Dietary Intake, Body Composition, and Menstrual Cycle Changes during Competition Preparation and Recovery in a Drug-Free Figure Competitor: A Case Study

Abstract

Physique competitions are events in which competitors are judged on muscular appearance and symmetry. The purpose of this retrospective case study was to describe changes in dietary intake, body mass/composition, and the menstrual cycle during the 20-week competition preparation (PREP) and 20-week post competition recovery (REC) periods of a drug-free amateur female figure competitor (age = 26–27, BMI = 19.5 kg/m2). Dietary intake (via weighed food records) and body mass were assessed daily and averaged weekly. Body composition was estimated via Dual-energy X-ray absorptiometry (DXA) and 7-site skinfold measurements. Energy intake, body mass and composition, and energy availability decreased during the 20-week PREP period (changes of ~298 kcals, 5.1 kg, 6.5% body fat, and 5.4 kcal/kg fat free mass, respectively) and returned to baseline values by end of the 20-week REC period. Menstrual cycle irregularity was reported within the first month of PREP and the last menstruation was reported at week 11 of PREP. Given the potentially adverse health outcomes associated with caloric restriction, future, prospective cohort studies on the physiological response to PREP and REC are warranted in drug-free, female physique competitors.

Physical health and symptoms of relative energy deficiency in female fitness athletes

“…3,[11][12][13] These athletes keep track of their total energy and macronutrient intake, eat fibrous foods, follow a high-protein diet, and diet for several weeks to allow for a slow rate of BW loss. 3,[11][12][13][14][15][16][17] The athletes also prepare meals for several days ahead, eat frequently during the day, and make sure to adjust meal intake according to the exercise sessions. [12][13][14][15] Additionally, they emphasize resistance exercise, [13][14][15][16][17] which specifically may be favorable in reducing the detrimental effect of dieting and low BW on lean body mass and BMD.…”

“…3,[11][12][13][14][15][16][17] The athletes also prepare meals for several days ahead, eat frequently during the day, and make sure to adjust meal intake according to the exercise sessions. [12][13][14][15] Additionally, they emphasize resistance exercise, [13][14][15][16][17] which specifically may be favorable in reducing the detrimental effect of dieting and low BW on lean body mass and BMD. 5,[13][14][15][16][17][18][19] However, FA are understudied with regard to physical and mental health variables, like the ones identified as symptoms of RED-s. 1,3,7 Previous studies of athletes in bodybuilding sports reveal issues with binge eating, and report on a high prevalence of previous eating disorders, specifically among females.…”

“…[12][13][14][15] Additionally, they emphasize resistance exercise, [13][14][15][16][17] which specifically may be favorable in reducing the detrimental effect of dieting and low BW on lean body mass and BMD. 5,[13][14][15][16][17][18][19] However, FA are understudied with regard to physical and mental health variables, like the ones identified as symptoms of RED-s. 1,3,7 Previous studies of athletes in bodybuilding sports reveal issues with binge eating, and report on a high prevalence of previous eating disorders, specifically among females. 3 Recent findings in groups of fitness athletes are indications of a continued, strict dieting behavior beyond the competitive season, not to enhance performance, but to comply with the modern lean and fit body ideal.…”

“…3,4 Hence, there are reasons for concern for the health of these athletes. At the time, only four case studies [14][15][16][17] and four cohort publications [18][19][20][21] report on health outcomes in females related to dieting for fitness sport participation. Among the publications with post-competition measures, 14,17,20,21 changes in BW and composition were reported to be temporary, with return to or above baseline 14,17,20 or normal, healthy levels 21 within 1-4 months post-dieting.…”

“…At the time, only four case studies [14][15][16][17] and four cohort publications [18][19][20][21] report on health outcomes in females related to dieting for fitness sport participation. Among the publications with post-competition measures, 14,17,20,21 changes in BW and composition were reported to be temporary, with return to or above baseline 14,17,20 or normal, healthy levels 21 within 1-4 months post-dieting. Unfortunately, shortages in these studies are either lack of reports on BMD, 14,16,17,21 lack of psychometric outcomes, 14,15,21 lack of post-competition measures, 15,16 or lack of comparisons to a healthy reference group not participating in this sport.…”