Dietary Strategies to Maintain Low Body Weight Include Consumption of Low Energy Dense Foods in Women with Menstrual Disturbances

Open Access
Bowell, Jessica Lynn
Area of Honors:
Bachelor of Science
Document Type:
Thesis Supervisors:
  • Nancy Williams, Thesis Supervisor
  • Stephen Jacob Piazza, Honors Advisor
  • energy density
  • amenorrhea
  • female athlete triad
  • dietary patterns
Previous research has demonstrated that women with exercise associated menstrual cycle disturbances (EAMD) including oligomenorrhea or amenorrhea, display restrictive eating patterns. Energy density is defined as the number of kilocalories (kcal) per gram of food or beverage consumed. Strategies to manipulate energy density to achieve increased satiety by incorporation of low energy dense foods into the diet have been recommended for weight loss in obese individuals. The purpose of this study was to determine whether this same strategy to maintain low caloric intake by consuming foods low in energy density is particularly prominent in exercising women with EAMD. A secondary purpose was to identify what specific food groups are consumed to maintain a diet low in energy density. Volunteers in a cross-sectional study were retrospectively characterized by menstrual status into two groups: (1) EAMD (n=12), including women with amenorrhea, and (2) Ovulatory Controls (OV) (n=13). Two 3-day diet records were collected one month apart and analyzed to calculate energy density and other dietary parameters. Measures of aerobic fitness and body composition were obtained. EAMD and OV were similar with respect to age, age of menarche, gynecological age, BMI, VO2 max, and exercise minutes per week. EAMD had a lower percent body fat (20. 9 ± 1.2%) compared to the OV women (25.7± 1.3%) (p=0.013). EAMD also had a lower total fat mass than OV women (11.6 ± 0.7 vs. 15.3 ± 0.9 kg, respectively; (p=0.005)). Energy intake was lower in EAMD compared to OV women (1663 ± 165 vs. 2187 ± 140 kcals, respectively; (p=0.024)). Diets in EAMD and OV were similar when macronutrient content was compared. Energy density was significantly lower in the EAMD women (0.71 ± 0.06 kcals/gram) compared to the OV women (1.02 ± 0.09) when beverages were included in the calculation (p=0.012), but there was no statistically significant difference in energy density between EAMD (1.07 ± 0.06) and OV women (1.24 ± 0.08) when non-caloric beverages were excluded from the calculation (p=0.098). Vegetable consumption was significantly higher in EAMD compared to OV women (29.6 ± 3.5 vs. 19.3 ± 3.0 servings, respectively; p=0.047), as was condiment consumption (9.2 ± 1.1 vs. 4.4 ± 1.0 servings, respectively; p=0.007). Women with EAMD consume food with lower energy density and likely achieve this lower energy density due to the consumption of non-caloric beverages. These behaviors may represent a strategy to successfully restrict calories and maximize satiety. This study is supported by the U.S. Department of Defense, Army Medical Research and Materiel Command (W81XWH-06-1-0145) and the National Athletic Training Association Foundation Grant #206GGP008