | | | | - Ying Q. Won
- University of Kansas, Department of Psychology
| | | | | | - Daiil Jun
- University of Kansas, Department of Psychology
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Smith AB, Gay JL, Monsma EV, Arent SM, Sarzynski MA, Emerson DM, Torres-McGehee TM. Investigation of Eating Disorder Risk and Body Image Dissatisfaction among Female Competitive Cheerleaders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042196. [PMID: 35206381 PMCID: PMC8872421 DOI: 10.3390/ijerph19042196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/07/2022] [Accepted: 02/11/2022] [Indexed: 12/04/2022]
Abstract
Social agents associated with cheerleading environments are increasingly linked to body image dissatisfaction (BID) and eating disorders (ED). This study examined ED risk across team type, squad type, and position. An additional purpose determined BID in clothing type (daily clothing, midriff uniform, and full uniform), and meta-perceptions from the perspective of peers (MP peers), parents (MP parents), and coaches (MP coaches). Female cheerleaders (n = 268) completed an online survey which included demographics, the Eating Attitudes Test-26, and pathogenic behavior questions. Body image perceptions were assessed by using the Sex-Specific Figural Stimuli Silhouettes. Overall, 34.4% of cheerleaders (n = 268; mean age: 17.9 ± 2.7 years) exhibited an ED risk. Compared to All-Star cheerleaders, college cheerleaders demonstrated significant higher ED risk (p = 0.021), dieting subscale scores (p = 0.045), and laxative, diet pill, and diuretic use (p = 0.008). Co-ed teams compared to all-girl teams revealed higher means for the total EAT-26 (p = 0.018) and oral control subscale (p = 0.002). The BID in clothing type revealed that cheerleaders wanted to be the smallest in the midriff option (p < 0.0001, η2 = 0.332). The BID from meta-perception revealed that cheerleaders felt that their coaches wanted them to be the smallest (p < 0.001, η2 = 0.106). Cheerleaders are at risk for EDs and BID at any level. Regarding the midriff uniform, MP from the perspective of coaches showed the greatest difference between perceived and desired body image.
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Affiliation(s)
- Allison B. Smith
- School of Kinesiology, University of Louisiana at Lafayette, Lafayette, LA 70507, USA
- Correspondence:
| | - Jennifer L. Gay
- Department of Health Promotion & Behavior, University of Georgia, Athens, GA 30602, USA;
| | - Eva V. Monsma
- Department of Physical Education, University of South Carolina, Columbia, SC 29208, USA;
| | - Shawn M. Arent
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA; (S.M.A.); (M.A.S.); (T.M.T.-M.)
| | - Mark A. Sarzynski
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA; (S.M.A.); (M.A.S.); (T.M.T.-M.)
| | - Dawn M. Emerson
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS 66160, USA;
| | - Toni M. Torres-McGehee
- Department of Exercise Science, University of South Carolina, Columbia, SC 29208, USA; (S.M.A.); (M.A.S.); (T.M.T.-M.)
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Weight Pressures and Eating Disorder Symptoms among Adolescent Female Gymnasts of Different Performance Levels in Greece. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9020254. [PMID: 35204974 PMCID: PMC8870309 DOI: 10.3390/children9020254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/24/2022] [Accepted: 02/11/2022] [Indexed: 01/12/2023]
Abstract
This study examined the weight pressures within the gymnastics environment and explored associations between these pressures and eating disorder (ED) symptoms in adolescent female gymnasts. One hundred and forty-seven competitive gymnasts and 122 recreational-level gymnasts (11–17 years old) completed the Eating Attitudes Test (EAT-26), the Weight-Pressures in Sport-Females (WPS-F), the Social Desirability Scale (SDS) and provided information on their training. It was found that 16.3% of competitive gymnasts and 7.4% of non-competitive gymnasts scored ≥20 in EAT-26, indicating disordered eating behavior. Competitive gymnasts scored higher than non-competitive in the total score of EAT-26 (p = 0.027), as well as in the total score of WPS-F, the sport and coaches weight pressures sub-scale and the appearance and performance weight pressures sub-scale (p < 0.001). Multiple regression analyses indicated that sport and coaches weight pressures, appearance and performance weight pressures and body mass index accounted for 30.3% of the variance of EAT-26 in competitive gymnasts, while the appearance and performance weight pressures sub-scale accounted for 16.3% of the variance of EAT-26 in non-competitive gymnasts. Sport and coaches weight pressures are associated with ED in competitive gymnasts, while body appearance and performance demands correlate with ED in female gymnasts irrespective of competitive level.
