Possible use of soy supplementation in prevention and treatment of the Female Athlete Triad

1. Possible use of soy supplementation in prevention and treatment of the Female Athlete Triad

2. http://www.femaleathletetriad.org/ • Generally consider female athlete triad to be a concern for elite athletes, however it can happen to various degrees to any female • If you have one symptom, you should be checked for other signs as well • Occurs most often in sports where physique and weight are of higher importance – dance, distance running, swimming, etc • Women strive for leanness – which results in dramatic weight loss and consequently low %BF

3. Effect of Female Athlete Triad • Poor nutrition leads to hormone imbalance, causing a decrease in estrogen, and consequently amenhorrea • The prevalence of amenorrhea has been reported to be fairly high in the athletic population with some published reports as high as 66% • amenorrhea in the general population is between 2% - 5% (www.sportsmd.com) • Estrogen decreases bone resorption, therefore if you have low estrogen, more bone will be reabsorbed • This is why post menopausal women have increased chances for fractures and osteoporosis • Changes in bone density can be seen within a few months • More immediate concern is with stress fractures (chances of stress fracture triple), long term concern of osteoporosis

4. What about the pill? • Oral contraceptives are given to help females maintain normal menstrual cycles and increase estrogen • According to Brown University, the pill does not prevent against bone demineralization • Suggest that only when proper energy balance has been restored that bones can begin rebuilding • Endogenous estrogen does not have the same affinity for receptors as endogenous estrogen, or carry out the same biological processes http://www.hormoneprofile.com/howhormoneswork.htm

5. What about soy supplementation in the diet? Many foods contain phytoestrogens - compounds that have a similar chemical structure to estrogen and will stimulate similar effects as endogenous estrogen Foods containing Phytoestrogens: soy beans dried beans tofu lentils tempeh rice soy beverages alfalfa linseed mung beans sesame seeds apples wheat carrots berries wheat germ oats rice bran barley soy linseed bread

6. Would soy supplementation work to prevent or treat female athlete triad? • Women with poor nutrition, low percent body fat, and are amenorrheic may benefit from the phytoestrogens in soy products • Supplementation with soy would increase protein intake, subsiding negative energy balance while phytoestrogens in soy may prevent or help to subside amenorrhea and allow competition at the leanest healthy body weight • There have been very few studies that have evaluated hormonal response due to phytoestrogens in elite female athletes • 2001 study involving Romanian gymnasts preparing for Olympics: • 4-6 hours of strenuous training daily and restricted food intake to maintain • optimal body mass • All participants were ~15 years old and where primary amenorrheic • Regular diet provided 50kcal/kg/day and 1.7-1.8g protein/kg/day • (100lb girl = 45kg =2250kcal/day =76-81kg protein/day) • Supplemented with 1 g soy protein/ kg (+45g protein daily) • All had low estradiol and progesterone • Both groups had increased prolactin – supplemented group more than non supplemented • Result of strenuous exercise; contributes to amenorrhea • There was really no difference in hormonal profile between the two groups

7. Other mechanisms causing low estrogen • Adrenal exhaustion? • Occurs when under constant stress, producing a lot of cortisol, causes “burn out” of adrenal glands • Causes other hormonal pathways to be out of wack Low progesterone?