The effect of shift work on body mass index: A systematic review and meta-analysis of observational studies.

CONTEXT: Shift work involves working outside the standard working hours of 9 am to 5 pm Monday to Friday and may include working evening, night, weekend, or rotating shift patterns. Since shift workers sleep less and their circadian rhythms are disrupted, they are reported to have higher body weight than day workers. OBJECTIVE: This meta-analysis aims to determine whether shift workers (SW) are more prone to higher body mass index (BMI) than their day workers (DW) counterparts. It also addresses the question of whether the duration of shift work exposure, sex, or occupational type affect BMI value. METHODS: Four databases that is PubMed, EBSCO Host, Scopus, and Web of Science were searched for reports published up to October 2023. RESULTS: Sixty-three studies involving a total of 693 449 participants met our inclusion criteria. Meta-analyses showed a significant effect of shift work on BMI value (standard mean difference; SMD: 0.10 kg/m2 [95% confidence interval; 95% CI: 0.07; 0.13; p < .001]) as compared with non-shift counterparts. Subgroup analysis revealed that shift work significantly increased BMI for studies where male working on this job schedule (SMD: 0.10 kg/m2 [95% CI: 0.04; 0.17; p = .0018]) for studies where shift workers worked ≥13 years (calculated as the median of shift work experience; SMD: 0.14 kg/m2 [95% CI: 0.10; 0.18; p < .001]) as well as for studies where industrial (SMD: 0.12 kg/m2 [95% CI: 0.05; 0.19; p = .0012]) and other type of occupations were dominated (0.12 kg/m2 [95% CI: 0.07; 0.16; p < .001]). CONCLUSIONS: We found that in general working on a shift schedule increases BMI as compared with day workers, especially in case of male employed in this job schedule, for shift workers working for long periods of time (≥13 years), and for shift workers employed in industry and other type of occupations(e.g., airline workers, firefighters, police officers, blue collar, security personnel, bus drivers, garbage collectors, railway workers, postal, oil and gas workers).

A Meta-Analysis of Randomized Controlled Trials of the Effects of Soy Intake on Inflammatory Markers in Postmenopausal Women.

BACKGROUND: Elevated concentrations of serum inflammatory cytokines, specifically TNF-α and IL-6, as well as C-reactive protein (CRP), are commonly observed after menopause. OBJECTIVES: Because soy isoflavones may have some anti-inflammatory potential, the aim of the present systematic review and meta-analysis of randomized controlled trials (RCTs) was to explore whether soy intake affects serum markers of inflammation in postmenopausal women. METHODS: PubMed, Web of Science, and the Cochrane Library were systematically searched up to August 2020. All RCTs that met the following criteria were included: 1) studies of the effects of soy intake on inflammatory markers; 2) any date of publication; 3) conducted on postmenopausal women; 4) with sufficient quantitative data for meta-analysis. Effect sizes were expressed as weighted mean differences (WMDs) and 95% CIs. A total of 24 RCTs assessing the effects of soy intake on serum concentrations of CRP, TNF-α, and IL-6 were included in the analysis. A random-effects model was used to determine the overall effect. RESULTS: Soy supplementation significantly reduced CRP by 0.11 mg/L in postmenopausal women (95% CI: -0.22, -0.004 mg/L; P = 0.0414), but did not affect IL-6 or TNF-α. Significant reductions in CRP concentration occurred when natural soy products were given (WMD: -0.23 mg/L; 95% CI: -0.29, -0.17 mg/L; P < 0.001). This is equivalent to a ∼9% reduction in CRP concentration from baseline. CONCLUSIONS: Although our meta-analysis found evidence that soy products significantly reduce CRP concentrations in postmenopausal women, the mechanisms by which soy foods and their constituents affect inflammatory biomarkers still need to be clarified.This systematic review was registered at www.crd.york.ac.uk/prospero/ as CRD42020179232.

Lactobacillus rhamnosus has no beneficial effect on anthropometric parameters, carbohydrate metabolism and androgen status in women with polycystic ovary syndrome.