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Examination of the Prevalence of Female Athlete Triad Components among Competitive Cheerleaders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031375. [PMID: 35162393 PMCID: PMC8835590 DOI: 10.3390/ijerph19031375] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/19/2022] [Accepted: 01/22/2022] [Indexed: 12/10/2022]
Abstract
The purpose of this study was to examine individual and combined Female Athlete Triad components within collegiate cheerleaders, an at-risk group. Cheerleaders (n = 19; age: 20.3 ± 1.2 years) completed anthropometric measurements, health history questionnaires, resting metabolic rate, the eating disorder inventory-3 and symptom checklist, blood sample, and DXA scan. Participants completed dietary and exercise logs for 7 days and used heart rate monitors to track daily and exercise energy expenditure. Proportions were calculated for low energy availability (LEA) risk, disordered eating risk, and pathogenic behaviors. Chi-square analysis was used to determine the difference between cheerleaders who experience low EA with or without disordered eating risk. All cheerleaders demonstrated LEA for the days they participated in cheerleading practice, 52.6% demonstrated LEA with eating disorder risk and 47.4% demonstrated LEA without eating disorder risk, 52.6% self-reported menstrual dysfunction, 14% experienced menstrual dysfunction via hormonal assessment, and 0% demonstrated low bone mineral density. Overall, 47.7% presented with one Triad component, 52.6% demonstrated two Triad components using self-reported menstrual data, and 10.5% demonstrated two Triad components using hormonal assessments. All cheerleaders displayed LEA. These findings support the need for increased education on the individual components of the Triad and their potential consequences by qualified personal.
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Xu AL, Beck JJ, Sweeney EA, Severson MN, Page AS, Lee RJ. Understanding the Cheerleader as an Orthopaedic Patient: An Evidence-Based Review of the Literature. Orthop J Sports Med 2022; 10:23259671211067222. [PMID: 35083360 PMCID: PMC8785319 DOI: 10.1177/23259671211067222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/27/2021] [Indexed: 11/24/2022] Open
Abstract
Cheerleading is a highly popular youth sport in the United States and has been increasingly recognized in recent years for its athleticism and competitive nature. The sport has changed dramatically since its inception. When the sport of cheerleading was first developed, its primary purpose was to entertain crowds and support other athletes. Today, cheerleaders are competitive athletes themselves. Cheerleaders, most of whom are in the pediatric age group, and their parents commonly approach orthopaedic surgeons and sports medicine physicians with questions regarding the risks associated with participation in the sport. Appropriate clinical guidance is especially important for athletes returning to the sport after an injury. However, unlike other popular sports (eg, football, basketball, and volleyball), the intricacies of cheerleading are not well-known to those outside the sport, including many health care providers. Previous studies have reported on the epidemiological patterns of injuries associated with cheerleading and how such aesthetic sports affect the body, finding that fractures and concussions are prevalent and that catastrophic injuries are more common than in most other sports. Here, we provide an evidence-based discussion of 10 pertinent topics regarding cheerleading and its risks to the musculoskeletal system. The purpose of this review is to provide a comprehensive resource for orthopaedic surgeons and sports medicine physicians who care for these athletes.
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Affiliation(s)
- Amy L. Xu
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland, USA
| | - Jennifer J. Beck
- Orthopaedic Institute for Children/UCLA, Santa Monica, California, USA
| | - Emily A. Sweeney
- Sports Medicine Center, Children’s Hospital Colorado, Aurora, Colorado, USA
- Department of Orthopaedic Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Megan N. Severson
- Carilion Clinic Orthopaedic Surgery, Roanoke, Virginia, USA
- Department of Orthopaedic Surgery, Virginia Tech-Carilion School of Medicine, Roanoke, Virginia, USA
| | - A. Stacie Page
- Department of Physical Medicine and Rehabilitation, The Johns Hopkins Hospital, White Marsh, Maryland, USA
| | - R. Jay Lee
- Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland, USA
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12
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Drawings or 3D models: Do illustration methods matter when assessing perceived body size and body dissatisfaction? PLoS One 2021; 16:e0261645. [PMID: 34932599 PMCID: PMC8691601 DOI: 10.1371/journal.pone.0261645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 12/07/2021] [Indexed: 11/19/2022] Open
Abstract
Research has reported that both men and women experience body dissatisfaction. Among other instruments, a widely used method to assess perceived body size and body dissatisfaction are figure rating scales. Although a variety of illustration methods (e.g., three-dimensional, or 3D, models and line-drawing models) have been used to create these figure rating scales, to date, they have not been directly compared to one another. Thus, in the first study, which includes 511 participants at a mean age of 46 years old (range: 20–70), the present research work aims to assess how the line-drawing and 3D model scales, representing different body illustration methods, relate to each other. Furthermore, the first study assesses the validity of the indication of body dissatisfaction measured using these figure rating scales by comparing them to body checking or scrutinizing behavior and body appreciation levels. The project’s second study examines the two figure rating scales using objectively measured anthropometric data. In total, 239 participants at a mean age of 54 years (range: 18–94) were included. The results show that figure rating scales can be considered tools that measure perceptual body image due to their positive correlations with body checking behavior (for women) and their negative correlations with body appreciation. The 3D model and line-drawing scales show good to excellent inter-scale reliability, and both scales agree equally well with body mass index (BMI) measurements. Thus, the 3D model and line-drawing scales both seem well suited for assessing perceived body size and perceptual body dissatisfaction, suggesting that neither illustration method is superior to the other.
