ABCDE Assessment | Measures | Comments |
---|---|---|
Anthropometric |
| Valid and reliable methods of body composition should be sought (eg, DXA, skinfold assessment using the ISAK standards; 4-component models assessing fat, fat-free and lean tissue mass and total body water; measurement of hydration status using urine specific gravity recommended for all anthropometric assessments) Careful reflection is required to ascertain whether assessment of body mass and composition may trigger more problems BMI and MI are measures (indices) for ‘relative body weight’ (ponderosity), but not for body composition |
Biochemical |
| In females with menstrual dysfunction, prolactin needs to be assessed to rule out pituitary tumour; if ovarian cysts and oligomenorrhoea, androgens should be assessed57 Oestradiol and testosterone should be included in men and women athletes |
Clinical |
| Medical history should include DE and EDs. If this is a preparticipation physical examination, then include a general medical history, including menstrual history/status, bone health, history of stress fracture and other injuries, osteoporosis. Screening for DE and EDs with screening tools and/or clinical interview and identification of physical signs and symptoms (see tables 1 and 2) |
Dietary |
| Energy intake, energy density; macronutrients (expressed in g/kg/d) and micronutrients, fluid balance and hydration (including sweat rate), food restrictions, allergies, intolerance; scary foods; nutrient and fluid timing; carbohydrate availability during intense training; carbohydrate and fibre related to appetite; recovery nutrition; competition preparation and fuelling, travel nutrition and appetite issues during travel or intense training Dietary assessment methods: consider validity and reliability,58 as well as additional burden and stress on athletes with DE/ED when using diaries and food logs Energy availability, including the assessment of energy expenditure (see below) |
Environmental |
| Total daily energy expenditure, including resting metabolic rate, spontaneous physical activity, exercise energy expenditure; evaluation of training/competition plan in discussion with coach; consideration of environmental factors (eg, training at altitude); leanness/non-leanness sport; countries at risk for inadequate food access and food safety concerns; work/school schedules and time for food preparation, eating, recovery; level of athlete and experience |
ABCDE, Anthropometric, Biochemical, Clinical, Dietary and Environmental; BMI, body mass index; DE, disordered eating; DXA, dual energy e-ray absorptiometry; EDs, eating disorders; FSH, follicle stimulating hormone; ISAK, International Society for the Advancement of Kinanthropometry; LH, luteinising hormone; MI, mass index; TSH, thyroid stimulating hormone.