{"id":37,"date":"2024-04-04T06:59:27","date_gmt":"2024-04-04T03:59:27","guid":{"rendered":"https:\/\/sisu.ut.ee\/spordimeditsiini-algkursus\/soomishaired-spordis-madal-energiatarbimine\/"},"modified":"2024-04-04T06:59:55","modified_gmt":"2024-04-04T03:59:55","slug":"soomishaired-spordis-madal-energiatarbimine","status":"publish","type":"page","link":"https:\/\/sisu.ut.ee\/spordimeditsiini-algkursus\/soomishaired-spordis-madal-energiatarbimine\/","title":{"rendered":"S\u00f6\u00f6mish\u00e4ired spordis. Madal energiatarbimine"},"content":{"rendered":"<p>\n\tS\u00f6\u00f6mish\u00e4ired on t\u00f5sine probleem paljudel spordialadel:\n<\/p>\n<ul>\n<li>\n\t\tk\u00f5rge intensiivsuse ja suure treeningmahuga spordialad;\n\t<\/li>\n<li>\n\t\tkaalukategooriaga spordialad;\n\t<\/li>\n<li>\n\t\testeetilised spordialad jt.\n\t<\/li>\n<\/ul>\n<p>\n\tSpordiga seonduvalt v\u00f5ib olla v\u00e4ga varieeruv s\u00f6\u00f6mis- ja k\u00e4itumismuster. H\u00e4irunud s\u00f6\u00f6misk\u00e4itumine (<em>disordered eating<\/em>, DE) t\u00e4histab s\u00f6\u00f6mise mittevastavust tegelike vajadustega, millega sageli kaasneb pidev kontroll kehakaalu \u00fcle. Naistel kaasnevad probleemiga menstruatsioonih\u00e4ired. Sekundaarse amenorr\u00f6a sagedus naissportlaste seas on kuni 70%, ning selle peamiseks p\u00f5hjuseks on \u00fclem\u00e4\u00e4rased treeningkoormused ja madal energiatarbimine. Madala energiasaadavuse p\u00f5hjused vaata joonis 10.\n<\/p>\n<p style=\"text-align: center\">\n\t<img loading=\"lazy\" decoding=\"async\" width=\"692\" height=\"398\" class=\"alignnone wp-image-89\" src=\"https:\/\/sisu.ut.ee\/wp-content\/uploads\/sites\/469\/screenshot_2021-02-19_at_13.50.39.png\" title=\"screenshot_2021-02-19_at_13.50.39.png\" alt=\"Joonis\" srcset=\"https:\/\/sisu.ut.ee\/wp-content\/uploads\/sites\/469\/screenshot_2021-02-19_at_13.50.39.png 692w, https:\/\/sisu.ut.ee\/wp-content\/uploads\/sites\/469\/screenshot_2021-02-19_at_13.50.39-300x173.png 300w\" sizes=\"auto, (max-width: 692px) 100vw, 692px\">\n<\/p>\n<p>\n\t<strong>Joonis 10. Madala energiasaadavuse p\u00f5hjused.<\/strong>\n<\/p>\n<p>\n\t<span lang=\"ET\"><span style=\"line-height:115%\">H\u00e4irunud s\u00f6\u00f6misk\u00e4itumine v\u00f5ib viia kolme kliiniliselt diagnoositava s\u00f6\u00f6mish\u00e4ireni:<\/span><\/span>\n<\/p>\n<ol>\n<li>\n\t\t<b><span lang=\"ET\"><span style=\"line-height:115%\">Anoreksia e ps\u00fc\u00fchiline isutus<\/span><\/span><\/b><span lang=\"ET\"><span style=\"line-height:115%\"> (<i>Anorexia nervosa, AN<\/i>). Pidev kehakaalu m\u00f5\u00f5tmine, toidu piiramine ja p\u00fc\u00fce kehalist koormust suurendada<\/span><\/span>\n\t<\/li>\n<li>\n\t\t<b><span lang=\"ET\"><span style=\"line-height:115%\">Buliimia e liigs\u00f6\u00f6mise s\u00f6\u00f6stud<\/span><\/span><\/b><span lang=\"ET\"><span style=\"line-height:115%\"> (<i>Bulimia nervosa, BN<\/i>)<br>Meelega esilekutsutud oksendamised p\u00e4rast liigs\u00f6\u00f6mist (2-3 korda n\u00e4dalas)<\/span><\/span>\n\t<\/li>\n<li>\n\t\t<b><span lang=\"ET\"><span style=\"line-height:115%\">EDNOS<\/span><\/span><\/b><span lang=\"ET\"><span style=\"line-height:115%\"> (<\/span><\/span><b><i><span lang=\"EN-US\"><span style=\"line-height:115%\">E<\/span><\/span><\/i><\/b><i><span lang=\"EN-US\"><span style=\"line-height:115%\">ating <b>D<\/b>isorder <b>N<\/b>ot <b>O<\/b>therwise <b>S<\/b>pecified<\/span><\/span><\/i><span lang=\"ET\"><span