The aim of this study was to assess the effect of a twenty-week weight-reducing diet with a low glycemic index and with or without Lactobacillus rhamnosus supplementation on changes in anthropometric, metabolic, and hormonal parameters in women with polycystic ovary syndrome (PCOS). The subjects were assigned to one of two intervention groups: the D group (n = 21) received a weight-reduction diet with a low glycemic index, and the DP group (n = 19) received a weight-reduction diet with a low glycemic index, as well as supplementation with Lactobacillus rhamnosus. Anthropometric, metabolic, and hormonal parameters were evaluated at baseline and after twenty weeks of intervention. After twenty weeks, significant reductions in weight, body mass index, fat mass, and waist circumference were seen in both groups, but no significant differences between the groups were observed. The intervention resulted in changes in glucose assessment after two hours in oral glucose tolerance test and in insulin assessment after two hours in oral glucose tolerance test. In the D group, the testosterone level and free androgen index decreased significantly. In overweight and obese women with PCOS, probiotic supplementation taken alongside a twenty-week low-glycemic-index weight-reduction diet has no additional beneficial effects on anthropometrical parameters, carbohydrate metabolism, or androgen status, compared with the low-glycemic-index weight-reduction diet alone.

Dietary Factors and the Risk of Depression among Women with Polycystic Ovary Syndrome.

This study aimed to assess the association between dietary factors and depression in a group of polycystic ovary syndrome (PCOS) women and to evaluate potential interactions and the mediating role of BMI in this relationship. One hundred and sixteen women with PCOS were asked to complete the Dietary Habits and Nutrition Beliefs Questionnaire and the manual for developing of nutritional data (KomPAN questionnaire) and the Beck Depression Inventory. The population was divided into two groups: (1) not at risk of depression (ND), n = 61, and (2) at risk of depression (RD), n = 55. Significantly higher BMI values were observed in the RD group than in the ND group. In the RD group, the intake of vegetables and legumes was lower than in the LD group, but the consumption of sweet beverages and energy drinks was higher. Consumption of vegetables and legumes at least twice per day is known to be associated with a 62% lower probability of the risk of depression in PCOS women. Furthermore, women with overweight and obesity have a 5.82 times greater chance of depression than women with normal body weight. Our findings show that there is a significant association between certain dietary factors, BMI, and symptoms of depression in PCOS women.

Effects of dietary seaweed on obesity-related metabolic status: a systematic review and meta-analysis of randomized controlled trials.

CONTEXT: Seaweed is a promising source of anti-obesity agents, including polysaccharides, proteins, polyphenols, carotenoids, and n-3 long-chain polyunsaturated fatty acids. The anti-obesity effects of such compounds may be due to several mechanisms, including inhibition of lipid absorption and metabolism, effect on satiety, and inhibition of adipocyte differentiation. OBJECTIVE: The aim of this study was to assess the evidence from human randomized controlled trials for the effects of seaweed on body-weight status as well as lipid and nonlipid parameters in adults with overweight and obesity. DATA SOURCES: Four databases-Medline, Scopus, Web of Science, and Cochrane Library-were searched from December 2022 to June 2023 using the following key words: Seaweed OR fucoxanthin OR alginates OR fucoidans OR phlorotannin's OR macroalgae OR marine algae AND obesity OR overweight OR BMI OR body mass index. DATA EXTRACTION: Eleven interventional studies (10 parallel and 1 crossover) were extracted. DATA ANALYSIS: Meta-analysis showed a significant effect, favoring the intervention group for BMI (body mass index) (standardized mean difference [SMD]: -0.40; 95% CI: -0.65 to -0.16 kg/m2; P = 0.0013) and percentage of fat mass (SMD: -1.48; 95% CI: -2.66% to -0.30%, P = 0.0138). The results were seen when refined or extracted brown seaweed (BMI) or only refined brown seaweed (% fat mass) were administered to participants for at least 8 weeks. Moreover, a significant overall effect of seaweed supplementation on total cholesterol (SMD: -7.72; 95% CI: -12.49 to -2.95 mg/dL; P = 0.0015) and low-density-lipoprotein cholesterol (SMD: -7.33; 95% CI: -11.64 to -3.02 mg/dL; P < 0.001) was noted. Any significant effects of seaweed on glucose metabolism were not shown. CONCLUSION: Edible seaweed supplementation shows potential for managing obesity and disorders of the blood lipid profile when administered to participants for at least 8 weeks. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42022378484 (www.crd.york.ac.uk/PROSPERO).

