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Cited by 106Hypothalamic control of reproductive hormonesEating Disorders and BehaviorsMenstrual Health and Disorders

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

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Fahrenholtz, I. L., Sjödin, A., Benardot, D., Tornberg, Å. B., Skouby, S., Faber, J., Sundgot‐Borgen, J. K., Melin, A. K.·2018·Scandinavian Journal of Medicine & Science in Sports
DOI 10.1111/sms.13030
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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, T 3 , 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.

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  • Sufficient energy is crucial for training consistency, particularly during intensified periods, as prolonged energy restriction can lead to impaired physiological function, maladaptation to prescribed training, and an increased risk of fatigue, illness, and injury.

    “It is widely accepted that sufficient energy is crucial for training consistency, particularly during intensified periods, as prolonged energy restriction can lead to impaired physiological function, maladaptation to prescribed training, and an increased risk of fatigue, illness, and injury [61,64,114–116].”

    From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [61]

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Authors
Fahrenholtz, I. L., Sjödin, A., Benardot, D., Tornberg, Å. B., Skouby, S., Faber, J., Sundgot‐Borgen, J. K., & Melin, A. K.
Affiliations
  • University of Copenhagen (DK)
  • Georgia State University (US)
  • Lund University (SE)
  • Norwegian School of Sport Sciences (NO)
Corresponding author
Melin, A. K.
ORCID
Venue
Scandinavian Journal of Medicine & Science in Sports
Publisher
Wiley
Published
2018-02-05
Volume
28
Issue
3
Pages
1139-1146
ISSN
  • 0905-7188 (ISSN-L)
  • 1600-0838
DOI
10.1111/sms.13030
OpenAlex
W2775617072
Cited by
106
References
37
Citations by year
2026: 4 · 2025: 12 · 2024: 12 · 2023: 13 · 2022: 12 · 2021: 11 · 2020: 26 · 2019: 11 · 2018: 5
FWCI
13.34
Type
journal article
Language
en
Open access
Licence
Locations
  • Scandinavian Journal of Medicine and Science in Sports (publishedVersion)
  • PubMed (publishedVersion)
  • Lund University Publications (Lund University) (submittedVersion)
  • NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
Funders
Københavns Universitet
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
Keywords
energy deficiency, menstrual disorders, female endurance athletes, eumenorrhea, resting metabolic rate, estradiol, cortisol, body composition, energy availability, catabolic state, energy expenditure, thyroid hormones, fasting blood glucose, disordered eating, female athlete triad
MeSH terms
Adult, Basal Metabolism, Blood Glucose, Body Composition, Energy Metabolism, Estradiol, Feeding Behavior, Female, Humans, Hydrocortisone, Menstruation, Menstruation Disturbances, Physical Endurance, Saliva, Thyrotropin, Triiodothyronine, Diet Records, Young Adult, Athletes

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