PhD defence - Anna Melin

Anna Melin is defending her PhD thesis

Energy Availability and Reproductive Function in Female Endurance Athletes


19 January 2015 at 13:00


Auditorium A1-01.01, Festauditoriet, Bülowsvej 17, Frederiksberg.


Associate Professor Christian Mølgaard (chair), Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark

Professor Angelica Lindén Hirschberg, MD, Department of Obstetrics and Gynecology, Karolinska University Hospital, Stockholm, Sweden

Professor, Dan Benardot, PhD, DHC, RD, LD, FACSM, Department of Nutrition, Byrdine F. Lewis School of Nursing and Health Professions, Atlanta


Associate Professor Anders Sjødin, Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark

Senior Lecturer Åsa Tornberg, Lund University, Sweden

Professor Sven Skouby, Herlev Hospital, Denmark

Professor Jorunn Sundgot-Borgen, The Norwegian School of Sport Sciences, Norway

About the thesis

The overall aim of this PhD project was to study the prevalence and potential dietary risk factors and consequences of current low EA and oligomenorrhea/functionel hypothalamic amenorrhea (FHA) in a group of female elite endurance athletes.

The results indicated that athletes with current low and reduced EA, as well as those with oligomenorrhea/FHA, had lower RMR compared to those with either current optimal EA or eumenorrheic athletes. Furthermore, athletes with secondary FHA had increased work efficiency compared to eumenorrheic subjects, indicating a more profound metabolic adaptation in female athletes with clinical menstrual dysfunction.

All three Triad conditions were common in this group of athletes, despite a normal BMI range and body composition. Furthermore, issues and physiological symptoms related to current low and reduced EA and oligomenorrhea/FHA were not limited to impaired bone health, but also included hypoglycaemia, hypercholesterolemia, and hypotension.

The results indicated that diets lower in energy density, fat content, compact carbohydrate-rich foods and energy-containing drinks, together with higher fibre content, were associated with current low and reduced EA and oligomenorrhea/FHA, and may constitute targets for dietary intervention in order to prevent and treat these conditions.

The LEAF-Q, a screening tool was developed and tested and showed an acceptable sensitivity, specificity, and internal consistency, which indicates that it has the potential to be a useful self-reported screening tool to complement existing validated disordered eating screening instruments for the identification of female athletes at risk for the Triad.

2015, 190 pages, ISBN 978 87 7611 830 3