The effects of time-restricted eating and Ramadan fasting on gut microbiota composition: a systematic review of human and animal studies.

CONTEXT: It is well known that the microbiome undergoes cyclical diurnal rhythms. It has thus been hypothesized that meal timing may affect gut microbial composition, function, and host health. OBJECTIVE: This review aims to examine the effects of time-restricted eating (TRE) and Ramadan fasting (RF) on the composition of the gut microbiota in animal and human studies. The associations between composition of microbiota and host metabolic parameters are also examined. DATA SOURCES: A search was performed on the PubMed, Cochrane, Scopus, and Web of Science databases up to December 31, 2022. The search strategy was performed using the Medical Subject Heading (MeSH) terms "intermittent fasting" and "gastrointestinal microbiome" and the key words "Ramadan fasting" and "microbes." DATA EXTRACTION: Seven human studies (4 TRE and 3 RF) and 9 animal studies (7 TRE, 2 RF-like) were retrieved. DATA ANALYSIS: TRE and RF in human studies lead to an increase in gut microbial community alpha-diversity. In animal studies (both TRE and RF-like), fasting is not associated with improved alpha-diversity, but enhancement of microbial fluctuation is observed, compared with high-fat diet ad libitum groups. Within Firmicutes and Bacteroidetes phyla, no specific direction of changes resulting from fasting are observed in both animals and human. After TRE or RF, a greater abundance of the Faecalibacterium genus is observed in human studies; changes in Lactobacillus abundance are found in animal studies; and increases in Akkermansia are seen both in humans and in animals fed a feed-pellet diet. Only 2 human studies show a beneficial correlation between microbiota changes and host metabolic (HDL cholesterol) or anthropometric parameters (body mass index). CONCLUSIONS: These findings support the importance of both regimens in improving the gut microbiota composition. However, based on results of animal studies, it can be suggested that diet remains the essential factor in forming the microbiota's environment. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42021278918.

Effects of Probiotics Supplementation on Gastrointestinal Symptoms in Athletes: A Systematic Review of Randomized Controlled Trials.

This study examines the effectiveness of probiotic supplementation on gastrointestinal (GI) symptoms, the gut barrier function, and inflammatory markers in athletes based on data from randomised controlled trials. Searches were conducted in PubMed, the Cochrane Library, and the Web of Science up to October 2021. The protocol for this review was registered with PROSPERO (CRD42021284938). Two reviewers independently screened the titles, abstracts, and full texts to identify articles on the influence of probiotics or symbiotics on GI symptoms, gut barrier function, and cytokines, and the quality of the studies was assessed using RoB2. Ten articles involving 822 athletes were included in this review. A single strain Lactobacillus bacteria was used in three studies, seven studies used a Lactobacillus and Bifidobacterium multi-strain cocktail, and one study used this cocktail with a prebiotic. Only slight evidence was found for a positive effect of probiotics on GI symptoms in athletes during training, exercise, and competition, so it was not possible to identify the best product for managing GI symptoms in athletes. Due to the small number of studies, it was also difficult to find a direct association between the reduced exercise-induced perturbations in cytokines, gut barrier function, and GI symptoms after probiotic supplementation.

ß-glucuronidase activity is associated with carbohydrate metabolism but not with androgen status in overweight and obese women with polycystic ovary syndrome.

