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Donna Beshgetoor and Jeanne F. Nichols

This study compared the dietary intakes of supplementing (SA) and non-supplementing athletes (NSA). Twenty-five female master athletes (mean age = 50.4 yr) participated in the study (SA = 16, NSA = 9). Four-day diet records were analyzed using Nutritionist V. Statistical significance (p < .005) was determined by independent t tests. No significant differences were observed in intakes of kilocalories (SA = 2079 ± 628 kcals, NSA = 2001 ± 435 kcals), protein (SA = 104 ± 75 g, NSA = 84 ± 35 g), fat (SA = 65 ± 39 g, NSA = 61 ± 22 g), or carbohydrates (SA = 269 ± 112 g, NSA = 277 ± 43 g). Mean intakes exceeded Dietary Reference Intake (DRI) guidelines for all micro-nutrients except calcium and vitamin E (NSA = 79% and 87% of DRI, respectively). SA had significantly greater total intakes than NSA for calcium (p = .0001), magnesium (p = .004), vitamin C (p = .003), and vitamin E (p = .001). Results suggest that female master athletes may rely on dietary supplements rather than nutrient-dense food choices to provide daily nutritional needs.

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Donna Beshgetoor, Jeanne F. Nichols, and Inah Rego

The focus of this prospective, observational study was to determine the effect of sport-specific training and calcium intake on bone mineral density (BMD) in female master cyclists, runners and non-athletes. Thirty women (12 cyclists, 9 runners, 9 controls), mean age of 49.6 ±7.9 years, were assessed at baseline and 18 months for calcium intake (4-day records), current exercise activity (recall questionnaire), and BMD of the lumbar spine and hip (DXA). A three (cyclists, runners, controls) by two (0 and 18 months) repeated measures ANOVA demonstrated a significant interaction effect of sport and time at the femoral neck (p < .04). Tukey post hoc analysis indicated that the BMD of the femur was maintained in cyclists and runners but declined in controls (p < .05). A significant time effect was noted in BMD at the lumbar spine (p < .001) and the trochanter (p < .003). BMD of the lumbar spine was maintained in runners but declined in cyclists (p < .007) and in controls (p < .03), while trochanteric BMD declined in all groups (p < .01). No significant interaction effect of sport and dietary calcium intake was noted for BMD at any site.

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Deborah F. Verfaillie, Jeanne F. Nichols, Ellen Turkel, and Melbourne F. Hovell

The purpose of this study was to compare the effects of resistance training alone or in combination with balance and gait training on balance and gait measures in seniors. Subjects, ranging in age from 65 to 83 years, were randomly assigned to a strength and balance/gait group (SB, n = 21 ) or a control group (S, n = 18) receiving strength and relaxation training. Both groups significantly increased their strength and gait speed over the 12-week training period, but step length remained unchanged. The results suggest that elders can make significant gains in muscular strength and walking speed through resistance training, and that adding balance and gait training to resistance training can significantly improve some balance and gait measures beyond improvements achieved from strength training alone. If replicated, these results set the stage for investigations of injury control benefits possible from balance training.

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Michelle T. Barrack, Marta D. Van Loan, Mitchell Rauh, and Jeanne F. Nichols

This prospective study evaluated the 3-year change in menstrual function and bone mass among 40 female adolescent endurance runners (age 15.9 ± 1.0 years) according to baseline disordered eating status. Three years after initial data collection, runners underwent follow-up measures including the Eating Disorder Examination Questionnaire and a survey evaluating menstrual function, running training, injury history, and prior sports participation. Dual-energy X-ray absorptiometry was used to measure bone mineral density and body composition. Runners with a weight concern, shape concern, or global score ≥4.0 or reporting >1 pathologic behavior in the past 28 days were classified with disordered eating. Compared with runners with normal Eating Disorder Examination Questionnaire scores at baseline, runners with disordered eating at baseline reported fewer menstrual cycles/year (6.4 ± 4.5 vs. 10.5 ± 2.8, p = .005), more years of amenorrhea (1.6 ± 1.4 vs. 0.3 ± 0.5, p = .03), and a higher proportion of menstrual irregularity (75.0% vs. 31.3%, p = .02) and failed to increase lumbar spine or total hip bone mineral density at the 3-year follow-up. In a multivariate model including body mass index and menstrual cycles in the past year at baseline, baseline shape concern score (B = −0.57, p value = .001) was inversely related to the annual number of menstrual cycles between assessments. Weight concern score (B = −0.40, p value = .005) was inversely associated with lumbar spine bone mineral density Z-score change between assessments according to a multivariate model adjusting for age and body mass index. These finding support associations between disordered eating at baseline and future menstrual irregularities or reduced accrual of lumbar spine bone mass in female adolescent endurance runners.

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Jeanne F. Nichols, Mitchell J. Rauh, Michelle T. Barrack, Hava-Shoshana Barkai, and Yael Pernick

The authors’ purpose was to determine the prevalence and compare associations of disordered eating (DE) and menstrual irregularity (MI) among high school athletes. The Eating Disorder Examination Questionnaire (EDE-Q) and a menstrual-history questionnaire were administered to 423 athletes (15.7 ± 1.2 y, 61.2 ± 10.2 kg) categorized as lean build (LB; n = 146) or nonlean build (NLB; n = 277). Among all athletes, 20.0% met the criteria for DE and 20.1% for MI. Although the prevalence of MI was higher in LB (26.7%) than NLB (16.6%) athletes (P = 0.01), no differences were found for DE. For both sport types, oligo/amenorrheic athletes consistently reported higher EDE-Q scores than eumenorrheic athletes (P < 0.05). Athletes with DE were over 2 times as likely (OR = 2.3, 95%CI: 1.3, 4.2) to report oligo/amenorrhea than athletes without DE. These data establish an association between DE and MI among high school athletes and indicate that LB athletes have more MI but not DE than NLB athletes.

