Exam 2 The Exercising Female

During moderate intensity, aerobic exercise in thermoneutral environment rises core body temperature rises an average of ______ degrees Celsius during the first 30 minutes of exercise

1.5

In animal studies, an increase of more than ____ degrees Celsius during pregnancy has been observed to cause major congenital malformations

1.5

The triad is NOT only the combination of eating disorders, ______, and osteoporosis

Amenorrhea

Sub-clinical MD (e.g., anovulation, short luteal phase, and luteal deficiency) are ________. These women do not know they have a MD

Asymptomatic

Conceptually, ________ is the amount of dietary energy remaining after exercise training for all other functions of the body

Energy availability Other functions of the body are cellular maintenance and repair, thermoregulation, immunity, growth, reproduction

How is energy availability calculated mathematically?

Dietary energy intake—Exercise energy expenditure The calculation must be normalized to FFM to account for differences in FFM

The disruption of LH pulsatility in exercising women is prevented by ________ in compensation for exercise energy expenditure

Dietary supplementation

Placental (and than fetal) uptake of glucose is independent of insulin and is driven by ________

Diffusion

What are the 4 reproductive characteristics of amenhorrheic athletes?

Disrupted LH pulsatility Results in inhibition of estradiol and progesterone synthesis and release from the ovary Inhibits ovulation No menstrual cyclity (decreased insulin, IGF-1, T3, leptin, and glucose) (increased cortisol and growth hormone)

What are the 3 reproductive characteristics of regularly menstruating athletes?

Disrupted LH pulsatility less severe than for amenorrheic athletes Less progesterone synthesis Shortened luteal phase

If heat production exceeds the heat ______ capacity, for example, exercise during a hot, humid environment, or during high intensity exercise, the core body temperature will rise

Dissipation

Treatment with oral contraceptives ______ correct metabolic abnormalities that impair bone health in undernourished

Does not

The primary aim of treatment for the Female Athlete Triad is to increase _____

Energy availability The key behavior modification for reversing amenorrhea is to raise energy availability(EA) > 30 kcal/kgFFM/day.

What are the 3 spectrums of the triad between health and disease? What are they linked by?

Energy availability, bone mineral density, and menstrual function Endocrine mechanisms

What is adverse fetal metabolic programming?

Exposure of fetus to hyperglycemic environment may lead to altered insulin kinetics and increased adiposity

What is gestational diabetes?

Form of diabetes similar to Type 2 that is first diagnosed during pregnancy (increased insulin resistance)

Exercise during pregnancy may provide additional health benefits to women with _______ diabetes

Gestational

______ are a group of weight-restricted athletes who practice weight cycling to comply with body-mass standards

Jockeys

The ______ women are, the more they differ from men in trying to lose weight!

Leaner

When comparing male jockeys with age, gender and BMI controls, they had:

Lower blood levels of IGF-I Lower blood levels of testosterone Lower BMD

Can regular exercise reverse preeclampsia if it develops?

NO

Does exercise have a disruptive effect on LH pulsatility beyond the impact of its energy cost on Energy Availability?

No

Fetus is completely dependent on the mother for all _______ support

Nutritional

________ in pregnancy has minimum risks and has shown to benefit most women

Physical activity

______ is the second leading cause of maternal mortality

Preeclampsia

_______ also should be avoided throughout pregnancy because the fetus is at an increased risk for for decompression sickness during this activity

Scuba diving Sky diving should also be avoided

What are the risk factors for gestational diabetes?

Sedentary life style, obesity, and genetics

Some, but not all, studies of male athletes have found disrupted testosterone, LH pulsatility, and _____________

Sperm function Inconsistent results Observed effects have not fallen into the infertile range

The dominant method of reducing energy availability varies between ______

Sports

Women who engage in ________ exercise require frequent and closer medical supervision

Strenuous

The triad is NOT caused by low body fatness or _____

Stress

What is the definition of the female athlete triad?

The harmful effects of excessive energy deficiency on the reproductive and skeletal health of physically active women.

True or false: The effects of the female athlete triad occur in both men and women, and in other mammals.

True But more female athletes than male athletes practice diet and exercise behaviors that cause excessive energy deficits

Women with gestational diabetes have a greater risk of developing ________ later in life

Type 2 diabetes

What are 3 risk factors for preeclampsia?

Type 2 diabetes Obesity Hypertension

Recreational and competitive athletes with ________ pregnancies can remain active during pregnancy and should modify their usual exercise routines as medically indicated.

Uncomplicated

What are the concerns of exercising during pregnancy?

Will reduced uterine blood flow lead to insufficient oxygen to the fetus? Are there dangers of miscarriage and the final outcome of pregnancy? Does exercise training cause a low birth weight in the fetus? Will the fetus suffer from hyperthermia due to increased exercising temperature? Will there be reduced carbohydrate availability to the fetus?