OBJECTIVES: The aim of this study was to evaluate the relationship between ß-glucuronidase and androgen levels in overweight and obese women with polycystic ovary syndrome (PCOS). The connection between ß-glucuronidase, the abundance of selected gut bacteria, carbohydrate metabolism, and diet quality was also determined. METHODS: This cross-sectional study was conducted with 56 women with a mean age of 29.14 ± 5.11 y and a mean body mass index (BMI) of 34.15 ± 5.72 kg/m2. Anthropometrical parameters, fecal ß-glucosidase activity, and selected food frequency intake were measured. RESULTS: Women with better quality diets, apart from lower BMI and better carbohydrate metabolism parameters, had more abundant Faecalibacterium prausnitzii and Akkermansia muciniphila. Two-hour oral glucose tolerance test (OGTT-2h-glu; mg/dL) was the main predictor of ß-glucuronidase activity and there was no relationship between ß-glucuronidase activity and androgen levels. Non-Healthy Diet Index-14 (nHDI-14) was the main predictor for A. muciniphila, Bifidobacteriu. longum, and F. prausnitzii abundance. QUICKI was a significant predictor of A. muciniphila abundance and OGTT-2h-glu was a significant predictor of F. prausnitzii abundance. CONCLUSION: There was no relationship between ß-glucuronidase activity and androgen levels in overweight and obese women with PCOS, but ß-glucuronidase activity may be an important factor in carbohydrate metabolism. Modulation of the abundances of F. prausnitzii, A. muciniphila, and B. longum using special diets should thus be considered a promising intervention.

Association of diet quality and hormonal status in exercising women with menstrual disturbances.

Diet plays a role in the pathophysiology and treatment of women with hyperandrogenic menstrual disturbances; however, limited research exists examining components of dietary intake in women with subclinical menstrual disturbances. The aim of this investigation was to evaluate the relationship between diet quality and hormonal status in exercising women with menstrual disturbances. Eighty exercising women with ovulatory menstrual cycles (OV; n = 32), women with oligo/amenorrhea without evidence of hyperandrogenism (Oligo/Amen-LowFAI; n = 28), and women with oligo/amenorrhea and evidence of subclinical hyperandrogenism (Oligo/Amen-HighFAI; n = 32) participated in the cross-sectional observational study (Clinical Trial Number: NCT00392873). Self-reported menstrual history, resting energy expenditure, body composition, hormonal and metabolic hormone concentrations determined reproductive and metabolic status. Serum androgens and calculated free androgen index (FAI) determined androgen status. The Diet Quality Index International (DQI-I) and the Dietary Inflammatory Index (DII) evaluated quality of diet. Oligo/Amen-HighFAI group had the highest androgen concentrations (P < 0.05) and lower DQI-I score compared to OV group and Oligo/Amen-LowFAI (P < 0.05). The Oligo/Amen-HighFAI group consumed less of vitamin A, B2, B6, B12, magnesium, and potassium compared to the Oligo/Amen-LowFAI group (all P < 0.05). In the women with menstrual disturbances with subclinically elevated androgens, poor diet quality is related to altered hormonal parameters which may have implications for future nutritional treatment strategies.

[Comparison of eating habits among students according to sex and level of physical activity]. / Porównanie nawyków zywieniowych mlodziezy z uwzglednieniem plci oraz poziomu aktywnosci fizycznej.

The aim of the study was to evaluate nutritional habits of high school students, depending on their sex and physical activity. The investigated population included 147 students in age of 17.5 +/- 1.5 y (girls DZ = 98, boys CH = 49) with different level of physical activity (athletes SPO, moderate physical activity UAF, low physical activity NAF). Nutritional data were obtained by FFQ and calculated for selected food-groups and generally as young healthy eating index YHEI. International IPAQ was used to determine the level of physical activity and anthropometric measured were conducted to estimated BMI and body fat status. It was indicated the YHEI in athletes was significantly higher (p < 0.05) compared to rest of students. Moreover, a significant difference (p < 0.05) in YHEI in DZ compared to CH was also found. The significant differences (p < 0.05) in the frequency of consumption of red meat, vegetable oil and sweetned drinks was revealed between DZ and CH adolescents. The frequency of consumption of vegetable oil, fast - foods, sweets, alcoholic drinks, energy drinks and isotonic drinks varied with the level of physical activity. Frequency of consumption of sweets negatively correlated with skinfold thickness in DZ, whereas positive correlation between consumption frequency of energy drinks, BMI and skinfold thickness was found in CH. The results show, that nutritional habits of the athletes was most approached to nutritional guidelines. CH, nutritional habits may predicted to overweight and obesity in CH group more distinctly than in DZ group.

