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Dietary Intervention Restored Menses in Female Athletes with Exercise-Associated Menstrual Dysfunction with Limited Impact on Bone and Muscle Health

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Title Dietary Intervention Restored Menses in Female Athletes with Exercise-Associated Menstrual Dysfunction with Limited Impact on Bone and Muscle Health
Names Cialdella-Kam, Lynn (creator)
Guebels, Charlotte P. (creator)
Maddalozzo, Gianni F. (creator)
Manore, Melinda M. (creator)
Date Issued 2014-07-31 (iso8601)
Note This is the publisher’s final pdf. The published article is copyrighted by the author(s) and published by MDPI. The published article can be found at: http://www.mdpi.com/journal/nutrients.
Abstract Exercise-related menstrual dysfunction (ExMD) is associated with low
energy availability (EA), decreased bone mineral density (BMD), and increased risk of
musculoskeletal injury. We investigated whether a 6-month carbohydrate-protein
(CHO-PRO) supplement (360 kcal/day, 54 g CHO/day, 20 g PRO/day) intervention would
improve energy status and musculoskeletal health and restore menses in female athletes
(n = 8) with ExMD. At pre/post-intervention, reproductive and thyroid hormones, bone
health (BMD, bone mineral content, bone markers), muscle strength/power and protein
metabolism markers, profile of mood state (POMS), and energy intake (EI)/energy
expenditure (7 day food/activity records) were measured. Eumenorrheic athlete controls
with normal menses (Eumen); n = 10) were measured at baseline. Multiple linear regressions
were used to evaluate differences between groups and pre/post-intervention blocking on
participants. Improvements in EI (+382 kcal/day; p = 0.12), EA (+417 kcal/day; p = 0.17)
and energy balance (EB; +466 kcal/day; p = 0.14) were observed with the intervention but
were not statistically significant. ExMD resumed menses (2.6 ± 2.2-months to first menses;
3.5 ± 1.9 cycles); one remaining anovulatory with menses. Female athletes with ExMD for
>8 months took longer to resume menses/ovulation and had lower BMD (low spine
(ExMD = 3; Eumen = 1); low hip (ExMD = 2)) than those with ExMD for <8 months; for
2 ExMD the intervention improved spinal BMD. POMS fatigue scores were 15% lower in
ExMD vs. Eumen (p = 0.17); POMS depression scores improved by 8% in ExMD
(p = 0.12). EI, EA, and EB were similar between groups, but the intervention (+360 kcal/day)
improved energy status enough to reverse ExMD despite no statistically significant
changes in EI. Similar baseline EA and EB between groups suggests that some ExMD
athletes are more sensitive to EA and EB fluctuations.
Genre Article
Access Condition http://creativecommons.org/licenses/by/3.0/us/
Topic amenorrhea
Identifier Cialdella-Kam, L., Guebels, C. P., Maddalozzo, G. F., & Manore, M. M. (2014). Dietary Intervention Restored Menses in Female Athletes with Exercise-Associated Menstrual Dysfunction with Limited Impact on Bone and Muscle Health. Nutrients, 6(8), 3018-3039. doi:10.3390/nu6083018

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