style=\"line-height:115%\">) \u2013 t\u00e4psustamata s\u00f6\u00f6mish\u00e4ire. Siia alla kategoriseeruvad nn naissportlase triaad ja suhteline madal energiatarbimine spordis (<b><i>R<\/i><\/b><i>elative <b>E<\/b>nergy \u00a0<b>D<\/b>eficit in <b>S<\/b>ports \u2013 <b>REDs<\/b><\/i>)<\/span><\/span>\n\t<\/li>\n<\/ol>\n<p>\n\t<span lang=\"ET\"><span style=\"line-height:115%\">Anoreksia ja buliimia sagedus tavapopulatsioonis:<\/span><\/span>\n<\/p>\n<ul>\n<li style=\"margin-bottom: 0cm\">\n\t\t<span style=\"line-height:normal\"><i><span lang=\"ET\">Anorexia nervosa:\u00a0<\/span><\/i><span lang=\"ET\">0,5-3,7%<\/span><\/span>\n\t<\/li>\n<li style=\"margin-bottom: 0cm\">\n\t\t<span style=\"line-height:normal\"><i><span lang=\"ET\">Bulimia nervosa:\u00a0<\/span><\/i><span lang=\"ET\">1,1-4,2%<\/span><\/span>\n\t<\/li>\n<li style=\"margin-bottom: 0cm\">\n\t\t<span style=\"line-height:normal\"><span lang=\"ET\">Mehed:naised: 1:6-10<\/span><\/span>\n\t<\/li>\n<li style=\"margin-bottom: 0cm\">\n\t\t<span style=\"line-height:normal\"><span lang=\"ET\">Paranemine BN korral halvema prognoosiga<\/span><\/span>\n\t<\/li>\n<li style=\"margin-bottom: 0cm\">\n\t\t<span style=\"line-height:normal\"><span lang=\"ET\">Suremus: 5-20%<\/span><\/span>\n\t<\/li>\n<\/ul>\n<p>\n\tS\u00f6\u00f6mish\u00e4irete ja h\u00e4irunud s\u00f6\u00f6misk\u00e4itrumise puhul on iseloomulik:\n<\/p>\n<ul>\n<li>\n\t\tkinnism\u00f5tted dieedist ja kehakaalust;\n\t<\/li>\n<li>\n\t\tp\u00fchendumine treenimisele;\n\t<\/li>\n<li>\n\t\tsportimine teiste tegevuste arvelt (kool, t\u00f6\u00f6, suhted jt);\n\t<\/li>\n<li>\n\t\tsaavutustega mitterahulolu;\n\t<\/li>\n<li>\n\t\tperfektsionism jne.\n\t<\/li>\n<\/ul>\n<p>\n\tSpordikeskkonnast l\u00e4htuvad s\u00f6\u00f6mish\u00e4ireid soodustavad tegurid:\n<\/p>\n<ul>\n<li>\n\t\tkaalupiirangud ja standardid, teadlik v\u00f5i teadvustamata surve treeneri v\u00f5i kaaslaste poolt;\n\t<\/li>\n<li>\n\t\tsportliku soorituse hindamise kriteeriumite subjektiivsus v\u00e4limuse alusel jne;\n\t<\/li>\n<li>\n\t\tsotsiokultuurilised tegurid: 95% naistest hindab oma keha 25% suuremaks kui see tegelikult on.\n\t<\/li>\n<\/ul>\n<p>\n\t<strong>AN korral on iseloomulik:<\/strong>\n<\/p>\n<p>\n\tBrad\u00fckardia, perifeersed tursed, kuiv nahk, lanugo, pruritus, gastrointestinaalsed probleemid (konstipatsioon, \u201ere-feeding\u201c s\u00fcndroom jne), amenorr\u00f6a, osteopeenia, osteoporoos, hupoglukeemia, kilpn\u00e4\u00e4rme funktsiooni h\u00e4ired, aneemia jne.\n<\/p>\n<p>\n\t<strong>BN korral on iseloomulik:<\/strong>\n<\/p>\n<p>\n\tGastrointestinaalsed probleemid (hammaste erosioon, GERD, konstipatsioon, \u00f6sofagiit jne), ar\u00fctmiad, kardiom\u00fcopaatia, ebaregulaarne menstruatsioon, elektrol\u00fc\u00fctide tasakaalu h\u00e4ired, deh\u00fcdratsioon, nefropaatia jne.\n<\/p>\n<p>\n\tRiskifaktorid, mis halvendavad s\u00f6\u00f6mish\u00e4irete prognoosi:\n<\/p>\n<ul>\n<li>\n\t\ts\u00f6\u00f6mish\u00e4ire algus vanemas eas\n\t<\/li>\n<li>\n\t\tv\u00e4ga suur ja kiire kaalulangus\n\t<\/li>\n<li>\n\t\tanorektilised ja buliimilised s\u00fcmptomid koos\n\t<\/li>\n<li>\n\t\th\u00e4irunud peresuhted\n\t<\/li>\n<li>\n\t\thiline ravi algus\n\t<\/li>\n<\/ul>\n<p>\n\tKirjanduse andmetel esineb h\u00e4irunud s\u00f6\u00f6misk\u00e4itumist teatud spordialadel isegi kuni 62%-l nais- ja 33%-l meessportlastest, millega tihtipeale kaasneb normist madalam kehamassiindeks (KMI)\u00a0ja keha rasva sisaldus. S\u00f6\u00f6mish\u00e4ire v\u00f5i h\u00e4irunud s\u00f6\u00f6misk\u00e4itumine seostub oluliselt s\u00fcdame-veresoonkonna, immuun-, endokriin-, metaboolse- , hematoloogilise-, tugi-liikumis- jt elunds\u00fcsteemide funktsiooni h\u00e4irumisega (joonis 11).