Reducing Stress Fracture in Physically Active Military Women (1998) / Chapter Skim
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3 Effects of Caloric Intake, Physical Activity and Hormonal Factors on Bone Health
3 Effects of Caloric Intake, Physical Activity and Hormonal Factors on Bone Health
Pages 43-50
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From page 43... ...
In military women, there is cause for concern about hypothalamic amenorrhea due to physical or emotional stress, excessive exercise and/or eating disorders, therapy with gonadotropin-releasing hormone (Gnome agonists for the treatment of endometriosis, and the use of contraceptives that prevent menstruation; all ofthese factors may lower BMD and increase the risk for stress fractures. A decrease in hypothalamic GnRH leads to anovulation and increased bone resorption due to decreased estradiol secretion.
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From page 44... ...
Although exact numbers are not available for the military population, dietary energy restriction to maintain "optimal" body weight is common in the civilian population, and young women entering the military may already be involved in chronic dietary practices that may negatively influence their nutrient and hormonal status and thereby their bone health (IOM, 1998~. Effects of Low Energy Intake on Hormonal Levels and Bone Health The impact of low energy intake on the hormonal milieu in young women of military age is well documented.
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From page 45... ...
. The suppression of T3 and the changes in LH pulsatility occurred at a threshold level of energy availability (operationally defined as dietary energy intake minus exercise energy expenditure)
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From page 46... ...
Incidence of Caloric Restriction and Disordered Eating Patterns in Military Women Because stress fractures occur primarily during basic training, it would be useful to know the dietary practices of women who enter into the military to determine if caloric restriction and disordered eating patterns are related to the incidence of stress fractures. Most reports of diagnosed eating disorders in the civilian population place the incidence of anorexia nervosa at 0.5 to ~ percent by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV, ~ 994)
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From page 47... ...
Hypothalamic Amenorrhea and Bone Health Premature bone demineralization occurs in women with hypothalamic amenorrhea and oligomenorrhea associated with eating disorders and strenuous physical activity. This complex syndrome has been referred to as the female athlete triad (ACSM, ~ 997, Bennel1 et al., ~ 995~.
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From page 48... ...
Possible Effects of Excessive Exercise on Bone Health In general, exercise promotes bone mineralization, but the beneficial effect of exercise on BMD can be lost, and significant bone loss can result if exercise training is excessive (Hergenroeder, 19951. Regular recreational exercise at or above a basic conditioning level does not increase infertility or disturb the menstrual cycle, but abrupt.
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From page 49... ...
Premature bone demineralization occurs in women with hypothalamic amenorrhea and Oligomenorrhea associated with eating disorders as well as with strenuous physical activity. Eating disorders are rare among military women; however, representative data are not available on the prevalence of disordered eating patterns among military women.
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