Sport Team-Centered Program Appears Effective in Reducing Disordered Eating Among Female High School
November 05, 2004
By Journal of the American Medical Association
A peer-led, sport team-centered program reduces eating disordered behavior and body-shaping drug use in female high school athletes.
According to an article in the November issue of the
Archives of Pediatrics & Adolescent Medicine, one
of the JAMA/Archives journals, about half of male and
female high school students participate in school sports.
For young women, pressures to be thin may be compounded
by influences of their sport, resulting in more disordered
eating behaviors, drug use (tobacco, diet
pills, diuretics, laxatives, amphetamines, and anabolic
steroids). Athletic teams provide a natural setting
for programs to educate about eating disorders and drug
use, the article states. The ATHENA (Athletes Targeting
Healthy Exercise and Nutrition Alternatives) program
is a school-based, team-centered program that focuses
on promoting healthy nutrition and effective exercise
training as alternatives to harmful behavior in young
women.
Diane L. Elliot, M.D., of Oregon Health & Science University, Portland, and colleagues evaluated the ATHENA program's efficacy at 18 high schools among 928 female students (average age, 15.4 years). Schools were randomly assigned to implement the eight-week ATHENA program curriculum (45 minutes per week) incorporated into a team's usual practice activities, or to engage in any of the usual programs for eating disorder prevention offered by the particular school (usual care). Athletes were surveyed on dieting, nutrition, and exercise habits before and after the study. Topics in the ATHENA program were gender specific, were led by the athletes participating, and included information on healthy sport nutrition, effective exercise training, drug use, media images of women and depression prevention.
The researchers found that athletes participating in
the ATHENA program reported significantly less ongoing
and new use of diet pills, and less use of amphetamines,
anabolic steroids, and sport supplements. These athletes
also reported more seatbelt use and less new sexual
activity. The ATHENA athletes also had positive changes
in healthy eating behaviors, and reductions in intent
to use diet pills in the future, vomiting to lose
weight and tobacco use.
"The ATHENA curriculum succeeded in most of its prevention and health promotion goals," the authors write. "Following their sport season, intervention students reported less ongoing and new diet pill use and less new use of athletic-enhancing, body-shaping substances (amphetamines, anabolic steroids, and muscle-building supplements). Experimental participants understood more about the presented topics, had improved self-reported dietary habits, and indicated greater self-efficacy for exercise training," write the researchers.
Athena: A Promising Program Up Against Stiff Competition
In an accompanying editorial, Jorge E. Gomez, M.D., of the University of Texas Health Science Center at San Antonio, writes of the ATHENA program: "The credibility of the intervention has been well established, however, with the scientific rigor of this study. Nevertheless, the ATHENA intervention faces stiff competition. While girls can be taught to see through advertising images of thin women, the siege from the media will continue to be relentless. In addition, there is a widely held belief among coaches that making an athlete thinner or leaner will make him or her a better athlete."
"In defense of coaches, their jobs often depend on the success of their athletes, even at the high school level," states Dr. Gomez. "The belief that a thinner athlete is a better athlete, combined with the coaches' imperative to enhance all modifiable factors to ensure athletic success, often translates into pressure on young athletes to achieve a level of thinness as a performance criterion. However, the relationship between body composition and athletic performance is not straightforward."
"There is little or no scientific evidence to support the idea that simply making a normal-weight athlete weigh less will, independent of other training adaptations, make him or her a better athlete. Efforts to make a normal-weight athlete leaner, or thinner, like restricting calories or excessive exercise, for the sake of improving athletic performance, are misguided," Dr. Gomez writes.
"Undergraduate coaching curricula and continuing education should include more factual information to help dispel the myths relating performance and thinness to the benefit of young athletes," Dr. Gomez concludes.
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