Effects of dietary intervention in young female athletes with menstrual disorders
Journal of the International Society of Sports Nutrition
Effects of dietary intervention in young female athletes with menstrual disorders
Karolina agowska 0 2
Karina Kapczuk 1
Zbigniew Friebe 1
Joanna Bajerska 0 2
0 Department of Human Nutrition and Hygiene, Dietetic Division, University of Life Sciences , Wojska Polskiego 28 str, 60-637 Poznan , Poland
1 Department of Perinatology and Gynecology, Division of Gynecology, Karol Marcinkowski University of Medical Sciences in Poznan , Polna 33 str, 60-535 Poznan , Poland
2 Department of Human Nutrition and Hygiene, Dietetic Division, University of Life Sciences , Wojska Polskiego 28 str, 60-637 Poznan , Poland
Background: The aim of this study was to evaluate the influence of three months of dietary intervention on menstrual cycle in young female athletes with amenorrhea or oligomenorrhea. Methods: From forty-five female professional athletes with menstrual irregularity that were recruited thirty-one, aged 18.1 2.6 years, completed the study and were analyzed. Hyperprolactinemia, thyroid dysfunction, primary ovarian failure and hyperandrogenism were excluded in the study participants. The subjects started intense training at the age of 11.2 3.5 years and continued during next 6.8 3.3 years. Energy and nutrients intake, total energy expenditure, energy availability and body composition as well as serum concentrations of LH, FSH, 17 - beta estradiol and progesterone were measured at the beginning of the study and after three months of individualized dietary intervention. Results: Following three months of dietary intervention significant increase in energy intake (2354 539 vs. 258 8 557 kcal, P = 0.004) and energy availability (28.3 9.2 vs. 35.8 12.3 kcal/kg FFM/d, P = 0.011) was observed as well as improved energy balance (288 477 vs. -51 224 kcal/d, P = 0.002). Though no changes in BMI and body composition were noted but significant rise in LH concentrations (3.04 1.63 vs. 4.59 2.53 mIU/ml, P = 0.009) and LH to FSH ratio (0.84 0.56 vs. 0.96 0.52, P = 0.001) was achieved, but no restoration of menstrual cyclicity. Conclusions: This report provides further support for the role of energy deficiency in menstrual disorders among young female athletes and the benefits of an adequate energy intake and energy availability on hormones concentration. Continuation controlled dietary intervention is needed to assess the extent to which long-term improvement in the nutritional status results in improvements in the hormonal status of female athletes, to an extent that would allow the regulation of the menstrual cyclity.
Menstrual disorders; Female athletes; Nutritional habits; Nutritional status; Dietary intervention
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Background
The strenuous physical activity of professional female
athletes may generate serious health problems. It is
estimated that between 16% [1] and 61% [2] of female athletes
suffer from hypothalamic-pituitary menstrual disorders. In
studies conducted by Torstveit et al. [3], the frequency of
menstrual disorders among elite female athletes was
34.5% in aesthetic disciplines, 30.9% in endurance
disciplines, 23.5% in weight class disciplines, 17.6% in
antigravitation disciplines, 16.7% in technical disciplines,
12.8% in ball game and power sport disciplines.
There is a disturbingly low level of knowledge among
athletes of different sports disciplines regarding the
potential health effects of untreated menstrual
dysfunctions [4,5]. Young female athletes are not aware that a
long-term negative energy balance, inadequate nutrient
intake, and endocrine disorders including the
hypothalamicpituitary-ovarian axis are particularly dangerous in the
period of achieving the peak bone mass and may
contribute to metabolism disturbances in the skeletal tissue.
Christo et al. [6] observed significantly lower BMD values
in the lumbar spine area among athletes with menstrual
disorders compared to physically active and sedentary
women with regular cycles. The study of Nicolas et al. [7]
also showed a significantly decreased bone density in
athletes suffering from amenorrhea and oligomenorrhea.
Studies of athletes with amenorrhea and low bone mass
showed that even after the restoration of the menstrual
cycle bone density remained significantly lower compared
to the average value of women in this age group [8].
Prolonged menstrual disorders have a negative effect
on the quality and quantity of plasma lipoproteins, which
favors the formation of atherosclerotic lesions. Significant
differences in blood lipid parameters in athletes with
amenorrhea compared to athletes with regular cycles have
been demonstrated. In the study of Rickenlund et al. [9],
athletes with amenorrhea had significantly higher
levels of total and LDL cholesterol compared to
athletes and sedentary women with regular cycles. The
increase in the LDL levels was higher when the energy
intake was lower.
Taking the afore mentioned into account it seemed
appropriate to take steps to limit me (...truncated)