Adverse Eating Attitudes and Inadequate Calcium Intake and Their Relationship to the Prevalence of Skeletal Fracture Injuries among Competitive American Figure Skater

The Female Athlete Triad (Triad) and Relative Energy Deficiency in Sport (RED-S) describe conditions in which energy availability (EA) is low relative to the imbalance between dietary energy intake and energy expenditure required for health and activities of daily living, growth, and sporting activities. Figure skating as an aesthetic sport, requires great demands on time and is a sport whose participants can be affected by such syndromes, but has been minimally studied. The objective of this non-experimental, cross-sectional survey study was to identify the association between the Triad and RED-S' overlapping components of adverse eating attitudes, low calcium intake, and the prevalence for skeletal fracture injuries among competitive American figure skaters. An online survey was administered over an 8-month period, and risk for adverse eating attitudes, calcium intake, and history of skeletal fracture injury was assessed by collection self-reported data through this online survey.;A total of 74 skaters participated in this study. Of those 74, 50 skaters (8 males and 42 females) completed the survey in its entirety, with an average age of 18.12 years +/- 4.27 years. Findings were not significant for an increase in risk for adverse eating attitudes among skaters, X 2 (1, n = 60) = 0.04, p = 0.84. No significant association was found between being at risk for adverse eating attitudes and inadequate calcium intake, X 2 (1, N = 54) = 0.48, p = 0.49. However, there was a statistically significant, negative linear relationship (r = --0.28, p < 0.05,) between EAT-26 scores and the calcium intakes. No association was found between the prevalence for skeletal fracture injury and one's risk for having adverse eating attitudes, X2 (1, N = 51) = 0.05, p = 0.87. Prevalence for skeletal fracture injury and inadequate calcium intake were not significantly associated, X2 (1, N = 50) = 0.14, p = 0.07. There were no significant differences in the mean EAT score between males and females, t(58) --1.01, p = 0.32. While these findings do not support the increased risk to adverse eating habits and inadequate calcium intake reported in other studies, the negative relationship between calcium intake and increased risk to adverse eating attitudes is of note and warrants further investigation. Research would benefit from understanding more about the changes seen in the health of figure skating's athletes, with efforts made to increase recognition and resources available for the prevention, diagnosis, and treatment of each component of the Triad or RED-S.