Clinical Trial: Effect of Intense Training on Ovarian Function and Bone Turnover

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Impact of Intense Exercise Training on Energy Availability, Ovarian Function and Bone Turnover in Female Athletes

Brief Summary: The investigators propose a prospective, longitudinal, department funded study protocol to evaluate whether changes in energy availability, during a period of highly intensified exercise training, will increase bone turnover markers and decrease ovarian function and exercise performance, in a dose-dependent fashion in competitive female athletes.

Detailed Summary: Female athletes participating in sports which emphasize leanness as a factor to success, while also imposing large exercise training loads, present a high prevalence of endocrine and metabolic alterations linked to low energy stores, including suppressed ovarian function and bone loss. Increased bone turnover resulting from low energy stores and suppressed estrogen production may hold the most adverse consequences for long term health, increasing the risk of premature osteopenia, while increasing the risk of stress fractures in the short term. Chronically low energy stores may also contribute to the development of overreaching and overtraining syndromes, characterized by excessive, lasting fatigue and long-term decreases in performance, which can compromise these athletes' health and athletic career. The investigators propose the first longitudinal study aiming to demonstrate the link between low energy status, impaired ovarian function, bone turnover and decreased performance in free-living, competitive female athletes. After a 4-week baseline period of habitual training, athletes will undergo 4 weeks of intensified training (IT), during which the exercise load is increased by 30% from their individual baseline load in order to sharply increase energy expenditure. As athletes will be let to freely adjust their food intake, the investigators aim to test the hypothesis that athletes will fail to adjust food intake sufficiently to match energy expenditure, and that the resulting decrease in energy availability (EA, energy intake - energy expenditure from exercise) will influence, in a dose-dependent fashion, the suppression of estrogen production, the increase in bone turnover and the severity of performance decrement. The IT period will then be followed by a 2-week taper (REC), in which exercise training volume will be reduced by 50% from baseline. The investigators will assess whether EA returns to baseline values, and characterize changes in bone turnover during th
Sponsor: USDA, Western Human Nutrition Research Center

Current Primary Outcome: Change in energy availability (energy intake - energy expenditure of physical activity) [ Time Frame: Baseline (week 4), after 4 weeks of intensified training (week 8) and after a two-week recovery period (week 10) ]

The investigators aim to capture the spectrum and variability of energy availability in endurance athletes under normal training conditions, describing in detail training regimen, total energy expenditure and nutrition habits during three distinct phases of training that are habitually followed by endurance athletes.


Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Change in athletic performance [ Time Frame: Baseline (week 4), after 4 weeks of intensified training (week 8) and after a two-week recovery period (week 10) ]
    The investigators will measure the effect of energy availability on exercise performance during baseline, after 4 weeks of intensified training, and after a 2-week recovery, by measuring the relationship of energy availability to maximal oxygen consumption (VO2max) and 3200 meter time trial performance. The investigators will test the hypothesis that performance will be affected by changes in energy availability in a dose-dependent fashion.
  • Change in ovarian function [ Time Frame: Baseline (week 4), after 4 weeks of intensified training (week 8) and after a two-week recovery period (week 10) ]
    The investigators will measure salivary estradiol and progesterone concentrations daily throughout the study, in order to test the hypothesis that ovarian function may be suppressed by intensified training and decreased energy availability.
  • Change in bone turnover markers [ Time Frame: Baseline (week 4), after 4 weeks of intensified training (week 8) and after a two-week recovery period (week 10) ]
    The investigators will measure plasma bone turnover markers during baseline and at the end of the intensified training period, in order to test the hypothesis that bone turnover may be compromised by intensified training and decreased energy availability.


Original Secondary Outcome: Same as current

Information By: USDA, Western Human Nutrition Research Center

Dates:
Date Received: August 21, 2014
Date Started: January 2014
Date Completion:
Last Updated: January 26, 2016
Last Verified: September 2015