Probiotic Supplementation and Respiratory Infection and Immune Function in Athletes: Systematic Review and Meta-Analysis of Randomized Controlled Trials.

OBJECTIVE: To evaluate the effectiveness of probiotic supplementation on upper respiratory tract infection (URTI) and inflammatory markers in elite athletes. DATA SOURCES: We searched the PubMed, EBSCOhost, Scopus, and Web of Science databases using the following terms: probiotic OR probiotics AND exercise OR sport OR athletes AND URTI OR respiratory infection OR URTIs OR inflammation OR inflammatory OR cytokines. STUDY SELECTION: We screened the titles and abstracts of 2498 articles using our inclusion criteria. A total of 14 articles were selected for further analysis. DATA EXTRACTION: For each study, 2 independent reviewers extracted the study design, participant characteristics, inclusion and exclusion criteria, intervention characteristics, outcome measures, and main results. DATA SYNTHESIS: We did not observe an effect of probiotic supplementation on the number of days of illness or the mean number or duration of URTI episodes but did note an effect of probiotic supplementation on the total symptom severity score (-0.65; 95% CI = -1.05, -0.25; P = .02). Lower levels of interleukin 6 (-2.52 pg/mL; 95% CI = -4.39, -0.66 pg/mL; P = .002) and tumor necrosis factor α (-2.31 pg/mL; 95% CI = -4.12, -0.51 pg/mL; P = .01) were also reported after supplementation. CONCLUSIONS: This meta-analysis provides evidence that probiotic supplementation, especially among professional athletes, is an effective way to decrease the total URTI symptom severity score. In addition, probiotic supplementation may decrease interleukin 6 and tumor necrosis factor α levels. More studies involving larger groups are needed to better assess this effect. The optimal timing, duration, composition, and dose of such supplementation need to be determined.

Improvement of glucose metabolism in pregnant women through probiotic supplementation depends on gestational diabetes status: meta-analysis.

The aim of this study was to assess the effects of probiotic and synbiotic supplementation on glucose metabolism in pregnant women using data from randomized controlled trials. Furthermore, this meta-analysis examines whether the observed effects depend on the presence or absence of gestational diabetes mellitus (GDM), and if the effect is dependent on the type of supplement used (probiotic or synbiotic). We performed a literature search of databases (Medline, Scopus, Web of Knowledge, and Cochrane Library) and identified all relevant randomized controlled trials (RCTs) published prior to May 2019. We compared the effects of probiotic supplementation with the administration of placebos in pregnant women with and without GDM. The systematic review and meta-analysis protocol were registered in the International Prospective Register of Systematic Reviews as number CRD 42019111467. 1119 study participants from 15 selected studies were included. The participants in four studies did not have GDM (being recruited to the study before week 20 of pregnancy) and the participants in the rest of the studies were diagnosed with GDM between weeks 24 and 28 of gestation. The meta-analysis showed that supplementation lowers serum glucose, insulin levels, and HOMA-IR index, but only in pregnant women with GDM. Moreover, both probiotics and synbiotics lower serum insulin level and HOMA-IR index, but the glucose lowering effect is specific only to probiotics and not synbiotics. Probiotic supplementation may improve glucose metabolism in pregnant women with GDM. There is a need for more RCT studies with larger groups to better estimate this effect.

The Relationship between Vitamin D Status and the Menstrual Cycle in Young Women: A Preliminary Study.

