Q: My daughter has been watching what she eats and has really been paying close attention to her body fat over the past couple of months. She is a track and cross-country athlete who doesn’t have much fat to begin with. Could this be destructive?

A: The short answer is “yes,” this could be destructive not only to her performance but to her health.

The long answer takes us down a path that many female athletes may find themselves on. At the performance clinic where I work, I see a lot of driven, Type A personality, scholastically achieving athletes who carry this behavior over to their diets and exercise routines. What they don’t realize is the result of their actions could be detrimental.

What many of us, men and women alike, strive for is a healthy balance of nutrition and exercise that allows us potential for physical growth while maintaining our goal weight or percent body fat. Many women take this equation to the limits of their own bodies, causing irregular or even absent menstrual cycles (amenorrhea). Amenorrhea can be triggered by many different factors such as stress, over-training and low body-fat percentage. Current research shows a significant correlation between body-fat percentage lower than 15 percent in females and amenorrhea.

This can cause a decrease in bone mineral density, and several long-term studies show increases in stress fractures and signs of osteopenia (a precursor to osteoporosis). The frightening part about these findings is many of the women are in their early 30s and just wanting to start a family.

Now, my intention of addressing this potential problem is not to scare you or your daughter, but educate you and encourage you to seek medical attention if needed. This is also a good time to remind young and old alike to try to get at least 1,000 milligrams of calcium per day (some studies suggest up to 1,500 mg/day).

The best form of calcium ingestion is through whole food dairy products. Calcium citrate seems to be the second-best way if you need to take a supplement. Studies have shown that commercially sold Citracal, a citrate product, has been more effective in getting calcium into the bloodstream than the competing carbonate product. While the rate of absorption into the bloodstream seems to be disputed in the journals, most advocates will argue the acidity in calcium citrate is better for absorption.

If you are using the much-cheaper calcium carbonate supplement, I would recommend just taking the carbonate with a glass of grapefruit or orange juice to combat that claim. Please consult with your physician before using any supplements.

It’s great that your daughter is actively engaged in looking and performing at her best, and I hope this will provide some guidelines to watch out for as you continue toward better health.