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Katie J. Thralls, Jeanne F. Nichols, Michelle T. Barrack, Mark Kern, and Mitchell J. Rauh

Early detection of the female athlete triad is essential for the long-term health of adolescent female athletes. The purpose of this study was to assess relationships between common anthropometric markers (ideal body weight [IBW] via the Hamwi formula, youth-percentile body mass index [BMI], adult BMI categories, and body fat percentage [BF%]) and triad components, (low energy availability [EA], measured by dietary restraint [DR], menstrual dysfunction [MD], low bone mineral density [BMD]). In the sample (n = 320) of adolescent female athletes (age 15.9± 1.2 y), Spearman’s rho correlations and multiple logistic regression analyses evaluated associations between anthropometric clinical cutoffs and triad components. All underweight categories for the anthropometric measures predicted greater likelihood of MD and low BMD. Athletes with an IBW ≤85% were nearly 4 times more likely to report MD (OR = 3.7, 95% CI [1.8, 7.9]) and had low BMD (OR = 4.1, 95% CI [1.2, 14.2]). Those in <5th percentile for their age-specific BMI were 9 times more likely to report MD (OR 9.1, 95% CI [1.8, 46.9]) and had low BMD than those in the 50th to 85th percentile. Athletes with a high BF% were almost 3 times more likely to report DR (OR = 2.8, 95% CI [1.4, 6.1]). Our study indicates that low age-adjusted BMI and low IBW may serve as evidence-based clinical indicators that may be practically evaluated in the field, predicting MD and low BMD in adolescents. These measures should be tested for their ability as tools to minimize the risk for the triad.

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Jeanne F. Nichols, Karen P. Nelson, Katrina K. Peterson, and David J. Sartoris

The purpose of this investigation was to determine the effects of high-intensity strength training on bone mineral density (BMD) of 34 non-estrogen-repleted, active women over 60 years of age. The study was designed as a randomized, nonblinded trial in which subjects were stratified into rank-ordered pairs by level of physical activity, then randomly assigned into either a weight training (WT) or a control (CON) group. BMD of the spine (L2–L4), hip, and total body was assessed at 0, 6, and 12 months by dual energy x-ray absorptiometry. Group-by-time repeated-measures ANOVA demonstrated no effect of weight training on BMD, despite marked gains in muscular strength for all exercises. The high-intensity weight training utilized in this study did not induce positive changes in BMD of the hip and spine of previously active, non-estrogen-repleted older women. However, the protocol was safe, enjoyable, and highly effective in increasing muscular strength.

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Jeanne F. Nichols, Lori M. Hitzelberger, Jennifer G. Sherman, and Patricia Patterson

This study examined the efficacy of a progressive resistance exercise program, using equal concentric/eccentric (CE) or greater eccentric/concentric (GE) workloads, for increasing strength and improving functional abilities of community-dwelling older adults. Sixty men and women were randomly assigned to one of three groups: CE, GE, or control. All strength testing and training took place on six Lifecircuit machines. Functional tests included a bas carry, weighted stair climb, shelf task 1-RM, and static balance. Significant interactions in strength tests were noted for the chest, back, and shoulder exercises. GE improved in shoulder strength more than CE and control For functional measures, all weight trainers were grouped and compared to controls. A significant interaction occurred for the stair climb and balance with the exercise groups decreasing stair climb time by 11% and increasing balance time by 26%. Relative improvements by weight trainers of 12% for the shelf task and 7% for the bag carry were not significant. These data indicate that a moderate intensity resistance program can have positive effects on tasks required for everyday function.

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Jeanne F. Nichols, Hilary Aralis, Sonia Garcia Merino, Michelle T. Barrack, Lindsay Stalker-Fader, and Mitchell J. Rauh

There is a growing need to accurately assess exercise energy expenditure (EEE) in athletic populations that may be at risk for health disorders because of an imbalance between energy intake and energy expenditure. The Actiheart combines heart rate and uniaxial accelerometry to estimate energy expenditure above rest. The authors’ purpose was to determine the utility of the Actiheart for predicting EEE in female adolescent runners (N = 39, age 15.7 ± 1.1 yr). EEE was measured by indirect calorimetry and predicted by the Actiheart during three 8-min stages of treadmill running at individualized velocities corresponding to each runner’s training, including recovery, tempo, and 5-km-race pace. Repeated-measures ANOVA with Bonferroni post hoc comparisons across the 3 running stages indicated that the Actiheart was sensitive to changes in intensity (p < .01), but accelerometer output tended to plateau at race pace. Pairwise comparisons of the mean difference between Actiheart- and criterion-measured EEE yielded values of 0.0436, 0.0539, and 0.0753 kcal · kg−1 · min−1 during recovery, tempo, and race pace, respectively (p < .0001). Bland–Altman plots indicated that the Actiheart consistently underestimated EEE except in 1 runner’s recovery bout. A linear mixed-model regression analysis with height as a covariate provided an improved EEE prediction model, with the overall standard error of the estimate for the 3 speeds reduced to 0.0101 kcal · kg−1 · min−1. Using the manufacturer’s equation that combines heart rate and uniaxial motion, the Actiheart may have limited use in accurately assessing EEE, and therefore energy availability, in young, female competitive runners.