Influence of Menopausal Status on Lipids and Lipoproteins and Fat Mass Distribution: The Pioneer Project

Following menopause, fat redistribution and increased risk for dyslipidemia are common. The influence of menopause; however, on the associations between total and regional fat mass with lipids and lipoproteins remains unclear. PURPOSE: The purpose of this investigation was to determine the influence of menopausal status on associations between total and regional fat mass and lipids and lipoproteins. METHODS: Sedentary, non-smoking women (n=209) were grouped based on current menstrual status: premenopausal (n=143, mean±SD; age=42.7±7.7 yr, BMI=24.5±4.0 kg•m -2, WC=77.4±9.9 cm) or postmenopausal (n=66, mean±SD; age=52.9±5.3 yr, BMI= 24.9±4.2 kg•m -2, WC=78.8±9.9 cm). Fasting (12 hr) serum samples were analyzed for total cholesterol (TC), triglyceride (Tg), LDL-C, HDL-C, HDL2-C, and HDL3-C concentrations. Total (TF), abdominal (AF), hip (HF) and mid-thigh (MTF) fat mass were quantified by DXA. A MANCOVA was used to determine differences between groups for total and regional fat mass and lipids and lipoproteins controlling for HRT status. Stepwise multiple regression analysis was used to determine if menopausal status influenced the association of total and regional fat mass with lipids and lipoproteins. The criterion reference for statistical significance was set at a P \u3c 0.05. RESULTS: Postmenopausal women had significantly greater TC, HDL-C, LDL-C and HDL3-C concentrations than premenopausal women. No significant differences were observed between groups for total and regional fat mass. In premenopausal women, AF predicted TC, but no associations were observed in postmenopausal women. In premenopausal women, AF+HF and AF+TF were significant predictors of Tg and LDL-C, respectively. In contrast, only AF predicted Tg and LDL-C in postmenopausal women. AF+MTF best predicted HDL-C in premenopausal women; however, TF+MTF best predicted HDL-C in postmenopausal women. In premenopausal women, no associations were observed with HDL2-C or HDL3-C. TF and TF+MTF were best predictors of HDL2-C and HDL3-C, respectively in postmenopausal women. CONCLUSION: Menopausal status has an effect on lipid and lipoprotein-cholesterol concentrations, but not on total and regional fat mass. In addition, menopausal status had an influence on the associations of total and regional fat mass with lipids and lipoproteins

Misunderstanding the Female Athlete Triad: Refuting the IOC Consensus Statement on Relative Energy Deficiency in Sport (RED-S)

We are concerned that readers of the IOC paper will be confused and misled by the poorly referenced statements and frank (and sometimes dangerous) errors in the paper. The IOC authors should publish a correction of these and other errors noted. Broadening research of low energy availability in other groups, such as the male athlete, athletes of diverse ethnicities and the disabled athlete may help to advance science and may one day warrant introduction of a specific term for whatever serious clinical sequelae of energy deficiency may be discovered in future research on men. Research on the “Female Athlete Triad” has forged a platform from which a broad array of healthcare providers (e.g., physicians, sport dietitians, mental health professionals and athletic trainers) have made great strides in learning how to manage and treat affected women. Research on the “Female Athlete Triad” has also been translated to the lay public such that more and more affected female athletes and exercising women willingly seek education, prevention and treatment. Meanwhile, subsuming the term “Female Athlete Triad” under the umbrella of the term RED-S has the potential to confuse rather than enlighten, and undo decades of work educating and advocating for awareness, prevention and treatment for the Triad. The individual most impacted by the de-emphasis on the Triad will be the female athlete herself. The overwhelming clinical importance of the Female Athlete Triad compared with other conditions under the proposed RED-S umbrella will continue to make a specific reference for the Triad useful for those who deal with it, including physicians, coaches, sport dietitians, athletics trainers, parents and, most importantly, female athletes. As such, efforts promoting awareness, prevention and treatment of the Female Athlete Triad remain critically important and should not be overshadowed by an ill-conceived and poorly defended new construct