BACKGROUND: The aim of this study was to evaluate serum vitamin D levels and to compare these with the menstrual cycle in young women with different body weights. METHODS: Eighty-four students were recruited into the study of which 77 remained at the study's completion. Women were assigned to one of two subgroups, according to their 25-hydroxy vitamin D test level [25(OH)D] in which 60 women had low 25(OH)D levels (LD < 30 ng/mL) and 17 had normal levels (ND > 30 ng/mL ≤ 80 ng/mL). RESULTS: In the LD group, 40% of participants reported having long cycles, 27% were classified as having oligomenorrhoea, and 13% as having amenorrhoea. In the ND group, only 12% reported menstrual cycle disorders, 6% had oligomenorrhoea, and 6% had amenorrhoea. Women who did not meet the recommended level of 30 ng/mL of 25(OH)D had almost five times the odds of having menstrual cycle disorders as women who were above the recommended vitamin D level. CONCLUSION: A relationship was demonstrated between the frequency of menstrual disorders and low levels of vitamin D. Supplementation is necessary in women with low levels of vitamin D in order to compensate for this deficiency and to assess its effect in regulating menstrual disorders.

The Role of Vitamin D Oral Supplementation in Insulin Resistance in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

OBJECTIVE: To evaluate the effect of vitamin D supplementation (alone or with co-supplementation) on insulin resistance in patients with polycystic ovary syndrome (PCOS). METHODS: We performed a literature search of databases (Medline, Scopus, Web of Knowledge, Cochrane Library) and identified all reports of randomized controlled trials (RCTs) published prior to April 2018. We compared the effects of supplementation with vitamin D alone (dose from 1000 IU/d to 60,000 IU/week) or with co-supplements to the administration of placebos in women diagnosed with PCOS. The systematic review and meta-analysis protocol was registered in the International Prospective Register of Systematic Reviews (Prospero) as number CRD42018090572. MAIN RESULTS: Eleven of 345 identified studies were included in the analysis; these involved 601women diagnosed with PCOS. Vitamin D as a co-supplement was found to significantly decrease fasting glucose concentrations and the HOMA-IR value. HOMA-IR also declined significantly when vitamin D was supplemented with a dose lower than 4000 IU/d. CONCLUSIONS: Evidence from RCTs suggests that the supplementation of PCOS patients with continuous low doses of vitamin D (<4000 IU/d) or supplementation with vitamin D as a co-supplement may improve insulin sensitivity in terms of the fasting glucose concentration (supplementation with vitamin D in combination with other micronutrients) and HOMA-IR (supplementation with vitamin D in continuous low daily doses or as co-supplement).

Comparison of anthropometrical parameters and dietary habits of young women with and without menstrual disorders.

AIM: The aim of this study was to assess the nutritional status and dietary habits of young women, in order to explore their relationship with the menstrual cycle and to determine the proportion of women with menstrual cycle irregularities. METHODS: A total of 348 young women aged 15-25 years (19.7 ± 3.7 years) participated in the study and were assigned to a younger group (15-18 years; YG) or an older group (19-25 years; OG). Two subgroups were also distinguished: women with menstrual disorders (MD) and women with regular cycles (RC). Body mass, waist circumference, fat mass (FM), energy and nutrient intakes, and eating behaviour of the subjects were evaluated. RESULTS: In both age groups, women with menstrual cycle disorders were more likely to have higher body weight, higher body mass index, larger waist circumference and higher body FM. The daily diets of these women contained larger quantities of animal protein and fat, including saturated fat (in OG), but were poorer in vitamins B1 and B6 (in YG) and in iron. Disinhibition was significantly more common in the MD group. CONCLUSIONS: The results of this study suggest that nutritional habits and status can interfere with the course of the menstrual cycle in young women.

Testosterone concentrations in female athletes and ballet dancers with menstrual disorders.

