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Energy availability and the female athlete triad in elite endurance athletes

Melin, A. ; Tornberg, Åsa LU orcid ; Skouby, S. ; Moller, S. S. ; Sundgot-Borgen, J. ; Faber, J. ; Sidelmann, J. J. ; Aziz, M. and Sjodin, A. (2015) In Scandinavian Journal of Medicine & Science in Sports 25(5). p.610-622
Abstract
The female athlete triad (Triad), links low energy availability (EA), with menstrual dysfunction (MD), and impaired bone health. The aims of this study were to examine associations between EA/MD and energy metabolism and the prevalence of Triad-associated conditions in endurance athletes. Forty women [26.2 +/- 5.5 years, body mass index (BMI) 20.6 +/- 2.0 kg/m(2), body fat 20.0 +/- 3.0%], exercising 11.4 +/- 4.5 h/week, were recruited from national teams and competitive clubs. Protocol included gynecological examination; assessment of bone health; indirect respiratory calorimetry; diet and exercise measured 7 days to assess EA; eating disorder (ED) examination; blood analysis. Subjects with low/reduced EA (< 45 kcal/kg FFM/day), had... (More)
The female athlete triad (Triad), links low energy availability (EA), with menstrual dysfunction (MD), and impaired bone health. The aims of this study were to examine associations between EA/MD and energy metabolism and the prevalence of Triad-associated conditions in endurance athletes. Forty women [26.2 +/- 5.5 years, body mass index (BMI) 20.6 +/- 2.0 kg/m(2), body fat 20.0 +/- 3.0%], exercising 11.4 +/- 4.5 h/week, were recruited from national teams and competitive clubs. Protocol included gynecological examination; assessment of bone health; indirect respiratory calorimetry; diet and exercise measured 7 days to assess EA; eating disorder (ED) examination; blood analysis. Subjects with low/reduced EA (< 45 kcal/kg FFM/day), had lower resting metabolic rate (RMR) compared with those with optimal EA [28.4 +/- 2.0 kcal/kg fat-free mass (FFM)/day vs 30.5 +/- 2.2 kcal/kg FFM/day, P < 0.01], as did subjects with MD compared with eumenorrheic subjects (28.6 +/- 2.4 kcal/kg FFM/day vs 30.2 +/- 1.8 kcal/kg FFM/day, P < 0.05). 63% had low/reduced EA, 25% ED, 60% MD, 45% impaired bone health, and 23% had all three Triad conditions. 53% had low RMR, 25% hypercholesterolemia, and 38% hypoglycemia. Conclusively, athletes with low/reduced EA and/or MD had lowered RMR. Triad-associated conditions were common in this group of athletes, despite a normal BMI range. The high prevalence of ED, MD, and impaired bone health emphasizes the importance of prevention, early detection, and treatment of energy deficiency. (Less)
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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Energy metabolism, eating disorders, osteoporosis, amenorrhea, hypercholesterolemia
in
Scandinavian Journal of Medicine & Science in Sports
volume
25
issue
5
pages
610 - 622
publisher
Wiley-Blackwell
external identifiers
  • wos:000364595600018
  • scopus:84941736790
  • pmid:24888644
ISSN
1600-0838
DOI
10.1111/sms.12261
project
Fysiologiska och psykologiska aspekter på låg energitillgänglighet hos kvinnor - påverkan på metabolsim, prestation och hälsa
language
English
LU publication?
yes
id
838876b5-a602-411d-b1ec-763298863890 (old id 8383476)
date added to LUP
2016-04-01 14:57:49
date last changed
2023-04-28 13:48:49
@article{838876b5-a602-411d-b1ec-763298863890,
  abstract     = {{The female athlete triad (Triad), links low energy availability (EA), with menstrual dysfunction (MD), and impaired bone health. The aims of this study were to examine associations between EA/MD and energy metabolism and the prevalence of Triad-associated conditions in endurance athletes. Forty women [26.2 +/- 5.5 years, body mass index (BMI) 20.6 +/- 2.0 kg/m(2), body fat 20.0 +/- 3.0%], exercising 11.4 +/- 4.5 h/week, were recruited from national teams and competitive clubs. Protocol included gynecological examination; assessment of bone health; indirect respiratory calorimetry; diet and exercise measured 7 days to assess EA; eating disorder (ED) examination; blood analysis. Subjects with low/reduced EA (&lt; 45 kcal/kg FFM/day), had lower resting metabolic rate (RMR) compared with those with optimal EA [28.4 +/- 2.0 kcal/kg fat-free mass (FFM)/day vs 30.5 +/- 2.2 kcal/kg FFM/day, P &lt; 0.01], as did subjects with MD compared with eumenorrheic subjects (28.6 +/- 2.4 kcal/kg FFM/day vs 30.2 +/- 1.8 kcal/kg FFM/day, P &lt; 0.05). 63% had low/reduced EA, 25% ED, 60% MD, 45% impaired bone health, and 23% had all three Triad conditions. 53% had low RMR, 25% hypercholesterolemia, and 38% hypoglycemia. Conclusively, athletes with low/reduced EA and/or MD had lowered RMR. Triad-associated conditions were common in this group of athletes, despite a normal BMI range. The high prevalence of ED, MD, and impaired bone health emphasizes the importance of prevention, early detection, and treatment of energy deficiency.}},
  author       = {{Melin, A. and Tornberg, Åsa and Skouby, S. and Moller, S. S. and Sundgot-Borgen, J. and Faber, J. and Sidelmann, J. J. and Aziz, M. and Sjodin, A.}},
  issn         = {{1600-0838}},
  keywords     = {{Energy metabolism; eating disorders; osteoporosis; amenorrhea; hypercholesterolemia}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{610--622}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Scandinavian Journal of Medicine & Science in Sports}},
  title        = {{Energy availability and the female athlete triad in elite endurance athletes}},
  url          = {{http://dx.doi.org/10.1111/sms.12261}},
  doi          = {{10.1111/sms.12261}},
  volume       = {{25}},
  year         = {{2015}},
}