Low RMRratio as a surrogate marker for energy deficiency, the choice of predictive equation vital for correctly identifying male and female ballet dancers at risk

Sarah Staal; Anders Mikael Sjödin; Ida Lysdahl Fahrenholtz; Karen Bonnesen; Anna Katarina Melin

doi:10.1123/ijsnem.2017-0327

Low RMR_ratio as a surrogate marker for energy deficiency, the choice of predictive equation vital for correctly identifying male and female ballet dancers at risk

Sarah Staal, Anders Mikael Sjödin, Ida Lysdahl Fahrenholtz, Karen Bonnesen, Anna Katarina Melin

19 Citations (Scopus)

Abstract

Ballet dancers are reported to have an increased risk for energy deficiency with or without disordered eating behavior. A low ratio between measured (m) and predicted (p) resting metabolic rate (RMRratio < 0.90) is a recognized surrogate marker for energy deficiency. We aimed to evaluate the prevalence of suppressed RMR using different methods to calculate pRMR and to explore associations with additional markers of energy deficiency. Female (n = 20) and male (n = 20) professional ballet dancers, 19-35 years of age, were enrolled. mRMR was assessed by respiratory calorimetry (ventilated open hood). pRMR was determined using the Cunningham and Harris-Benedict equations, and different tissue compartments derived from whole-body dual-energy X-ray absorptiometry assessment. The protocol further included assessment of body composition and bone mineral density, blood pressure, disordered eating (Eating Disorder Inventory-3), and for females, the Low Energy Availability in Females Questionnaire. The prevalence of suppressed RMRwas generally high but also clearly dependent on the method used to calculate pRMR, ranging from 25% to 80% in males and 35% to 100% in females. Five percent had low bone mineral density, whereas 10% had disordered eating and 25% had hypotension. Forty percent of females had elevated Low Energy Availability in Females Questionnaire score and 50% were underweight. Suppressed RMR was associated with elevated Low Energy Availability in Females Questionnaire score in females and with higher training volume in males. In conclusion, professional ballet dancers are at risk for energy deficiency. The number of identified dancers at risk varies greatly depending on the method used to predict RMR when using RMRratio as a marker for energy deficiency.

Original language	English
Journal	International Journal of Sport Nutrition & Exercise Metabolism
Volume	28
Issue number	4
Pages (from-to)	412-418
Number of pages	7
ISSN	1526-484X
DOIs	https://doi.org/10.1123/ijsnem.2017-0327
Publication status	Published - Jul 2018

Keywords

Faculty of Science
Energy availability
Ballet dancers
Relative energy deficiency
Resting metabolic rate
Bone mineral density

Access to Document

10.1123/ijsnem.2017-0327

Cite this

Low RMR_ratio as a surrogate marker for energy deficiency, the choice of predictive equation vital for correctly identifying male and female ballet dancers at risk. / Staal, Sarah; Sjödin, Anders Mikael; Fahrenholtz, Ida Lysdahl et al.

In: International Journal of Sport Nutrition & Exercise Metabolism, Vol. 28, No. 4, 07.2018, p. 412-418.

Research output: Contribution to journal › Journal article › Research › peer-review

@article{bb1087cbd6c84c56ab53816bcc3006f5,

title = "Low RMRratio as a surrogate marker for energy deficiency, the choice of predictive equation vital for correctly identifying male and female ballet dancers at risk",

abstract = "Ballet dancers are reported to have an increased risk for energy deficiency with or without disordered eating behavior. A low ratio between measured (m) and predicted (p) resting metabolic rate (RMRratio < 0.90) is a recognized surrogate marker for energy deficiency. We aimed to evaluate the prevalence of suppressed RMR using different methods to calculate pRMR and to explore associations with additional markers of energy deficiency. Female (n = 20) and male (n = 20) professional ballet dancers, 19-35 years of age, were enrolled. mRMR was assessed by respiratory calorimetry (ventilated open hood). pRMR was determined using the Cunningham and Harris-Benedict equations, and different tissue compartments derived from whole-body dual-energy X-ray absorptiometry assessment. The protocol further included assessment of body composition and bone mineral density, blood pressure, disordered eating (Eating Disorder Inventory-3), and for females, the Low Energy Availability in Females Questionnaire. The prevalence of suppressed RMRwas generally high but also clearly dependent on the method used to calculate pRMR, ranging from 25% to 80% in males and 35% to 100% in females. Five percent had low bone mineral density, whereas 10% had disordered eating and 25% had hypotension. Forty percent of females had elevated Low Energy Availability in Females Questionnaire score and 50% were underweight. Suppressed RMR was associated with elevated Low Energy Availability in Females Questionnaire score in females and with higher training volume in males. In conclusion, professional ballet dancers are at risk for energy deficiency. The number of identified dancers at risk varies greatly depending on the method used to predict RMR when using RMRratio as a marker for energy deficiency.",

