Physical and emotional problems of elite female gymnasts

Eating pathology in female gymnasts: potential risk and protective factors

Although participation in sports that emphasize aestheticism, such as women's gymnastics, are associated with higher rates of eating pathology, little is known about the risk and protective factors involved in this process. We established and tested a model proposing that body surveillance and body shame are processes by which pubertal development and training may uniquely contribute to pathological eating by sampling 100 competitive female gymnasts via questionnaires. We further tested whether self-esteem moderated several model relationships. Results demonstrated that pubertal development was associated with higher levels of body surveillance, body shame and disordered eating; whereas greater time spent training was associated with lower levels of body shame and disordered eating. Finally higher self-esteem was associated with lower levels of disordered eating, less body surveillance, and less body shame. Potential risk and protective factors for the development of eating pathology in female gymnasts are discussed.

Developmental Overview of Child and Youth Sports for the Twenty-first Century

This article presents an overview of sporting participation for children and adolescents from psychological, physical, social, developmental, and historical perspectives. The following areas are reviewed: (1) normal developmental readiness and sporting participation; (2) benefits and risks of athletic participation for the child and adolescent; (3) self concept and sporting participation; (4) adverse psychophysiological and somatoform effects of sports; (5) interactional and systemic contributions to adverse physical and psychological effects; (6) a historical/social perspective of sport in the United States; (7) the current and future role of psychiatrists in conjunction with sports medicine physicians; (8) the sports psychiatry interview of the child, family, and coach; and (9) summary and future challenges.

Physiological aspects and clinical sequelae of energy deficiency and hypoestrogenism in exercising women

Amenorrhoea associated with reduced caloric intake and strenuous exercise leads to hypoestrogenism and is associated with clinical manifestations that include disordered eating, stress fractures, osteoporosis, and, as recently reported, a potential increase in the risk of premature cardiovascular disease. Disordered eating, menstrual irregularities and bone loss comprise the clinical condition known as the 'female athlete triad'. The aetiology of the triad is linked to a high prevalence of disordered eating and cognitive restraint. This results in inadequate caloric intake for high exercise energy expenditures that leads to energy deficiency. This in turn stimulates compensatory mechanisms, such as weight loss or energy conservation, subsequently causing a central suppression of reproductive function and concomitant hypoestrogenism. Because the aetiology of menstrual disturbances and the female athlete triad is causally linked to energy deficiency, there is no justification for fears that exercise itself is unhealthy for women. However, improved detection, monitoring, and treatment of all components of the triad in exercising women should be emphasized. This paper critically reviews the physiological aspects and clinical sequelae of energy deficiency and hypoestrogenism associated with the female athlete triad in exercising women.

Does gymnastics training inhibit growth of females?

OBJECTIVE

The increasingly dominant performance of smaller-sized female gymnasts and increased magnitude of training beginning at an early age have prompted public and medical concerns, especially from an auxological perspective. The objective of this review is to determine if gymnastics training inhibits growth of females.

DATA SOURCES

An extensive research of MedLine (PubMed interface) along with cross-referencing was conducted using the Text and MeSH words "gymnastics" in combination with "growth," "maturation," "body height," "body weight," and "growth plate." Our analysis is limited to English articles only.

STUDY SELECTION

All published studies that included data related to the research questions were included.

MAIN RESULTS

Although data from three historical cohort studies indicate that female gymnasts are short even before they begin training, clinical reports and cohort studies do suggest that some female gymnasts experience attenuated growth during training followed by catch-up growth during periods of reduced training or retirement. There is conflicting evidence whether the "catch-up" is complete. There were no studies reporting prevalence or incidence of inadequate growth. Three cohort studies provide evidence of reduced growth but training was not partitioned from other confounding factors in the gymnastics environment. Although there is a paucity of studies examining the link of dietary practices with diminished growth in female gymnasts, a review of related dietary literature indicates the potential for insufficient energy and nutrient intake among female gymnasts.

CONCLUSIONS

Elite level or heavily involved female gymnasts may experience attenuated growth during their years of training and competition followed by catch-up growth during reduced training schedules or the months following retirement. However, a cause-effect relation between gymnastics training and inadequate growth of females has not been demonstrated.

Nonopaque crystal deposition causing ureteric obstruction in patients with HIV undergoing indinavir therapy

OBJECTIVE

We describe the unique CT features of ureteric calculi in six HIV-infected patients receiving indinavir, the most commonly used HIV protease inhibitor, which is associated with an increased incidence of urolithiasis.

CONCLUSION

Ureteric obstruction caused by precipitated indinavir crystals may be difficult to diagnose with unenhanced CT. The calculi are not opaque, and secondary signs of obstruction may be absent or minimal and should be sought carefully. Images may need to be obtained using i.v. contrast material to enable diagnosis of ureteric stones or obstruction in patients with HIV infection who receive indinavir therapy.