Increased Calorie Intake to Reverse Energy Deficiency in Exercising Women: Impact on Bone and Menstrual Cyclicity



Status:Completed
Conditions:Women's Studies
Therapuetic Areas:Reproductive
Healthy:No
Age Range:18 - 35
Updated:11/8/2014
Start Date:September 2006
End Date:September 2012
Contact:Darcy Gungor, M.Sc.
Email:deg182@psu.edu
Phone:814-867-2294

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"REFUEL" Active Women's Study II: Increased Caloric Intake to Reverse Energy Deficiency in Exercising Women: Impact on Bone and Menstrual Cyclicity

The purpose of this study is to examine the effects of increased food intake on the
menstrual cycle and bone health in physically active women who have irregular or absent
menstrual cycles. This study will examine whether a 12 month period of increased food
intake will cause menstrual cycles to resume and help bones get stronger.

Low levels of estrogen found in physically active, premenopausal women with irregular or
absent menstrual periods is likely caused by insufficient energy (calorie) intake compared
to energy expenditure. Premenopausal women with menstrual disturbances and amenorrhea suffer
from reductions in bone mineral density, particularly in the lumbar spine. Bone loss
observed in amenorrheic women may be serious enough to result in osteoporotic fractures, but
is also associated with a high prevalence of stress fractures. Increased calorie intake
should help improve energy status, menstrual status, and bone health.

Comparison: Premenopausal women with irregular or absent menstrual periods will be assigned
to either receive additional calories or serve as controls. A group of premenopausal women
with normal menstrual periods will also be used for comparison.

Inclusion Criteria for Ovulatory Control Volunteers:

- 18-35 years

- BMI 16-25 kg/m2

- At least 2 hr/wk of aerobic exercise

- Gynecological age >/= 5 years

- Weight stable (+/- 2 kg) last 6 months

- History of regular menses for 6 months

Inclusion Criteria for Women with Irregular or Absent Menses:

- 18-35 years

- BMI 16-25 kg/m2

- At least 3 hr/wk of aerobic exercise

- Gynecological age >/= 5 years

- Weight stable (+/- 2 kg) last 6 months

- No menses within past 3 months or 6 or less menses in last 12 months

- Low to normal bone mass (L1-L4 Z score
Exclusion Criteria for all participants:

- Hormonal contraceptives in last 6 months

- Smoking currently

- Current clinical diagnosis of an eating disorder

- Use of medications incompatible with measurement of reproductive or metabolic
hormones, including thyroid medications that may interfere with any of the study
outcomes.

- Dietary habits incompatible with prescribed diet for study

- Any metabolic, reproductive or bone disease

- Sedentary individuals with less than 120 minutes (2 hrs) of activity per week
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