PERFORMANCE AND HEALTH ENHANCED BY DIET

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 女性运动员三合会障碍在锻炼女性中的患病率被记录为月经紊乱的1-44%，饮食紊乱的2-66%，骨质疏松症和骨量减少的6%和48%。女性运动员的骨质丢失与髋部和脊柱应力性骨折和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引起的适应性变化，即循环代谢激素和静息能量消耗的减少，从而产生低代谢状态。慢性能量缺乏是公认的生殖功能抑制因素，最近，闭经运动员的骨丢失也与这些代谢变化直接相关，这种影响不依赖于雌激素状态的影响。虽然慢性能量缺乏在月经紊乱的女运动员中得到了很好的记录，但它对力量、力量、心肺耐力和特定运动表现的影响还没有被研究过。同样，扭转能源短缺是否会改善业绩也不得而知。鉴于女性运动员三合会障碍对健康的负面影响和对成绩的潜在影响，有必要进行研究，研究扭转这些负面后果的策略。目前，对于闭经运动员扭转能量缺乏和恢复月经功能还没有既定的指导方针。这项研究的总体目标是检查闭经运动员能量不足的逆转是否会产生显着的健康和成绩结果。我们将测试每天补充6个月的卡路里是否会a)扭转能量缺乏，b)恢复月经功能，c)导致骨转换的生化标记物的有利变化，以及c)与显著改善体能有关。一项针对18-35岁锻炼女性的随机前瞻性研究被提出，筛查期为2周，基线为4周，干预期为6个月。超过两周的筛查程序将包括荷尔蒙和月经史，功能性下丘脑闭经的记录，体重和成分的评估，饮食和体力活动。四周的基线程序将包括禁食血样T3、Ghrelin、P1NP、第二天清晨收集uCTX的无效尿液、3天饮食记录、测量24小时能量消耗(RT3加速计)、评估身体成分和骨密度(DXA)，以及肌肉力量、耐力、力量、心肺耐力测试，以及一项特定运动任务。然后，干预受试者将开始通过连续6个月的运动补充剂将膳食摄入量增加20%-30%，而对照组将维持他们通常的饮食。所有措施将在学习中期和学习后重复进行。我们预计，增加饮食摄入量将导致a)能量缺乏的逆转，b)月经的恢复，c)骨转换的有利变化，以及d)体能的显著改善。对照和干预受试者的数据将在前后进行比较，重复测量采用方差分析。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，从而改善绝经前锻炼女性的健康和表现。

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 c) 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.