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This study presents the diet and exercise strategies of a world-class bodybuilder during an 8-week precompetition period. Weighed food records were kept daily, and body fat, resting metabolic rate (RMR), ${\text{VO}}_2\max$ , blood lipids, and liver enzymes were measured. Two hrs of aerobic exercise and 3 hrs of weight training were done daily 6 daystweek. Mean energy intake was 4,952 kcallday (54 kcallkg) and included 1,278 kcallday from mediumchain triglycerides (MCT). Diet without MCT provided 76% of energy from carbohydrate, 19% from protein (1.9 g proteiag), and 5% from fat. Micronutrients were consumed at ≥ 100% of the RDA, except for zinc and calcium, without supplementation. Mean RMR was 2,098 kcallday and represented 43% of energy intake. ${\text{VO}}_2\max$ was 53 ml.kg⁻¹.min⁻¹. Underwater weighing showed that body fat decreased from 9% to 7%. Blood lipids were normal, but two liver enzymes were elevated (alanine and aspartate aminotransferase). This world-class bodybuilder achieved body fat goals by following a nutrient dense, high energy, high carbohydrate diet and an exercise program that emphasized both aerobic and anaerobic metabolism.

Studies examining the effects of diet (D) and diet-plus-exercise (DE) programs on resting metabolic rate (RMR) report equivocal results. The purpose of this study was to use meta-analysis to determine if exercise prevents the decrease in RMR observed with dieting. Results from the 22 studies included in this analysis revealed that the majority of studies used female subjects ages 31-45 years, who were fed a relatively low-fat, high-carbohydrate diet of less than 5,023 kJ · day¹. The predominant prescribed exercise was aerobic in nature, 31-60 min in duration, performed 4-5 days per week, and of moderate intensity (51-70% of ${\text{VO}}_{2\max }$ ). Contrary to what is reported in narrative reviews, RMR decreased significantly with both D and DE programs, and the drop with D was significantly greater than that with DE. In conclusion, the addition of exercise to dietary restriction appears to prevent some of the decrease in RMR observed in premenopausal women.

The cessation of menstrual function in the female athlete may reflect her inability to adapt to the environmental and lifestyle stressors associated with training and competition. As society's emphasis on thinness, dieting, and exercise continues to increase, so will the incidence of menstrual dysfunction in active females. Unfortunately, some individuals view athletic menstrual dysfunction as a benign consequence of strenuous exercise. Conversely, it is most likely a strong indicator of overtraining and a marker for future decrements in performance, and it can have long-term health consequences. Thus, it is imperative that the active female be appropriately educated regarding the adverse consequences of menstrual dysfunction and the interventions available. This paper focuses on the most current information regarding athletic menstrual dysfunction and its multifactorial etiology, especially the role of energy drain. In addition, common misconceptions, adverse health and performance effects, and available treatment options are discussed.

The resting metabolic rate (RMR) and thermic effect of a meal (TEM) were determined in 13 low-energy intake (LOW) and 11 adequate-energy intake (ADQ) male endurance athletes. The LOW athletes reported eating 1,490 kcal·day^-1 less than the ADQ group, while the activity level of both groups was similar. Despite these differences, both groups had a similar fat-free mass (FFM) and had been weight stable for at least 2 years. The RMR was significantly lower (p<0.05) in the LOW group compared to the values of the ADQ group (1.19 vs. 1.29 kcal·FFM^-1·hr^-l, respectively); this difference represents a lower resting expenditure of 158 kcal·day^-1. No differences were found in TEM between the two groups. These results suggest that a lower RMR is one mechanism that contributes to weight maintenance in a group of low- versus adequate-energy intake male athletes.

It is hypothesized that exercise-related menstrual dysfunction (ExMD) results from low energy availability (EA), defined as energy intake (EI)—exercise energy expenditure (EEE). When EI is too low, resting metabolic rate (RMR) may be reduced to conserve energy.

The purpose of this study was to determine the effect of a 15-week diet and exercise intervention program on energy balance, hormonal profiles, body composition, and menstrual function of an amenorrheic endurance athlete. The intervention program reduced training 1 day/week and included the use of a sport nutrition beverage providing 360 kcal/day. Three eumenorrheic athletes served as a comparison group and were monitored over the same 15-week period. The amenorrheic athlete experienced a transition from negative to positive energy balance, increased body fat from 8.2 to 14.4%, increased fasting luteinizing hormone (LH) from 3.9 to 7.3 mlU/ml, and decreased fasting cortisol from 41.2 to 33.2 pg/dl. The eumenorrheic subjects showed a 0.4% reduction in body fat, a decrease in follicular phase levels of LH from 7.9 to 6.5 mlU/ml, and no change in cortisol. These results suggest that nonpharmacological treatment can contribute to reestablishing normal hormonal profiles and menstrual cyclicity in amenorrheic athletes.

Chronic energy deficit is one of the strongest factors contributing to exercise-induced menstrual dysfunction. In such cases, macro- and micronutrient intakes may also be low. This study presents the results of a diet and exercise training intervention program, designed to reverse athletic amenorrhea, on improving energy balance and nutritional status in 4 amenorrheic athletes. The 20-week program provided a daily sport nutrition supplement and 1 day of rest/week. The intervention improved self-reported energy intake (El) and balance in all participants. The program increased protein intakes for the 3 athletes with a protein deficit to within the recommended levels for active individuals. Micronutrient intakes increased, as did serum concentrations of vitamin B12, folate, zinc, iron, and ferritin. These results indicate that some amenorrheic athletes have poor nutritional status due to restricted Els and poor food selections. A sport nutrition supplement may improve energy balance and nutritional status in active amenorrheic women.