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

Ida Lysdahl Fahrenholtz; Anders Mikael Sjödin; Dan  Benardot; Åsa Tornberg; Sven O. Skouby; Jens Faber; Jorunn Sundgot-Borgen; Anna Katarina Melin

doi:10.1111/sms.13030

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

Ida Lysdahl Fahrenholtz, Anders Mikael Sjödin, Dan Benardot, Åsa Tornberg, Sven O. Skouby, Jens Faber, Jorunn Sundgot-Borgen, Anna Katarina Melin

26 Citations (Scopus)

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 RMR_ratio (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.

Original language	English
Journal	Scandinavian Journal of Medicine & Science in Sports
Volume	28
Issue number	3
Pages (from-to)	1139-1146
Number of pages	8
ISSN	0905-7188
DOIs	https://doi.org/10.1111/sms.13030
Publication status	Published - Mar 2018

Keywords

Faculty of Science
Energy availability
Within-day energy balance
Relative energy deficiency
Amenorrhea
Catabolism
RMR
Resting metabolic rate

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10.1111/sms.13030

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@article{f7e18f44a2a949ecbeeeb4d715583a3d,

title = "Within-day energy deficiency and reproductive function in female endurance athletes",

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 = "Faculty of Science, Energy availability, Within-day energy balance, Relative energy deficiency, Amenorrhea, Catabolism, RMR, Resting metabolic rate",

author = "Fahrenholtz, {Ida Lysdahl} and Sj{\"o}din, {Anders Mikael} and Dan Benardot and {\AA}sa Tornberg and Skouby, {Sven O.} and Jens Faber and Jorunn Sundgot-Borgen and Melin, {Anna Katarina}",

note = "CURIS 2018 NEXS 052",

year = "2018",

month = mar,

doi = "10.1111/sms.13030",

language = "English",

volume = "28",

pages = "1139--1146",

journal = "Scandinavian Journal of Medicine & Science in Sports",

issn = "0905-7188",

publisher = "Wiley-Blackwell",

number = "3",

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TY - JOUR

T1 - Within-day energy deficiency and reproductive function in female endurance athletes

AU - Fahrenholtz, Ida Lysdahl

AU - Sjödin, Anders Mikael

AU - Benardot, Dan

AU - Tornberg, Åsa

AU - Skouby, Sven O.

AU - Faber, Jens

AU - Sundgot-Borgen, Jorunn

AU - Melin, Anna Katarina

N1 - CURIS 2018 NEXS 052

PY - 2018/3

Y1 - 2018/3

N2 - 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.

AB - 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.

KW - Faculty of Science

KW - Energy availability

KW - Within-day energy balance

KW - Relative energy deficiency

KW - Amenorrhea

KW - Catabolism

KW - RMR

KW - Resting metabolic rate

U2 - 10.1111/sms.13030

DO - 10.1111/sms.13030

M3 - Journal article

C2 - 29205517

SN - 0905-7188

VL - 28

SP - 1139

EP - 1146

JO - Scandinavian Journal of Medicine & Science in Sports

JF - Scandinavian Journal of Medicine & Science in Sports

IS - 3

ER -

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

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Keywords

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