title: Low-energy density and high fiber intake are dietary concerns in female endurance athletes.
abstract: Low or reduced energy availability (LEA) is linked to functional hypothalamic oligomenorrhea/amenorrhea (FHA), which is frequently reported in weight-sensitive sports. This makes LEA a major nutritional concern for female athletes. The aim of this study was to describe dietary characteristics of athletes with LEA and/or FHA. Endurance athletes (n = 45) were recruited from national teams and competitive clubs. Protocols included gynecological examination, body composition, eating disorder evaluation, and 7-day dietary intake and EA assessment. Athletes with disordered eating behavior/eating disorders (n = 11), menstrual dysfunction other than FHA (n = 5), and low dietary record validity (n = 4) were excluded. Remaining subjects (n = 25) were characterized by EA [optimal: ≥ 45 kcal (188 kJ)/kg fat-free mass (FFM)/day (n = 11), LEA: < 45 kcal (188 kJ)/kg FFM/day (n = 14)] and reproductive function [eumenorrhea (EUM; n = 10), FHA (n = 15)]. There was no difference in EA between FHA and EUM subjects. However, FHA and LEA subjects shared the same dietary characteristics of lower energy density (ED) [(P = 0.012; P = 0.020), respectively], and fat content [(P = 0.047; P = 0.027), respectively]. Furthermore, FHA subjects had a lower intake of carbohydrate-rich foods (P = 0.019), higher fiber content (P < 0.001), and drive for thinness score (P = 0.003). Conclusively, low ED together with high fiber content may constitute targets for dietary intervention in order to prevent and treat LEA and FHA in female athletes.
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark.|Department of Health Sciences, Division of Physiotherapy, Lund University, Lund, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Melin
authors.affiliation: Department of Health Sciences, Division of Physiotherapy, Lund University, Lund, Sweden.|Genetic & Molecular Epidemiology Unit, Lund University Diabetes Centre, Clinical Research Centre, Skåne University Hospital, Malmö, Sweden.
authors.forename: Å B
authors.initials: ÅB
authors.lastname: Tornberg
authors.affiliation: Endocrinological and Reproductive Unit, Department of Obstetrics/Gynaecology, Herlev Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: S
authors.initials: S
authors.lastname: Skouby
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark.
authors.forename: S S
authors.initials: SS
authors.lastname: Møller
authors.affiliation: Medical and Endocrinological Unit, Herlev Hospital, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Faber
authors.affiliation: Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
authors.forename: J
authors.initials: J
authors.lastname: Sundgot-Borgen
authors.affiliation: Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Sjödin
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000209:etiology / Q000503:physiopathology*; D056352:Athletes; D004032:Diet / Q000009:adverse effects; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004043:Dietary Fiber; D002149:Energy Intake; D005260:Female; D006801:Humans; D009042:Motivation; D009839:Oligomenorrhea / Q000209:etiology / Q000503:physiopathology*; D010807:Physical Endurance / Q000502:physiology*; D064133:Sports Nutritional Physiological Phenomena; D013851:Thinness / Q000523:psychology; D055815:Young Adult
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004043:Dietary Fiber
keywords: Amenorrhea; dietary fiber; energy availability; energy density