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13
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Torres-McGehee TM, Emerson DM, Pritchett K, Moore EM, Smith AB, Uriegas NA. Energy Availability with or without Eating Disorder Risk in Collegiate Female Athletes and Performing Artists. J Athl Train 2020; 56:993-1002. [PMID: 33351913 PMCID: PMC8448477 DOI: 10.4085/jat0502-20] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Female athletes/performing artists can present with low energy availability (LEA) either through unintentional (e.g., inadvertent undereating) or intentional methods (e.g., eating disorder [ED]). While LEA and ED risk have been examined independently, little research has examined these simultaneously. Awareness of LEA with or without ED risk may provide clinicians with innovative prevention and intervention strategies. OBJECTIVE To examine LEA with or without ED risk (e.g., eating attitudes, pathogenic behaviors) in female collegiate athletes/performing artists. DESIGN Cross-sectional and descriptive. SETTING Free-living in sport-specific settings. PARTICIPANTS Collegiate female athletes/performing artist (n=121; age: 19.8±2.0 years; height: 168.9±7.7 cm; weight: 63.6±9.26 kg) in equestrian (n=28), volleyball (n=12), softball (n=17), beach volleyball (n=18), ballet (n=26) and soccer (n=20) participated in this study. MAIN OUTCOME MEASURES Anthropometric measurements (height, weight, body composition), resting metabolic rate, energy intake, total daily energy expenditure, exercise energy expenditure, Eating Disorder Inventory-3 (EDI-3), and EDI-3 Symptom Checklist were assessed. Chi-square analysis examined differences between LEA and sport type, LEA and ED risk, ED risk and sport type, and pathogenic behaviors and sport type. RESULTS Female athletes/performing artists (81%; n=98) displayed LEA and significant differences were found between LEA and sport type (χ25=43.8, P<.01). Female athletes/performing artists (76.0%; n=92) presented with ED risk with no significant difference between ED risk and sport. EDI-3 Symptom Checklist revealed 61.2% (n=74) engaged in pathogenic behaviors, with dieting the most common (51.2%; n=62). Athletes/performing artist displayed LEA with ED risk (76.0%; n=92). No significant differences were found between LEA with ED risk and sport. Softball was the highest with 82.4% (n=14) reporting LEA with ED risk followed by ballet (76%; n=19). CONCLUSION Our results suggest a large proportion of collegiate female athletes/performing artists are at risk for LEA with ED risk, thus warranting education, identification, prevention, and intervention strategies relative to fueling for performance.
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Affiliation(s)
| | | | - Kelly Pritchett
- Central Washington University, , Twitter Handle: @KPritchettRD
| | - Erin M Moore
- University of South Florida, , Twitter Handle: @ErinMMoore2
| | - Allison B Smith
- University of South Carolina, , Twitter Handle: @ally_smith6
| | - Nancy A Uriegas
- University of South Carolina, , Twitter Handle: @Nancy_Uriegas
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Prevalence of Eating Disorder Risk and Body Image Dissatisfaction among ROTC Cadets. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218137. [PMID: 33158069 PMCID: PMC7663585 DOI: 10.3390/ijerph17218137] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/28/2020] [Accepted: 10/29/2020] [Indexed: 01/02/2023]
Abstract
Injury risk is multifactorial including non-modifiable and modifiable factors such as nutrition and mental health. The purpose of this study was to estimate eating disorder risk and body image (BI) dissatisfaction among Reserve Officers Training Corps (ROTC) cadets. A total of 102 (male: n = 75, female: n = 27; age: 20 ± 2 years) ROTC cadets self-reported height, current and ideal weight, and completed the Eating Attitudes Test-26 (EAT-26) and self-perceived BI current and perceived sex-specific figural stimuli. The overall eating disorder risk for ROTC cadets was 32.4%. No significant differences were found when comparing sex, ethnicity, or military branch. Overall risk of pathogenic behaviors included 11.8% who reported binge eating; 8.8% who used laxatives, diuretics, or diet pills; 8.8% who exercised for >60 min to control their weight; and 8.8% who lost 9.1 kg or more within the last 6 months. We identified significant interactions (p ≤ 0.01) between sex of the solider, overall perceptions of male and female soldiers, and BI self-perceptions. The ROTC cadets in this study displayed eating disorder risk and BI dissatisfaction, which is concerning for tactical readiness, long-term behavioral health issues, and injury from pathogenic behaviors. Education and quality healthcare are necessary to mitigate the increased risk of eating and BI dissatisfaction within this population.
