Energetic efficiency, menstrual irregularity, and bone mineral density in elite professional female ballet dancers. 2010

Ashley F Doyle-Lucas, and Jeremy D Akers, and Brenda M Davy
Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA.

Sports that emphasize low body weight for optimal performance, such as ballet, are associated with an increased prevalence of the female athlete triad (FT). Previous research in this area that involves dancers has been limited; the majority of studies have been performed on adolescents training in classical ballet, and not professional adult dancers. The purpose of this study is to compare the physical and behavioral characteristics of female elite ballet dancers to sedentary, recreationally active non-dancing controls, with regard to characteristics of the FT and energetic efficiency. Women aged 18 to 35 years were recruited as participants. The dancers (N = 15) and non-dancing controls (N = 15) were pair-matched via age (dancers: 24.3 ± 1.3 years; controls: 23.7 ± 0.9 years), body mass index (dancers: 18.9 ± 0.2; controls: 19.4 ± 0.2 kg/m 2 ), and fat-free mass (dancers: 44.3 ± 0.8; controls: 44.1 ± 0.9 kg). Assessments included habitual dietary intake using 4-day food records, self-reported physical activity, psychometric measures of eating behaviors, health and menstrual history, body composition and bone density (dual energy x-ray absorptiometry), and resting metabolic rate (RMR) assessed by indirect calorimetry. Characteristics of the FT, specifically menstrual irregularities (6 of 15 dancers reported irregular or no menses; 1 of 15 controls reported irregular menses) and low energy availability, were more prevalent in dancers than in pair-matched controls. Despite having a similar fat-free mass (FFM), dancers had a significantly lower absolute RMR (dancers: 1367 ± 27; controls: 1454 ± 34 kcal/d; p ≤ 0.05) and significantly lower RMR relative to FFM (dancers: 30.9 ± 0.6; controls: 33.1 ± 0.8 kcal/kg fat-free mass/d; p ≤ 0.05). Energy intake between dancers (1577 ± 89 kcal/d) and pair-matched controls (2075 ± 163 kcal/d) also differed significantly (p ≤ 0.01). Six of the 15 dancers met the criteria for the FT (including low bone mineral density, menstrual irregularities, and eating pathology accompanied by low energy availability) and, therefore, represent a population of individuals afflicted with this disorder. These findings provide insight as to the metabolic impact of chronic energy restriction, and suggest that alterations in RMR (i.e., energetic efficiency) may be an indicator of low energy availability. Future larger-scale studies are warranted to address this possibility. Interventions aimed at increasing energy availability in elite female ballet dancers may be needed to promote optimal health status.

UI MeSH Term Description Entries
D008599 Menstruation Disturbances Variations of MENSTRUATION which may be indicative of disease. Hypomenorrhea,Menstruation Disorders,Menstruation, Retrograde,Polymenorrhea,Irregular Menses,Irregular Menstruation,Menstrual Irregularities,Menstrual Irregularity,Disorder, Menstruation,Disorders, Menstruation,Disturbance, Menstruation,Disturbances, Menstruation,Irregularity, Menstrual,Menses, Irregular,Menstruation Disorder,Menstruation Disturbance,Menstruation, Irregular,Retrograde Menstruation
D010024 Osteoporosis Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis (OSTEOPOROSIS, POSTMENOPAUSAL) and age-related or senile osteoporosis. Age-Related Osteoporosis,Bone Loss, Age-Related,Osteoporosis, Age-Related,Osteoporosis, Post-Traumatic,Osteoporosis, Senile,Senile Osteoporosis,Osteoporosis, Involutional,Age Related Osteoporosis,Age-Related Bone Loss,Age-Related Bone Losses,Age-Related Osteoporoses,Bone Loss, Age Related,Bone Losses, Age-Related,Osteoporoses,Osteoporoses, Age-Related,Osteoporoses, Senile,Osteoporosis, Age Related,Osteoporosis, Post Traumatic,Post-Traumatic Osteoporoses,Post-Traumatic Osteoporosis,Senile Osteoporoses
D011628 Puberty, Delayed The lack of development of SEXUAL MATURATION in boys and girls at a chronological age that is 2.5 standard deviations above the mean age at onset of PUBERTY in a population. Delayed puberty can be classified by defects in the hypothalamic LHRH pulse generator, the PITUITARY GLAND, or the GONADS. These patients will undergo spontaneous but delayed puberty whereas patients with SEXUAL INFANTILISM will not. Delayed Puberty
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D001823 Body Composition The relative amounts of various components in the body, such as percentage of body fat. Body Compositions,Composition, Body,Compositions, Body
D002149 Energy Intake Total number of calories taken in daily whether ingested or by parenteral routes. Caloric Intake,Calorie Intake,Intake, Calorie,Intake, Energy
D002153 Calorimetry, Indirect Calculation of the energy expenditure in the form of heat production of the whole body or individual organs based on respiratory gas exchange. Calorimetry, Respiration,Calorimetries, Indirect,Calorimetries, Respiration,Indirect Calorimetries,Indirect Calorimetry,Respiration Calorimetries,Respiration Calorimetry
D003615 Dancing Rhythmic and patterned body movements which are usually performed to music. Ballet,Dance,Hip-Hop Dance,Jazz Dance,Line Dancing,Modern Dance,Salsa Dancing,Square Dance,Tap Dance,Dance, Hip-Hop,Dance, Jazz,Dance, Modern,Dance, Square,Dance, Tap,Dancing, Line,Dancing, Salsa,Hip Hop Dance
D005247 Feeding Behavior Behavioral responses or sequences associated with eating including modes of feeding, rhythmic patterns of eating, and time intervals. Dietary Habits,Eating Behavior,Faith-based Dietary Restrictions,Feeding Patterns,Feeding-Related Behavior,Food Habits,Diet Habits,Eating Habits,Behavior, Eating,Behavior, Feeding,Behavior, Feeding-Related,Behaviors, Eating,Behaviors, Feeding,Behaviors, Feeding-Related,Diet Habit,Dietary Habit,Dietary Restriction, Faith-based,Dietary Restrictions, Faith-based,Eating Behaviors,Eating Habit,Faith based Dietary Restrictions,Faith-based Dietary Restriction,Feeding Behaviors,Feeding Pattern,Feeding Related Behavior,Feeding-Related Behaviors,Food Habit,Habit, Diet,Habit, Dietary,Habit, Eating,Habit, Food,Habits, Diet,Pattern, Feeding,Patterns, Feeding,Restrictions, Faith-based Dietary
D005260 Female Females

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