Date of Award

Spring 2022

Degree Type



Exercise Science

Director of Thesis

Dr. Toni Torres-McGehee

Second Reader

Nancy A. Uriegas


Content: The Female Athlete Triad refers to three interrelated components: 1) low energy availability (LEA), with or without an eating disorder (ED); 2) harmful and physiologically impactful hormonal changes; and 3) alterations in bone mineral density, which are often experienced by individuals engaged in organized sports or other intense physical activities. This phenomenon is called the Female Athlete Triad because the relationship of components has thus far been observed primarily in females. A new term, the Male Athlete Triad, has been recently developed to describe the same phenomenon in males. LEA occurs when dietary energy intake (EI) is inadequate to support the energy expenditure required for daily activities and organ function after exercise energy expenditure (EEE) needs are met. Objective: To examine the prevalence of LEA with or without an ED in physically active individuals. A secondary purpose is to determine if physically active individuals are meeting the recommended macronutrient intake guidelines. Design: A cross-sectional study in a free-living environment. Participants: A sample of 58 physically active individuals (35 males and 23 females) who engage in exercise 3 times per week for at least one hour. Interventions: Independent variables in this study are sex (male, female) and energy availability (adequate EA, LEA) and dependent variables are ED risk (at risk or not at risk) and macronutrients (proteins, carbohydrates, fats). Main outcome measures: Participants completed a 7-day food intake diary to estimate EI and used a SenseWear heart rate monitor during physical activity to estimate EEE. ED risk was examined using the Eating Disorder Inventory 3 (EDI-3) and the EDI-3 Symptom Checklist. Macronutrient intake was calculated and compared using ACSM Nutrition Recommendations to determine if participants are below, within, or over recommendations. Anticipated Results: We expected to find that LEA was present in the majority of physically active individuals and that most of these individuals would display LEA with ED risk. Additionally, we expected that physically active individuals, regardless of activity type, would present with low carbohydrate intake, males would have higher protein intakes, and there would be no differences among fat intake. Conclusions: We found LEA risk and ED risk to be prevalent in males and females, although there were significant differences across sex. We also found a significant relationship between LEA and ED risk, and most participants who had LEA also had ED risk. Macronutrient intake was significantly different across sex, although carbohydrate intakes were low across all participants with 94.8% having inadequate intake. ED risk varied across sex with several significant differences in scales, composites and pathogenic behaviors across sex.

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