Prevalence of physically active females at risk for the female athlete triad in Spain

Background: The female athlete triad (Triad) refers to the interrelationship between energy availability, menstrual function, and bone health, which may have clinical and subclinical manifestations including eating disorders, functional hypothalamic amenorrhea, and osteoporosis. The aim of this study was to analyze the prevalence of physically active 15- to 45-year-old Spanish women at risk for the Triad. Methods: A descriptive cross-sectional study was carried out using the validated questionnaires ‘Low Energy Availability in Females Questionnaire’ (LEAF-Q) and the ‘Female Athlete Screening Tool’ (FAST). Exercising women were invited to participate anonymously and voluntarily by email via Spanish sports clubs and federations, as well as through social networks. The questionnaires were also distributed to elite athletes attending the High Performance Center of Sant Cugat del Vallès (Barcelona). Results: The study participants comprised 1154 physically active women (age = 28.5 ± 7.7 years; height = 165.2 ± 6.2 cm; body weight = 60.5 ± 9.7), representing 78 recreational and competitive level sports. The results showed that 40.0% (n = 462) were considered at risk for the Triad, while 24.3% (n = 280) were at risk for subclinical eating disorder, and 7.3% (n = 84) at risk for clinical eating disorder. Other results were: menstrual dysfunction displayed a positive correlation with the LEAF-Q score (r = 0.499, p = < 0.001); FAST presented an association with the LEAF-Q score (r = 0.252, p < 0.001); and body weight (r = 0.207, p = < 0.001) and body mass index (r = 0.225, p = < 0.001) displayed a positive correlation with the FAST score. Conclusion: Based on this research, the implementation of strategies for the prevention, diagnosis and treatment of the Triad disorders should be made a priority among physically active Spanish women.