The female athlete triad was first identified in 1992. As the name suggests, it consists of three parts: disordered eating, amennorrhea, and osteoporosis or osteopenia.
Although "eating disorder behaviors" (such as fasting, overexercise, abuse of laxatives, and self-induced vomiting) are often seen, disordered eating does not necessarily mean a clinical eating disorder. Even though eating disorders themselves are a form of disordered eating, it can also mean that an athlete is inadvertently not getting adequate nutrition. This is entirely possible if she has increased her training without increasing caloric intake enough to meet her new energy needs. "Orthorexia," or an obsession with eating "healthy" or "right," can also be deemed a type of disordered eating.
Whether the disordered eating is intentional or not, it is important that an athlete seek the counseling of a physician or a registered dietician before any serious problems result.
Recently, sports medicine journals have debated about the idea of including osteopenia, rather than osteoporosis, in the third point of the triad. Osteopenia is where bone density is lower than it should be, just a step above clinical osteoporosis. Both osteopenia and osteoporosis can lead to a greatly increased risk of stress fractures, particularly in such an intense sport as figure skating.
Athletes, particularly females, should take care to get enough calcium to help prevent osteoporosis or osteopenia, in addition to getting enough vitamin D and magnesium (which both aid calcium absorption) and get proper overall nutrition.