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15
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Reina AM, Monsma EV, Dumas MD, Gay JL. Body image and weight management among Hispanic American adolescents: Differences by sport type. J Adolesc 2019; 74:229-239. [PMID: 31271969 DOI: 10.1016/j.adolescence.2019.06.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 06/24/2019] [Accepted: 06/25/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Adolescents' body image concerns vary by sex, ages, and participation in different types of sports. Little is known about variability of body image and weight management behaviors by sport type in Hispanic American adolescents. This study examined whether body image distortion and dissatisfaction are associated with weight management behaviors by sex and sport type in Hispanic adolescents. METHODS A sample of 728 Hispanic participants from the United States (61.6% female, Mage = 12.36 ± 2.35) completed the Stunkard Figural Stimuli, reported weight management behaviors and sport participation. Sports were classified as non-aesthetic (such as soccer), aesthetic (such as cheerleading), or non-sport participation. Separate multiple linear regression and multinomial logistic regression models were conducted to test adjusted associations between body image dissatisfaction and distortion, and sport type with weight management behaviors. RESULTS AND CONCLUSIONS Participants in non-aesthetic sports (51.2% male) were more dissatisfied with their body image (want to be bigger; B = -0.17; p = .01) and were 1.5 times more likely to use exercise to lose weight than non-sport participants. Greater body image dissatisfaction increased the likelihood of weight management behaviors. As year in school increased, participants perceived themselves as smaller than their actual BMI and wanted to be smaller. Hispanic females exhibited similar trends to other ethnicities. However, Hispanic males may have interpreted a desire to be "smaller" as a more lean, muscular physique. Subsequent studies should focus on reasons for weight management, and whether those behaviors are healthy.
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Affiliation(s)
- Anita M Reina
- Department of Health Promotions and Behaviorism, College of Public Health, 100 Foster Rd 245A Wright Hall, University of Georgia, Athens, GA, 30602, USA.
| | - Eva V Monsma
- Department of Physical Education, College of Education, Blatt PE Center, 1300 Wheat St., University of South Carolina, Columbia, SC, 29201, USA.
| | - Marcus D Dumas
- Department of Health Promotions and Behaviorism, College of Public Health, 100 Foster Rd 251C Wright Hall, University of Georgia, Athens, GA, 30602, USA.
| | - Jennifer L Gay
- Department of Health Promotions and Behaviorism, College of Public Health, 100 Foster Rd 251E Wright Hall, University of Georgia, Athens, GA, 30602, USA.
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16
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García Sandoval JR, Caracuel JC, Cocca A, Cocca M, Ceballos Gurrola O. Relation Between Body Mass Index and Body Image in Spanish and Mexican Adolescents. Behav Med 2018; 44:280-288. [PMID: 28535140 DOI: 10.1080/08964289.2017.1332303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This article aims to study the relation between Body Mass Index (BMI) and body image in adolescents from two different social environments in Spain and Mexico, and to compare the construction of an appropriate body scheme in youth from these two countries. The majority of participants were found to be in the normal weight category of BMI. No significant differences were found in BMI or body image comparing Mexican and Spanish adolescents. Regardless of the country of origin, youth belonging to the weight deficit category of BMI overestimated their body shape, whereas those pertaining to overweight and obesity categories underestimated it. Both over- and underestimating own body shape imply higher risk to suffer from behavioral and psychological distresses, such as eating disorders. Further research is recommended in order to analyze the social, educational, and emotional patterns related to this occurrence and to improve their quality of life.