Menstrual disorders are common among female athletes and ballet dancers. Endocrine changes, such as high testosterone (HT) levels and high luteinizing hormone (LH)/follicle-stimulating hormone (FSH) ratios, may suggest functional ovarian hyperandrogenism which may induce such dysfunction. The aim of this study was therefore to evaluate endocrine status in female athletes and ballet dancers with menstrual disorders. Their nutritional status and dietary habits were analysed in relation to the testosterone levels. In a cross-sectional approach, 31 female athletes (18.1 ± 2.6 years) and 21 ballerinas (17.1 ± 0.9) with menstrual disorders participated in the study. The levels of serum LH, FSH, progesterone (P), estradiol (E2), prolactin (PRL), thyroid-stimulating hormone, testosterone (T) and sex hormone-binding globulinwere measured to assess hormonal status. In addition, the free androgen index (FAI) was calculated. Nutritional status, total daily energy expenditure and nutritional habits were evaluated. Girls were assigned to one of the following groups: low testosterone (LT) level, normal testosterone level or HT level. There were significant differences between ballerinas and other female athletes in terms of testosterone levels, FAI, age at the beginning of training, length of training period and age at menarche. The PRL level was lowest in the LT group while the FAI index was highest in the HT group. Daily energy and carbohydrate intakes were significantly lower in the HT group. T levels in the study subjects were found to be associated with nutritional factors, energy availability, age at the beginning of training and frequency of training. This is the first report of HT levels being associated with the status of a female ballet dancer, the age of menarche and the length of the training history. Further research is necessary to confirm the results in a larger study group.

Nine-month nutritional intervention improves restoration of menses in young female athletes and ballet dancers.

BACKGROUND: We hypothesized that an intervention designed to increase the energy and nutrient intake could serve as an efficacious method to restore normal menstrual functions in athletes and ballet dancers. METHODS: In this study, a 9-month nutritional intervention (NI) was conducted in 21 dancers and 31 athletes with menstrual disorders. Analyses of the body composition were performed, and the levels of LH, FSH, P, E2, TSH, T, PRL, SHBG, leptin, resting metabolic rate (RMR), energy and nutrient intake, total energy expenditure were estimated. The NI was based on an individual diet. The effects of the NI were controlled after 3, 6 and 9 months of use. RESULTS: The NI resulted in a significant change of the energy and nutrient intake. After 9 months, a significant increase in the LH level among dancers was observed, while in female athletes this effect was seen after 3 months of the NI use. The 9-month NI resulted in the restoration of regular menses in 3 dancers and 7 athletes, respectively. Women with regular cycles had a higher percentage of the fat mass (FM). CONCLUSIONS: A non-pharmacological intervention in female athletes and ballet dancers with menstrual disorders can restore regular menstrual cycles, although restoration of menses may take more than 1 year. An increase in the body fat mass may be one of the most important predictors of restoration of menses.

Effects of dietary intervention in young female athletes with menstrual disorders.

BACKGROUND: The aim of this study was to evaluate the influence of three months of dietary intervention on menstrual cycle in young female athletes with amenorrhea or oligomenorrhea. METHODS: From forty-five female professional athletes with menstrual irregularity that were recruited thirty-one, aged 18.1 ± 2.6 years, completed the study and were analyzed. Hyperprolactinemia, thyroid dysfunction, primary ovarian failure and hyperandrogenism were excluded in the study participants. The subjects started intense training at the age of 11.2 ± 3.5 years and continued during next 6.8 ± 3.3 years. Energy and nutrients intake, total energy expenditure, energy availability and body composition as well as serum concentrations of LH, FSH, 17 - beta estradiol and progesterone were measured at the beginning of the study and after three months of individualized dietary intervention. RESULTS: Following three months of dietary intervention significant increase in energy intake (2354 ± 539 vs. 258 8 ± 557 kcal, P = 0.004) and energy availability (28.3 ± 9.2 vs. 35.8 ± 12.3 kcal/kg FFM/d, P = 0.011) was observed as well as improved energy balance (-288 ± 477 vs. -51 ± 224 kcal/d, P = 0.002). Though no changes in BMI and body composition were noted but significant rise in LH concentrations (3.04 ± 1.63 vs. 4.59 ± 2.53 mIU/ml, P = 0.009) and LH to FSH ratio (0.84 ± 0.56 vs. 0.96 ± 0.52, P = 0.001) was achieved, but no restoration of menstrual cyclicity. CONCLUSIONS: This report provides further support for the role of energy deficiency in menstrual disorders among young female athletes and the benefits of an adequate energy intake and energy availability on hormones concentration. Continuation controlled dietary intervention is needed to assess the extent to which long-term improvement in the nutritional status results in improvements in the hormonal status of female athletes, to an extent that would allow the regulation of the menstrual cyclity.