\n<\/p>\n<p style=\"text-align: center\">\n\t<img loading=\"lazy\" decoding=\"async\" width=\"542\" height=\"530\" class=\"alignnone wp-image-90\" src=\"https:\/\/sisu.ut.ee\/wp-content\/uploads\/sites\/469\/screenshot_2021-02-23_at_07.55.09.png\" title=\"screenshot_2021-02-23_at_07.55.09.png\" alt=\"9\" srcset=\"https:\/\/sisu.ut.ee\/wp-content\/uploads\/sites\/469\/screenshot_2021-02-23_at_07.55.09.png 542w, https:\/\/sisu.ut.ee\/wp-content\/uploads\/sites\/469\/screenshot_2021-02-23_at_07.55.09-300x293.png 300w\" sizes=\"auto, (max-width: 542px) 100vw, 542px\">\n<\/p>\n<p>\n\t<strong>Joonis 11. Suhtelise energia defitsiidi poolt m\u00f5jutatavad sportlase organs\u00fcsteemid ja f\u00fcsioloogilised protsessid (t\u00f5lge, Mountjoy jt, 2018). <em>RED-s \u2013 relative energy deficiency in sports).<\/em><\/strong>\n<\/p>\n<h3>\n\t<strong>Naissportlase triaad (NT)<\/strong><br>\n<\/h3>\n<p>\n\tIseloomulik on (joonis 11):\n<\/p>\n<ul>\n<li>\n\t\tS\u00f6\u00f6mish\u00e4ire\n\t<\/li>\n<li>\n\t\tOligomenorrea\u00a0v\u00f5i amenorr\u00f6a\n\t<\/li>\n<li>\n\t\tOsteoporoos v\u00f5i osteopeenia\n\t<\/li>\n<\/ul>\n<p>\n\tNT tekib, kui\u00a0 energiatarbimine on p\u00fcsivalt alla 30 kcal\/kg rasvavaba massi kohta. Juhtivaks p\u00f5hjuseks on madal energiatarbimine ning seet\u00f5ttu on naissportlase triaadi ravis esmane vajalik meede energiatarbimise suurendamine ning energiakulu piiramine. \u00a0NB! osteopeenia (osteoporoos) v\u00f5ib avalduda aastaid hiljem peale s\u00f6\u00f6mish\u00e4ire ja amenorr\u00f6a tekkimist.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>S\u00f6\u00f6mish\u00e4ired on t\u00f5sine probleem paljudel spordialadel: k\u00f5rge intensiivsuse ja suure treeningmahuga spordialad; kaalukategooriaga spordialad; esteetilised spordialad jt. Spordiga seonduvalt v\u00f5ib olla v\u00e4ga varieeruv s\u00f6\u00f6mis- ja k\u00e4itumismuster. H\u00e4irunud s\u00f6\u00f6misk\u00e4itumine (disordered eating, DE) t\u00e4histab s\u00f6\u00f6mise mittevastavust tegelike vajadustega, millega sageli kaasneb pidev &#8230;<\/p>\n","protected":false},"author":243,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-37","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/sisu.ut.ee\/spordimeditsiini-algkursus\/wp-json\/wp\/v2\/pages\/37","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sisu.ut.ee\/spordimeditsiini-algkursus\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/sisu.ut.ee\/spordimeditsiini-algkursus\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/sisu.ut.ee\/spordimeditsiini-algkursus\/wp-json\/wp\/v2\/users\/243"}],"replies":[{"embeddable":true,"href":"https:\/\/sisu.ut.ee\/spordimeditsiini-algkursus\/wp-json\/wp\/v2\/comments?post=37"}],"version-history":[{"count":1,"href":"https:\/\/sisu.ut.ee\/spordimeditsiini-algkursus\/wp-json\/wp\/v2\/pages\/37\/revisions"}],"predecessor-version":[{"id":173,"href":"https:\/\/sisu.ut.ee\/spordimeditsiini-algkursus\/wp-json\/wp\/v2\/pages\/37\/revisions\/173"}],"wp:attachment":[{"href":"https:\/\/sisu.ut.ee\/spordimeditsiini-algkursus\/wp-json\/wp\/v2\/media?parent=37"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}