The objectives of this study were to examine the prevalence of disordered
eating (DE), pathogenic behaviours and menstrual irregularity in the older
female athletic population, and to compare with an equivalent sedentary
Cross sectional retrospective self reporting survey.
Research was conducted in Shropshire, UK, with participants recruited
locally and across the UK through social media.
Athletes (n = 84) were female runners training at least three times a week
with a minimum weekly mileage of 15 miles. Participants were recruited at
local running clubs and training venues, in addition to online club websites,
forums and Facebook. Controls (n = 77) were also recruited through social
media sites and local neighbourhood venues.
Main Outcome Measures
DE prevalence was assessed using the validated Eating Disorders
Examination Questionnaire (EDE-Q), assessing eating attitudes and
pathogenic behaviours. The International Physical Activity Questionnaire
(IPAQ) was used to measure activity level, and further questions evaluated
menstrual irregularity and weekly mileage. Menstrual status was defined as
eumenorrhoeic with a menstrual cycle of 28 days (± 7 days),
oligomenorrhoeic with intervals greater than 35 days and amenorrhoeic with
cycles greater than 90 days.
Athletes scored significantly greater in the subscale of eating concern (P =
0.015), however there was no significant difference in other subscales or
global scores. Overall prevalence of those “at risk” of DE was 22.6% in the
athletic group compared with 22.1% in the control (P = 0.934). Pathogenic
behaviours were all more frequent in the athletic group, with compulsive
exercise significantly more common in the athletic population (26.2% vs.
9.1%, P = 0.005). A total of 4 runners (4.8%) and 1 control (1.3%) met the
criteria for an eating disorder (ED) or an eating disorder not otherwise
specified (ED-NOS). There was no significant difference in menstrual
irregularity, with greater contraceptive use in the athletic group (36.9% vs.
14.3%, P = 0.001) and more controls were post-menopausal (40.3% vs.
15.5%, P = 0.001).
There is a considerable prevalence of DE in both the athletic and sedentary
older female population. Furthermore compulsive exercise is significantly
greater in the athletic population and in combination with DE has potential for
detrimental consequence. This study demonstrates the need for awareness
of DE and facets of the female athlete triad in older females, with targeted
education and prevention, in both the sedentary and athletic populations.||en_US