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Refutation of “the myth of the female athlete triad”
  1. A B Loucks
  1. Ohio University, Athens, Ohio, USA;

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    In its June 2006 issue, the British Journal of Sports Medicine published an article entitled “The myth of the female athlete triad”,1 which makes six allegations: (1) the 1997 American College of Sports Medicine (ACSM) Position Stand on the Female Athlete Triad discourages girls and women from participating in physical activity; (2) the ACSM Position Stand portrays female athletes as psychopathological; (3) no data link disordered eating to the induction of low energy availability in athletes; (4) no prospective data have shown low energy availability to cause infertility and osteoporosis in any species; (5) experiments in which low energy availability disrupted luteinizing hormone pulsatility and bone turnover in women do not apply to athletes; and (6) the female athlete triad does not exist.

    The first allegation is blatantly and flagrantly false. DiPietro and Stachenfeld1 write that “the female athlete triad stands in contrast to other ACSM, as well as World Health Organization and US Public Health Services Guidelines, which state that participation in sport or in physical activity promotes the health and safety of girls and young women.” In fact, the very first two sentences of the 1997 ACSM Position Stand on the Female Athlete Triad2 are “The majority of girls and women derive significant health benefits from regular physical activity without incurring health risks. They should be encouraged to be physically active at all phases of their lives.”

    The ACSM position stand goes on to warn female athletes against the hazards of undernutrition. The ACSM has a responsible tradition of warning the public against exercising in an unhealthy manner, including positions stands warning wrestlers against the hazards of unhealthy weight loss,3 warning runners against the hazards of heat and cold,4 and warning all athletes against the hazards of dehydration.5 No one interprets those …

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    • Competing interests: None declared.