Dietary Cognitive Restraint

Abstract

0219 Dietary cognitive restraint (CR) describes a conscious limitation of food intake in an effort to control body weight. Higher levels of CR have been reported in exercising women with exercise-associated menstrual disturbances (EAMD) when compared to levels in eumenorrheic (EU) active women. PURPOSE: To determine if dietary CR also serves as a marker for altered energy homeostasis in EAMD, since EAMD is also linked to physiological energy conserving adaptations. METHODS: Athletic women of varying activity levels (n = 38) completed the three factor eating questionnaire and the EDI2, and blood samples were obtained during the early follicular phase (days 2–6) of two consecutive menstrual cycles in EU athletes or day 1 of two consecutive 30-day periods in oligo/amenorrheic (O/Amen) athletes. Blood samples for each cycle were assayed for total triiodothyronine (TT3), insulin and leptin and levels for each cycle averaged for each subject. RESULTS: In this study, 18 athletes exhibited high CR (above the cut-off for normal, i.e. > 10), as defined in the original questionnaire, and 20 athletes demonstrated CR scores in the normal range. These groups were similar (p>0.05) with respect to age (24.6±0.8 yrs), height (164.2±9.5 cm), weight (57.3±1.1 kg), percent body fat (22.9±1.0), age of menarche (12.6±0.2 yrs) and VO2 max (44.2±0.9 ml/kg/min). The athletes with high CR (n = 18) had a higher (p<0.001) mean score of 14.3±0.7 compared to the non-CR group (n = 20) who had a mean score of 4.8±0.5. The high CR group also had a higher (p = 0.035) score on the EDI-2 subscale of drive for thinness than the non-CR group, 5.0±1.2 and 1.9±0.8, respectively. TT3 levels were lower (p = 0.023) in the high CR group (1.4±0.08 nmol/L) compared to the non-CR group (1.6±0.08 nmol/L). Insulin levels were lower (p = 0.048) in the high CR group (27.78±2.1 pmol/L) compared to the non-CR group (38.9±4.2 pmol/L). Leptin levels were similar (4.8±1.1 ng/ml, p = 0.28), likely due to similar fat mass (12.7±0.7 g) between the groups. Among the high CR group, 50% had either O/Amen (n = 9/18), whereas, among the non-CR group, 25% had either O/Amen (n = 5/20), demonstrating that high CR was dependent on menstrual status (χ2 = 9.9, p = 0.042). CONCLUSION: These data suggest that high CR is associated with markers of altered energy homeostasis indicating low energy availability, including TT3 and insulin, previously demonstrated to be low in athletic women with EAMD and that menstrual status was associated with high CR. Funded by Arthur Thornton Cardiopulmonary Fund.