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17
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Comparison of Body Composition Measurements in Lean Female Athletes. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2018; 11:417-424. [PMID: 29795733 PMCID: PMC5955308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
This study compared body composition measurements in lean female athletes. The primary objective was to compare the accuracy of percent body fat (%BF) determined by bioelectrical impedance analysis (BIA), air-displacement plethysmography (ADP), and underwater weighing (UWW) in female Division I cheerleaders (n = 10 bases, 6 back-spots, and 12 flyers) from two universities. The secondary objective was to compare health risk predicted by %BF to body mass index (BMI) categorizations. UWW was considered the gold standard for assessing %BF. Pearson correlation coefficients were used to determine associations between methods. Repeated measures analysis of variance was used to identify differences in %BF by method. BIA, ADP, and UWW were highly correlated (r ≥ .828, p < .001 for all). However, %BF by BIA (20.0 ± 5.2%) and ADP (19.3 ± 6.0%) was higher than %BF by UWW (15.9 ± 4.1%, p < .001). Health risk was predicted less often when classified based on very lean (risky low) %BF levels by BIA and ADP than UWW (7.1%, 3.6%, and 21.4%, respectively). This finding suggests that, similar to female track-and-field athletes who also exhibit lean muscular physiques, %BF is overestimated by BIA and ADP in female cheerleaders and health risk associated with low %BF is underestimated when compared to UWW. In contrast, BMI was not associated with %BF by any method and no participants were classified as underweight by this measure. Thus, BMI should not be used to predict health risk in lean female athletes, such as collegiate cheerleaders.
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18
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Dratva J, Bertelsen R, Janson C, Johannessen A, Benediktsdóttir B, Bråbäck L, Dharmage SC, Forsberg B, Gislason T, Jarvis D, Jogi R, Lindberg E, Norback D, Omenaas E, Skorge TD, Sigsgaard T, Toren K, Waatevik M, Wieslander G, Schlünssen V, Svanes C, Real FG. Validation of self-reported figural drawing scales against anthropometric measurements in adults. Public Health Nutr 2016; 19:1944-51. [PMID: 26879067 PMCID: PMC10270874 DOI: 10.1017/s136898001600015x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 12/15/2015] [Accepted: 01/11/2016] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The aim of the present study was to validate figural drawing scales depicting extremely lean to extremely obese subjects to obtain proxies for BMI and waist circumference in postal surveys. DESIGN Reported figural scales and anthropometric data from a large population-based postal survey were validated with measured anthropometric data from the same individuals by means of receiver-operating characteristic curves and a BMI prediction model. SETTING Adult participants in a Scandinavian cohort study first recruited in 1990 and followed up twice since. SUBJECTS Individuals aged 38-66 years with complete data for BMI (n 1580) and waist circumference (n 1017). RESULTS Median BMI and waist circumference increased exponentially with increasing figural scales. Receiver-operating characteristic curve analyses showed a high predictive ability to identify individuals with BMI > 25·0 kg/m2 in both sexes. The optimal figural scales for identifying overweight or obese individuals with a correct detection rate were 4 and 5 in women, and 5 and 6 in men, respectively. The prediction model explained 74 % of the variance among women and 62 % among men. Predicted BMI differed only marginally from objectively measured BMI. CONCLUSIONS Figural drawing scales explained a large part of the anthropometric variance in this population and showed a high predictive ability for identifying overweight/obese subjects. These figural scales can be used with confidence as proxies of BMI and waist circumference in settings where objective measures are not feasible.
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Affiliation(s)
- Julia Dratva
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, PO Box 4002, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Randi Bertelsen
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Christer Janson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Ane Johannessen
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Sciences, University of Bergen, Bergen, Norway
| | - Bryndis Benediktsdóttir
- Department of Allergy, Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland
| | - Lennart Bråbäck
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Bertil Forsberg
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Thorarinn Gislason
- Department of Allergy, Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland
| | - Debbie Jarvis
- Faculty of Medicine, National Heart & Lung Institute, Imperial College, London, UK
| | - Rain Jogi
- Lung Clinic, Foundation Tartu University Clinics, Tartu, Estonia
- Department of Pulmonary Medicine, Tartu University, Tartu, Estonia
| | - Eva Lindberg
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Dan Norback
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Ernst Omenaas
- Department of Clinical Sciences, University of Bergen, Bergen, Norway
| | - Trude D Skorge
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | | | - Kjell Toren
- Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Marie Waatevik
- Department of Clinical Sciences, University of Bergen, Bergen, Norway
| | | | - Vivi Schlünssen
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Cecilie Svanes
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
- Centre for International Health, University of Bergen, Bergen, Norway
| | - Francisco Gomez Real
- Department of Clinical Sciences, University of Bergen, Bergen, Norway
- Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway
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