Penn State University, University Park, PA, USA.
Penn State University, University Park, PA, USA; Penn State Harrisburg, Middletown, PA, USA.
Psychoneuroendocrinology. 2023 Jun;152:106079. doi: 10.1016/j.psyneuen.2023.106079. Epub 2023 Mar 8.
Disordered eating-related attitudes are a leading cause of energy deficiency and menstrual disturbances in exercising women. Although treatment recommendations include psychological counseling with increases in dietary intake, a key concern is whether increased dietary intake may exacerbate negative eating behaviors.
To determine the effects of a 12-month nutritional intervention on eating-related attitudes and psychological characteristics in exercising women with oligomenorrhea/amenorrhea (Oligo/Amen).
Intent-to-treat analysis of the REFUEL randomized controlled trial (#NCT00392873) in 113 exercising women (age [mean±SEM]:] 21.9 ± 0.4 yrs; BMI: 20.9 ± 0.2 kg/m). Women were randomized to increase energy intake 20-40% above baseline energy needs (Oligo/Amen+Cal, n = 40) or maintain energy intake (Oligo/Amen Control, n = 36) while maintaining their exercise behaviors. A reference group of ovulatory women (OVref, n = 37) maintained diet and exercise behaviors. Body composition, eating attitudes, stress, and depressive symptoms were assessed at baseline and every 3 months.
At baseline, the Oligo/Amen groups had higher drive for thinness, cognitive restraint, and eating disorder risk than OVref group (p < 0.001). Increased energy intake led to increases in percent body fat and fat mass (p < 0.010), but not psychobehavioral outcomes, in the Oligo/Amen+Cal compared to Oligo/Amen Control group. Independent of group, cognitive restraint decreased (p < 0.001) and resilient coping increased (p < 0.007) over 12-months, while perceived stress (p = 0.143) and depressive symptoms (p = 0.344) were unchanged.
Long-term nutritional intervention consisting of modest increases in dietary intake with guidance from a registered dietician and a psychologist increases body and fat mass without increasing disordered eating-related attitudes, stress, or depressive symptoms in exercising women with Oligo/Amen.
饮食相关态度紊乱是导致锻炼女性能量不足和月经紊乱的主要原因。尽管治疗建议包括心理辅导和增加饮食摄入，但一个关键问题是增加饮食摄入是否会加剧负面的饮食行为。
确定为期 12 个月的营养干预对患有少经/闭经（Oligo/Amen）的锻炼女性的饮食相关态度和心理特征的影响。
对#NCT00392873 的 REFUEI 随机对照试验（REFUEL）进行意向治疗分析，共有 113 名锻炼女性（年龄[均值±SEM]：21.9±0.4 岁；BMI：20.9±0.2kg/m）参与。女性被随机分为增加 20-40%基础能量需求以上的能量摄入（Oligo/Amen+Cal，n=40）或保持能量摄入（Oligo/Amen 对照组，n=36），同时保持锻炼行为。排卵女性参考组（OVref，n=37）保持饮食和锻炼行为。在基线和每 3 个月评估身体成分、饮食态度、压力和抑郁症状。
基线时，Oligo/Amen 组比 OVref 组有更高的瘦身欲望、认知控制和饮食失调风险（p<0.001）。与 Oligo/Amen 对照组相比，Oligo/Amen+Cal 组的能量摄入增加导致体脂肪和脂肪量增加（p<0.010），但对心理行为结果没有影响。独立于组，认知控制在 12 个月内下降（p<0.001），适应力应对增加（p<0.007），而感知压力（p=0.143）和抑郁症状（p=0.344）不变。
长期的营养干预包括由注册营养师和心理学家指导的适度增加饮食摄入，增加了身体和脂肪量，而不会增加患有少经/闭经的锻炼女性的饮食相关态度紊乱、压力或抑郁症状。