Concluded that exercise at intensity above of _______ may compromise fetal well being

maxMHR

Mean uterine artery volume blood flow was reduced by _______% during intensive exercise

25-60%

Fetal body core temperatures are about ____ degree Celsius higher than maternal temperatures

1

Nurse's Health Study of 4554 women who had a history of gestational diabetes followed from 1991-2007. Those who exercised _____ minutes a week at moderate intensity had a _____% lower risk of developing Type 2 diabetes

100 9%

In the absence of either medical or obstetric complications, _______ minutes of moderate exercise a day on most, if not all, days of the week is recommended for pregnant women.

20-30

Incidence of preeclampsia is ______% of pregnancies

3-7%

In untrained exercising women, LH pulsatility was disrupted below a threshold of EA = ____ kcal/kgFFM/day

30

When EA <______ kcal/kgFFM, the body does not have enough energy for: Cellular maintenance and repair, thermoregulation, immunity, growth, reproduction

30

Exercise prior to pregnancy gives a _______% reduction in risk in developing preeclampsia

30-80%

Restoring BMD may require body weight to be increased by raising EA> _____ kcal/kgFFM/day.

45

In habitually sedentary, regularly menstruating, healthy, young adults: Energy balance: EA = ~______ kcal/kgFFM Resting metabolism: EA = ~______ kcal/kgFFM

45 30

Exercise during pregnancy gives a _______% reduction in risk in developing preeclampsia

45-65%

Those who increased their activity by 150 minutes per week of moderate-intensity physical activity had a ______ lower risk of Type 2 diabetes

47%

Exercise at intensity above 90% of maximum maternal heart rate was associated with fetal _______

Bradycardia

What are reasons for low EA in athletes?

Compulsive - Sports programs need procedures for detecting athletes with eating disorders, referring them for psychiatric care, and restricting participation until they receive medical clearance. Inadvertent failure to match energy intake to activity-induced energy expenditure - Athletes need to eat by discipline, not appetite. Cognitive restraint to improve performance - Intentional efforts to improve performance by modifying body size and body composition. - Sports programs need weight and fat loss programs supervised by professional nutritionists. Cognitive Restraint to Improve Appearance -More young female athletes report improvement of appearance than improvement of performance as a reason for dieting. -Worldwide, at all deciles of BMI, about twice as many young women as young men perceive themselves to be overweight. • This perception affects their eating behavior. • More young women than men are actively trying to lose weight. • The multiple of women more than men who are actively trying to lose weight increases as BMI declines.

Amenorrheic athletes display alterations in metabolic hormones and substrates, suggesting that their menstrual disturbances may be caused by _____

Compulsive eating disorders

For _____ athletes, metabolic hormones and substrates are less severely altered than in amenorrheic athletes.

Cyclic

Activities with a high risk of ________ (gymnastics, horseback riding, downhill skiing, and vigorous racquet sports) or those with a high risk of abdominal trauma (ice hockey, boxing, soccer, and basketball) should be avoided during pregnancy

Falling

With preeclampsia, there is a greater risk of developing ________ after pregnancy

Hypertension

Preeclampsia is one of the _______ disorders of pregnancy

Hypertensive

Previously _______ women and those with medical or obstetric complications should be evaluated before recommendations for physical activity during pregnancy are made.

Inactive

What are the long term consequences of the triad?

Increased risk of post-menopausal osteoporosis

What is the only known treatment for preeclampsia?

Inducing delivery

What is the development of peak bone mass influenced by?

Mechanical loading Nutrition Hormonal levels Genetics

What are the short term consequences of the triad?

Metabolic: Reduced glycogen stores Reproductive: infertility Skeletal: -Adolescents: Failure to accumulate bone mass -Adults: Loss of bone mass -Increased risk of stress fractures

Amenorrhea is common among female athletes and _______ (______%) in the general population.

Rare 2-5%

LH pulsatility is disrupted by low Energy Availability, due to:

Reduced energy intake, Increased exercise energy expenditure A combination of both.

What are the 3 ways that energy availability can be reduced?

Reducing dietary energy intake, Increasing exercise energy expenditure, or A combination of both.

What is the female athlete triad? What are the 3 components?

Refers to three interrelated clinical disorders observed in some young, female athletes and other physically active women. Amenorrhea, osteoporosis, and low energy availability

In healthy adults, 30 kcal/kgFFM/day is ______

Resting metabolic rate Energy balance -33%

Clinical MD (e.g., amenorrhea and oligomenorrhea) are ________. Women with these MD know they have a MD

Symptomatic

Limited data to date (has/has not) shown that exercise during pregnancy can prevent the development of gestational diabetes

has not