Assessing the prevalence and risk of disordered eating in female netball players

Low energy availability (LEA) occurs when there is insufficient energy to support normal physiological function. This is caused when energy intake is lower than exercise energy expenditure, relative to fat-free body mass. Chronic LEA can result in disordered eating (DE), clinical eating disorders (ED) and reduced sporting performance. Professional female athletes are at higher risk of these concerns compared to amateur athletes, with 44% of professional athletes suffering from LEA and 27% experiencing DE. High prevalence of LEA and DE has been reported in a mixed cohort of female team sport athletes, but no research has been carried out on netball players specifically. Equally, it is unknown whether age, position or activity level of netball players affect risk. The aim of this study is to determine the risk of LEA, DE and ED in female netball players and to assess any differences across competitive levels of netball, age, time spent exercising and position. Adult female netball players (n = 108, 18–64 years, 169 ± 7 cm, 63.5 ± 5 kg) completed the London Sport Institute ethics committee-approved online survey, which consisted of the Female Athlete Screening Tool (FAST) and Low Energy Availability in Females (LEAF-Q) questionnaires (Folscher et al., 2015, Sports Medicine, 1, 29). FAST scores >78 suggest a potential ED and a LEAF-Q score ≥8 determine a player at risk of LEA. An effect size of 0.99 and beta at 1.00 was found using G* power post hoc analysis. LEAF-Q and FAST scores showed a moderate, but significant, positive correlation (r = 0.416, P < 0.01) using a Pearson correlation. Nearly half of the players (43%) were at risk of LEA, whilst 21% were recognised as being at risk of a clinical or subclinical ED. A one-way ANOVA determined that players who exercise 3–4 times per week had significantly higher FAST scores than those who exercised 1–2 times per week (F(3, 106) = 3.168, P = 0.027). No other significant differences between FAST or LEAF-Q scores for age, position, or competitive level were identified. Stepwise multiple regression also indicates that time spent exercising was a modest predictor of FAST scores (R2adj = 0.035, F(4, 105) = 1.996, P = 0.042). Our findings suggest that days spent exercising may be associated with eating pathology across all levels of netball player. Education may enable early identification of such issues and may prevent potential development of ED and performance deficits in female netball players.