PERFORMANCE AND HEALTH ENHANCED BY DIET

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得主要资金， 因此可以在其他CRISP条目中表示。列出的机构是 研究中心，而研究中心不一定是研究者所在的机构。 据记载，女性运动员三联症在运动女性中的患病率范围为月经紊乱1-44%，饮食失调2-66%，骨质疏松症和骨质减少分别为6%和48%。女性运动员的骨质流失与应力性骨折和髋关节和脊柱骨折的风险增加有关。三联症的病因涉及慢性能量缺乏和由此产生的适应性变化，即，循环代谢激素和静息能量消耗减少，产生低代谢状态。慢性能量缺乏是一个公认的抑制生殖功能的因素，最近，在amphorheic运动员的骨质流失已直接与这些代谢变化，以及独立的雌激素状态受损的影响。虽然慢性能量缺乏症在月经失调的女运动员中有很好的记录，但其对力量，功率，心肺耐力和特定运动表现的影响尚未得到研究。同样，逆转能量不足是否会改善性能也是未知的。鉴于女性运动员三联症对健康的负面影响和对成绩的潜在影响，有必要进行研究，探讨扭转这些负面结果的策略。目前，还没有建立的指南，以扭转能量缺乏和恢复月经功能的amphilanthropic运动员。本研究的总体目标是检查是否在amphilanthropic运动员的能量缺乏的逆转将产生显着的健康和性能的结果。我们将测试6个月的每日热量补充是否a）逆转能量缺乏，B）恢复月经功能，c）导致骨转换生化标志物的有利变化，以及d）与显著改善的身体表现相关。 在18-35岁的运动女性中进行了一项随机前瞻性研究，筛选期为2周，随后为4周基线和6个月干预期。 两周以上的筛选程序将包括功能性下丘脑性闭经的激素和月经史记录、体重和成分评估、饮食和体力活动。四周内的基线程序将包括 用于T3、胃饥饿素、P1 NP的空腹血液样品，用于uCTX的第二次晨尿收集，3天饮食日志，24小时能量消耗的测量（RT 3加速计），身体组成和骨密度（DXA）的评估，以及肌肉力量、耐力、力量、心肺耐力和运动特定任务的测试。然后，干预受试者将开始通过食用运动补充剂将饮食摄入量增加至正常卡路里摄入量的20-30%，持续6个月，而对照组将保持其常规饮食。所有测量将在研究中期和研究后重复进行。 我们预期增加膳食摄入将导致a）能量缺乏的逆转，B）月经的恢复，c）骨转换的有利变化，和d）身体表现的显著改善。将对照组和干预组受试者的前后数据进行比较，重复测量采用ANOVA。 如果我们的结果是积极的，这些信息可以用来为教练，运动教练和运动员自己制定实用的饮食指南，从而改善绝经前运动妇女的健康和表现。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The prevalence of Female Athlete Triad disorders in exercising women has been documented to range from 1-44% for menstrual disorders, 2-66% for disordered eating and 6 and 48% for osteoporosis and osteopenia, respectively. Bone loss in female athletes is associated with an increased risk of stress fractures and fractures of the hip and spine. The etiology of Triad disorders involves chronic energy deficiency and resulting adaptive changes, i.e., reductions in circulating metabolic hormones and resting energy expenditure, producing a hypometabolic state. Chronic energy deficiency is a well recognized factor in the suppression of reproductive function, and recently, bone loss in amenorrheic athletes has been directly linked to these metabolic changes as well, an effect independent of compromised estrogen status. Although chronic energy deficiency is well documented in female athletes with menstrual disturbances, its effects on strength, power, cardiorespiratory endurance, and specific sport performance have not been examined. Similarly, whether reversing energy deficiency will improve performance is not known. Given the negative health consequences and potential impact on performance of Female Athlete Triad disorders, studies are necessary that examine strategies to reverse these negative outcomes. Currently, there are no established guidelines for reversing energy deficiency and restoring menstrual function in amenorrheic athletes. The overall goal of this study is to examine whether the reversal of energy deficiency in amenorrheic athletes will produce significant health and performance outcomes. We will test whether 6 months of daily calorie supplementation will a) reverse energy deficiency, b) restore menstrual function, c) lead to favorable changes in biochemical markers of bone turnover, and d) be associated with significantly improved physical performance. A randomized prospective study in exercising women aged 18-35 yrs is proposed with a 2 week screening period followed by a 4 week baseline and 6 month intervention period. Screening procedures over two weeks will include hormonal and menstrual history documentation of functional hypothalamic amenorrhea, assessments of body weight and composition, diet and physical activity. Baseline procedures over four weeks will include fasting blood samples for T3, ghrelin, P1NP, 2nd morning void urine collections for uCTX, a 3-day diet log, measurement of 24 hour energy expenditure (RT3 accelerometer), assessment of body composition and bone density (DXA), and testing for muscular strength, endurance, power, cardiorespiratory endurance, and a sport specific task. Intervention subjects will then begin increasing dietary intake by 20-30% of eucaloric intake by consuming sports supplements for 6 months, while controls will maintain their usual diet. All measures will be repeated at mid and post-study points. We expect that increased dietary intake will lead to a) reversal of energy deficiency, b) restoration of menses, c) favorable changes in bone turnover, and d) significant improvement in physical performance. Data will be compared pre and post for controls and intervention subjects with ANOVA for repeated measures. If our results are positive, the information could be used to develop practical dietary guidelines for coaches, athletic trainers and athletes themselves, therefore improving health and performance in premenopausal exercising women.