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February 12, 2026PM&ROpen Access

Differences in female athlete triad risk factors between Japanese and American female runners: A comparative study

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Authors

ASAna Carla C. SalamunesPennsylvania State UniversityNKNatsue KoikawaJuntendo UniversityNWNancy I. WilliamsPennsylvania State University

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Implication

This observational study compares Triad risk factors in Japanese and American female runners, suggesting potential risks for Japanese athletes.

Key Points

  • This research aims to compare the prevalence of female athlete triad risk factors between Japanese and American female distance runners.
  • Observational, cross-sectional design
  • Included 77 female runners from two universities
  • Assessed Triad components: energy deficiency, menstrual disturbances, and poor bone health
  • Compared prevalence using chi-square and Fisher's exact tests
  • Analyzed group differences with t-tests and Mann–Whitney U tests
  • Japanese runners showed lower body weight and body fat percentage than American counterparts
  • Significantly lower bone mineral density at the lumbar spine, total hip, and femoral neck in Japanese runners
  • Higher prevalence of energy deficiency (56% vs. 32% in Americans) and history of stress fractures (50% vs. 17%)
  • 42% of Japanese runners experienced all three Triad components compared to 16% of Americans.

Cite This Study

Salamunes et al. (2026) studied this question.

synapsesocial.com/papers/698d6f0d5be6419ac0d55260https://doi.org/10.1002/pmrj.70099
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