Objectives The most common DSM-5 eating disorder (ED) diagnoses in adolescents are still anorexia nervosa and binge eating disorder.1 Comparing adolescence athletes and non-athletes, there is higher prevalence of ED in non-active population,2 not taking into account high risk – leanness sports, where prevalence is the highest.3 Literature is reporting a lack of studies in the field of ED in adolescent’s athletes,4 especially in Middle and Balkan part of Europe. Thus, the aim of this study was to compare prevalence of risk for ED in Slovenian adolescent athletes and non-athletes in male and female population and body composition in participants with and without risk for ED.
Methods A total of 583 adolescents, 273 females and 310 males, age from 15 to 17 years, were randomly selected from 40 Slovenian sport clubs and 4 high schools. All participants completed SCOFF questionnaire. Weight and body composition were measured with BIA – tetra polar eight point tactile electrodes. Based on the data, we have later on calculated body mass index (BMI) and BMI scores, considering age and gender, according to the WHO (World Health Organisation) percentile graphs.5
Results Prevalence for eating disorders was higher in female population (p < 0.001), where ratio for risk for ED was 1:3.5, boys compared to girls (Table 1). The differences in prevalence for ED between athletes and non-athletes inside groups formed by sex are insignificant. According to body composition, female athletes weighted less than non-athletes, p < 0.01, respectively. The difference was observed also in BMI score values (p < 0.05). Comparing the total sample of athletes and non-athletes, there was no difference in weight and BMI scores, same was observed in male sample group. BMI scores were significantly higher in female and male athletes with risk for ED, compared to athletes where risk was not detected (Table 1).
Conclusion Several studies have already found that overweight adolescents present a higher risk for ED (6), but never comparing and showing differences among groups of adolescents by sexes, athletes and non-athletes. Adolescents’ growth curves of who develop ED showed greater weight than those without ED. According to specific body composition, male athletes with risk for ED had significantly higher values of fat free mass. Results are showing that males are becoming more vulnerable for ED, and what is more, not just BMI, but also specific parameters of body composition should be evaluated when we are looking for risk factors for ED. Further longitudinal studies which are following detailed body composition measurements in correlation with ED occurrence should be done in the future.
Differences between athletes and non-athletes in risk for ED (Chi square test)
Differences between group with and without risk (unpaired t-test):
ap < 0.001;
bp < 0.01;
cp < 0.05;
dp = 0,069.
Smink FRE, Van Hoeken D, Oldehinkel AJ, Hoek HW. Prevalence and severity of DSM-5 eating disorders in a community cohort of adolescents. Int J Eat Disord 2014;47(6).
Martinsen M, Bratland-Sanda S, Eriksson AK, Sundgot-Borgen J. Dieting to win or to be thin? A study of dieting and disordered eating among adolescent elite athletes and non-athlete controls. Br J Sport Med 2009/12/23 ed. 2010;44(1):70–6.
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Nichols JF, Rauh MJ, Lawson MJ, Ji M, Barkai H-S. Prevalence of the female athlete triad syndrome among high school athletes. Arch Pediatr Adolesc Med 160(2):137–42.
Onis M de, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ 2007;85(9):660–7.
Babio N, Canals J, Pietrobelli A, Pérez S, Arija V. A two-phase population study: relationships between overweight, body composition and risk of eating disorders. Nutr Hosp. Aula Médica Ediciones 2009;24(4):485–91.
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