Author(s): DONTI, O., DONTI, A., MARAKI, M., PSYCHOUNTAKI, M., Institution: NATIONAL AND KAPODISTRIAN UNIVERSITY OF ATHENS, Country: GREECE, Abstract-ID: 1020

INTRODUCTION:
Excessive pressures to maintain a lean physique may lead adolescent athletes to dietary restraint and disordered eating behaviors. Lack of understanding the nutritional requirements of sport also influences athletes’ dietary habits and increases the risks of eating disorders and Relative Energy Deficiency Syndrome (RED-S); however, evidence is lacking in competitive athletes. This study examined eating disorder symptoms and knowledge of Relative Energy Deficiency Syndrome in a sample of 12–18-year-old artistic gymnasts.
METHODS:
Seventy-nine female adolescent artistic gymnasts, 34 international and national level (high-level; age: 14.4±1.3 y, BMI: 18.5±1.3 kg/m2) and 45 recreational and club level gymnasts (low-level; age: 14.0±1.3, BMI: 19.7±1.8 kg/m2) completed the Eating Disorder Examination Questionnaire (EDE-Q), the knowledge of the Relative Energy Deficiency Syndrome Questionnaire, the Social Desirability Scale (SDS), and provided information on their training.
RESULTS:
High-level gymnasts scored higher than low-level gymnasts in EDE-Q (32,35 vs. 6,67%, respectively; p = 0.002) and its subscales Restraint (p = 0.005), Eating Concerns (p = 0.002), Weight Concerns (p = 0.001), and Shape Concerns (p = 0.001). High-level gymnasts also reported more binge eating episodes than low-level (26,4 vs. 8,9%, respectively; p ≤ 0.007) and more menstrual disturbances (p = 0.002). No differences were observed between groups in purging, compulsive exercise, and knowledge of RED-S. Furthermore, knowledge of RED-S negatively correlated with self-induced vomiting in high-level gymnasts (r = -0.380, p = 0.05) and positively with menstrual disturbances in low-level gymnasts (r = 0.313, p = 0.05). Over 85% of the gymnasts in both groups reported having no prior knowledge of low energy availability or RED-S in sports, and 28.6–88.6% of all gymnasts failed to recognize known associations between insufficient energy intake and RED-S symptoms.
CONCLUSION:
High-level, adolescent artistic gymnasts show more eating pathology than low-level. Furthermore, gymnasts demonstrate limited awareness of how inadequate energy intake for the demands of the training may impair health and performance, irrespective of competitive level. Overlooking these risks may have significant implications for gymnasts eating behaviors and may also hinder early detection, self-control, and autonomy of female athletes, as well as the treatment of RED-S where necessary.