This work was presented in abstract form at the 2002 Endocrine Society Annual Meeting, San Francisco, California, USA, June 19-22, 2002.
Dose-Response Relationships Between Energy Availability and Bone Turnover in Young Exercising Women†
Article first published online: 19 APR 2004
Copyright © 2004 ASBMR
Journal of Bone and Mineral Research
Volume 19, Issue 8, pages 1231–1240, August 2004
How to Cite
Ihle, R. and Loucks, A. B. (2004), Dose-Response Relationships Between Energy Availability and Bone Turnover in Young Exercising Women. J Bone Miner Res, 19: 1231–1240. doi: 10.1359/JBMR.040410
The authors have no conflict of interest
- Issue published online: 2 DEC 2009
- Article first published online: 19 APR 2004
- Manuscript Accepted: 19 APR 2004
- Manuscript Revised: 31 MAR 2004
- Manuscript Received: 11 SEP 2003
- bone markers;
- energy availability;
- bone formation;
- bone resorption
To help refine nutritional guidelines for military servicewomen, we assessed bone turnover after manipulating the energy availability of 29 young women. Bone formation was impaired by less severe restrictions than that which increased bone resorption. Military servicewomen and others may need to improve their nutrition to avoid these effects.
Introduction: We determined the dose-response relationship between energy availability (defined as dietary energy intake minus exercise energy expenditure) and selected markers of bone turnover in 29 regularly menstruating, habitually sedentary, young women of normal body composition.
Materials and Methods: For 5 days in the early follicular phase of two menstrual cycles separated by at least 2 months, subjects expended 15 kcal/kgLBM/day in supervised exercise at 70% of aerobic capacity and consumed controlled amounts of a clinical dietary product in balanced (45 kcal/kgLBM/day) and one of three restricted (either 10, 20, or 30 kcal/kgLBM/day) energy availability treatments in random order. Blood was sampled at 10-minute intervals, and urine was collected for 24 h. Samples were assayed for plasma osteocalcin (OC), serum type I procollagen carboxy-terminal propeptide (PICP), and urinary N-telopeptide (NTX).
Results: NTX concentrations (p < 0.01) and indices of bone resorption/formation uncoupling (ZNTX-OC and ZNTX-PICP; both p < 10−4) were increased by the 10 kcal/kgLBM/day treatment. OC and PICP concentrations were suppressed by all restricted energy availability treatments (all p < 0.05). PICP declined linearly (p < 10−6) with energy availability, whereas most of the suppression of OC occurred abruptly between 20 and 30 kcal/kgLBM/day (p < 0.05).
Conclusions: These dose-response relationships closely resembled those of particular reproductive and metabolic hormones found in the same experiment and reported previously: similar relationships were observed for NTX and estradiol; for PICP and insulin; and for OC, triiodothyronine (T3), and insulin-like growth factor (IGF)-I. The uncoupling of bone resorption and formation by severely restricted energy availability, if left to continue, may lead to irreversible reductions in BMD, and the suppression of bone formation by less severe restrictions may prevent young women from achieving their genetic potential for peak bone mass. More prolonged experiments are needed to determine the dose-response relationships between chronic restrictions of energy availability and bone turnover.