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Scand J Med Sci Sports. 2018 Mar;28(3):1139-1146. doi: 10.1111/sms.13030. Epub 2018 Feb 5.

Within-day energy deficiency and reproductive function in female endurance athletes.

Author information

1
Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark.
2
Department of Nutrition, Georgia State University, Atlanta, GA, USA.
3
Department of Health Sciences, Lund University, Lund, Sweden.
4
Endocrinological and Reproductive Unit, Department of Obstetrics/Gynecology, Faculty of Health and Medical Sciences, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
5
Medical and Endocrinological Unit, Herlev Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Herlev, Denmark.
6
Norwegian School of Sport Sciences, Oslo, Norway.

Abstract

We aimed to estimate and compare within-day energy balance (WDEB) in athletes with eumenorrhea and menstrual dysfunction (MD) with similar 24-hour energy availability/energy balance (EA/EB). Furthermore, to investigate whether within-day energy deficiency is associated with resting metabolic rate (RMR), body composition, S-cortisol, estradiol, T3 , and fasting blood glucose. We reanalyzed 7-day dietary intake and energy expenditure data in 25 elite endurance athletes with eumenorrhea (n = 10) and MD (n = 15) from a group of 45 subjects where those with disordered eating behaviors (n = 11), MD not related to low EA (n = 5), and low dietary record validity (n = 4) had been excluded. Besides gynecological examination and disordered eating evaluation, the protocol included RMR measurement; assessment of body composition by dual-energy X-ray absorptiometry, blood plasma analysis, and calculation of WDEB in 1-hour intervals. Subjects with MD spent more hours in a catabolic state compared to eumenorrheic athletes; WDEB < 0 kcal: 23.0 hour (20.8-23.4) vs 21.1 hour (4.7-22.3), P = .048; WDEB < -300 kcal: 21.8 hour (17.8-22.4) vs 17.6 hour (3.9-20.9), P = .043, although similar 24-hour EA: 35.6 (11.6) vs 41.3 (12.7) kcal/kg FFM/d, (P = .269), and EB: -659 (551) vs -313 (596) kcal/d, (P = .160). Hours with WDEB <0 kcal and <-300 kcal were inversely associated with RMRratio (r = -.487, P = .013, r = -.472, P = .018), and estradiol (r = -.433, P = .034, r = -.516, P = .009), and positively associated with cortisol (r = .442, P = .027, r = .463, P = .019). In conclusion, although similar 24-hour EA/EB, the reanalysis revealed that MD athletes spent more time in a catabolic state compared to eumenorrheic athletes. Within-day energy deficiency was associated with clinical markers of metabolic disturbances.

KEYWORDS:

amenorrhea; catabolism; energy availability; relative energy deficiency; resting metabolic rate; within-day energy balance

PMID:
29205517
DOI:
10.1111/sms.13030
[Indexed for MEDLINE]

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