keywords = "Faculty of Science, Energy availability, Ballet dancers, Relative energy deficiency, Resting metabolic rate, Bone mineral density",

author = "Sarah Staal and Sj{\"o}din, {Anders Mikael} and Fahrenholtz, {Ida Lysdahl} and Karen Bonnesen and Melin, {Anna Katarina}",

note = "CURIS 2018 NEXS 261",

year = "2018",

month = jul,

doi = "10.1123/ijsnem.2017-0327",

language = "English",

volume = "28",

pages = "412--418",

journal = "International Journal of Sport Nutrition & Exercise Metabolism",

issn = "1526-484X",

publisher = "Human Kinetics, Inc",

number = "4",

}

TY - JOUR

T1 - Low RMRratio as a surrogate marker for energy deficiency, the choice of predictive equation vital for correctly identifying male and female ballet dancers at risk

AU - Staal, Sarah

AU - Sjödin, Anders Mikael

AU - Fahrenholtz, Ida Lysdahl

AU - Bonnesen, Karen

AU - Melin, Anna Katarina

N1 - CURIS 2018 NEXS 261

PY - 2018/7

Y1 - 2018/7

N2 - Ballet dancers are reported to have an increased risk for energy deficiency with or without disordered eating behavior. A low ratio between measured (m) and predicted (p) resting metabolic rate (RMRratio < 0.90) is a recognized surrogate marker for energy deficiency. We aimed to evaluate the prevalence of suppressed RMR using different methods to calculate pRMR and to explore associations with additional markers of energy deficiency. Female (n = 20) and male (n = 20) professional ballet dancers, 19-35 years of age, were enrolled. mRMR was assessed by respiratory calorimetry (ventilated open hood). pRMR was determined using the Cunningham and Harris-Benedict equations, and different tissue compartments derived from whole-body dual-energy X-ray absorptiometry assessment. The protocol further included assessment of body composition and bone mineral density, blood pressure, disordered eating (Eating Disorder Inventory-3), and for females, the Low Energy Availability in Females Questionnaire. The prevalence of suppressed RMRwas generally high but also clearly dependent on the method used to calculate pRMR, ranging from 25% to 80% in males and 35% to 100% in females. Five percent had low bone mineral density, whereas 10% had disordered eating and 25% had hypotension. Forty percent of females had elevated Low Energy Availability in Females Questionnaire score and 50% were underweight. Suppressed RMR was associated with elevated Low Energy Availability in Females Questionnaire score in females and with higher training volume in males. In conclusion, professional ballet dancers are at risk for energy deficiency. The number of identified dancers at risk varies greatly depending on the method used to predict RMR when using RMRratio as a marker for energy deficiency.

AB - Ballet dancers are reported to have an increased risk for energy deficiency with or without disordered eating behavior. A low ratio between measured (m) and predicted (p) resting metabolic rate (RMRratio < 0.90) is a recognized surrogate marker for energy deficiency. We aimed to evaluate the prevalence of suppressed RMR using different methods to calculate pRMR and to explore associations with additional markers of energy deficiency. Female (n = 20) and male (n = 20) professional ballet dancers, 19-35 years of age, were enrolled. mRMR was assessed by respiratory calorimetry (ventilated open hood). pRMR was determined using the Cunningham and Harris-Benedict equations, and different tissue compartments derived from whole-body dual-energy X-ray absorptiometry assessment. The protocol further included assessment of body composition and bone mineral density, blood pressure, disordered eating (Eating Disorder Inventory-3), and for females, the Low Energy Availability in Females Questionnaire. The prevalence of suppressed RMRwas generally high but also clearly dependent on the method used to calculate pRMR, ranging from 25% to 80% in males and 35% to 100% in females. Five percent had low bone mineral density, whereas 10% had disordered eating and 25% had hypotension. Forty percent of females had elevated Low Energy Availability in Females Questionnaire score and 50% were underweight. Suppressed RMR was associated with elevated Low Energy Availability in Females Questionnaire score in females and with higher training volume in males. In conclusion, professional ballet dancers are at risk for energy deficiency. The number of identified dancers at risk varies greatly depending on the method used to predict RMR when using RMRratio as a marker for energy deficiency.

KW - Faculty of Science

KW - Energy availability

KW - Ballet dancers

KW - Relative energy deficiency

KW - Resting metabolic rate

KW - Bone mineral density

U2 - 10.1123/ijsnem.2017-0327

DO - 10.1123/ijsnem.2017-0327

M3 - Journal article

C2 - 29405782

SN - 1526-484X

VL - 28

SP - 412

EP - 418

JO - International Journal of Sport Nutrition & Exercise Metabolism

JF - International Journal of Sport Nutrition & Exercise Metabolism

IS - 4

ER -