Our kids reap enormous physical, social, and psychological benefits by playing sports — and it is great to see them active and engaged. But when it comes to the growing number of teen girls participating — especially at more extreme levels — sports medicine experts say parents, coaches, and physicians need to keep a close eye on their nutrition.

Doctors, especially, must watch for health problems that can develop when these athletes exercise too much and don’t consume enough calories, a recent Reuters report stated.

Sports that put girls most at risk include those where they try to lose weight to improve their performance.

The health issues girls face if their nutritional needs aren’t being met increasingly include disordered eating, a halt in monthly menstrual cycles known as amenorrhea, and soft bones. Together, the three conditions are commonly referred to as the female athlete triad.

“Girls may have just one of these problems or a combination, in varying degrees,” the authors of a recent clinical guidance report said in Pediatrics.

“There are physicians that are unaware of the triad and its long-reaching consequences,” Dr. Margot Putukian, director of athletic medicine at Princeton University in New Jersey, told Reuters.

“When overtraining occurs, and elements of the triad surface, the concern is that it can be associated with disordered eating, menstrual dysfunction with subsequent bone health issues — and then certainly there can be dangerous consequences,” she added.

Sports that put girls most at risk include those for which they try to lose weight to improve their performance — often they’re working out intensely and restricting certain foods to stay thin or underweight. “This can hurt performance, slow growth and development, and increase the risk of injury and illness. This can also lead to an eating disorder, like anorexia or bulimia,” healthychildren.org reports.

[lz_bulleted_list title=”Higher Nutritional Risk Sports for Girls” source=”http://www.healthychildren.org”]Gymnastics|Dance|Diving|Figure skating|Long-distance running|Wrestling|Martial arts|Rowing[/lz_bulleted_list]

Too few calories can also lead to irregular periods or a halt in monthly menstrual cycles — although intense athletes tend to have more menstrual irregularities than girls who aren’t quite as athletic. Osteoporis is the other real risk young girls face as they get older, when they aren’t getting enough nutrients and calories.

“The personality most apt to get into trouble is often a high-commitment athlete who is willing to do whatever it takes to succeed,” said Sharon Chirban, a sports psychologist at Boston Children’s Hospital and Harvard Medical School, Reuters reported.

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The report recommends physicians do a better job of asking young girls about their menstruation, exercise, and eating habits to assess their risk for developing problems. Doctors, parents, and coaches should also understand that when girls show symptoms of one aspect of the triad, they’re at an increased risk for the other issues.

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“It has been my experience that coaches, parents, pediatricians, and family practice physicians are not experienced in caring for athletes, and athletes themselves are not aware of the health risks unique to the triad for female athletes,” Timothy Neal, a researcher with the athletic training program at Concordia University in Ann Arbor, Michigan, told Reuters.