Comparison Of Dietary Energy Density Between Active Women With And Without Exercise-Associated Menstrual Dysfunction (ExMD)

Abstract

A primary contributor to ExMD in active women is low energy availability, due to insufficient energy intake to match exercise energy expenditure. Many active women are also health conscious; thus, they may self-select foods lower in energy density (ED) and inadvertently contribute to inadequate energy intake. PURPOSE: To determine if active women with ExMD consume a diet lower in ED compared to eumenorrheic [EU] active controls. METHODS: Active women with and without ExMD were recruited (ExMD: n=9, age=24±6y; EU: n=18, age=27±6y). ED was calculated from 6-7d weighed food records: Method 1 included all beverages (e.g. juice, milk, soda, coffee, tea, alcohol, sport drinks) except for water; Method 2 included only food and liquid meal-replacement beverages, all other beverages excluded. Use of sport foods (SF), excluding sport beverages, was also examined: low-SF users (≤5% kcals/d) and high-SF users (≥5% kcal/d). Group ED comparisons were done using one-sided unpaired t-tests; one-way ANOVA for other variables. RESULTS: Groups did not differ for dietary ED. Overall, the mean ED was 10% lower in the ExMD group for both methods (Method 1: ExMD=1.13±0.17 kcal/g, EU=1.28±0.28 kcal/g; Method 2: ExMD= 1.57±0.25 kcal/g, EU=1.75±0.26 kcal/g) (adjusted p=0.098). A 10% decreased in ED translated to a 9% decrease in energy intake. Using Method 1, 100% of ExMD vs. 67% of EU consumed a low-ED diet. Using Method 2, 44% of ExMD vs. 11% of EU consumed a low-ED diet. Energy (ExMD=2237±378 kcal/d; EU=2456±470 kcal/d) and macronutrient intakes (g/kg and % of energy) did not differ between groups. ED was similar between low-SF (1.72±0.28 kcal/g) and high-SF (1.60±0.19 kcal/g) users. CONCLUSION: Regardless of the ED method, ED did not differ between groups. While not significant, ED was 10% lower in ExMD group, which resulted in a 9% decrease in energy intake. This energy difference could contribute to lower energy availability and contribute to ExMD. The relationship between ED and energy intake observed here is consistent with the research literature. ED did not differ between low-SF and high-SF users. Further research needs to examine the interaction of dietary ED and exercise on appetite and energy intake in active women, especially those in lean-build sports. Supported by GSSI Grand (OSU-J12850) and OSU AES Fund.