Bone parameters in relation to attitudes and feelings associated with disordered eating in oligo-amenorrheic athletes, eumenorrheic athletes, and nonathletes

Natalia Cano Sokoloff, Maria L. Eguiguren, Katherine Wargo, Kathryn E. Ackerman, Charumathi Baskaran, Vibha Singhal, Hannah Clarke, Meghan Slattery, Hang Lee, Kamryn T. Eddy, Madhusmita Misra

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Objectives Disordered eating may negatively impact bone in athletes. However, it is not known whether this effect is independent of the associated amenorrhea and relative hypercortisolemia. We aimed to compare attitudes, feelings, and cognitions associated with disordered eating using the Three-Factor Eating Questionnaire (TFEQ) and Eating Disorder Inventory-2 (EDI-2) in normal-weight oligomenorrheic athletes (OA), eumenorrheic athletes (EA), and nonathletes, and determine the associations with bone independent of confounders. Method 109 OA, 39 EA, and 36 nonathletes (14-25 years) completed the TFEQ and EDI-2. Dual-energy X-ray absorptiometry was used to assess spine bone mineral density (BMD), and high-resolution pQCT to assess radius microarchitecture. We measured integrated cortisol (q 20′, 11 PM-7 AM), bone formation (procollagen Type 1 N-terminal propeptide, P1NP), and resorption (C-telopeptide, CTX) markers in a subset. Results OA had lower spine BMD Z-scores than EA. Cognitive eating restraint (CER), drive for thinness (DT), ineffectiveness, and interoceptive awareness (IA) were higher in OA than EA (p<0.05); CER was higher in OA versus nonathletes (p=0.03). Pulsatile cortisol was positively associated with DT, ineffectiveness, and IA (p<0.03). CER was inversely associated with BMD Z-scores and P1NP, and ineffectiveness with radius cross-sectional area even after controlling for age, BMI, amenorrhea duration, and cortisol (p<0.03). Discussion Higher CER in athletes independently predicts lower BMD.

Original languageEnglish (US)
Pages (from-to)522-526
Number of pages5
JournalInternational Journal of Eating Disorders
Volume48
Issue number5
DOIs
StatePublished - Jul 1 2015
Externally publishedYes

Keywords

  • bone microarchitecture
  • bone mineral density
  • cognitive eating restraint
  • disordered eating
  • female athlete triad
  • oligomenorrhea

ASJC Scopus subject areas

  • Psychiatry and Mental health

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