Nutrition and the incidence of stress fractures in ballet dancers

Article Abstract:

Stress fractures, which are fine hairline fractures, occur frequently in dancers and other athletes, and have been correlated in women with amenorrhea, the absence of menstruation. The relationship of diet to these fractures has not been thoroughly studied, but dieting and associated amenorrhea are common in dancers. Ballet dancers were divided into two groups: 10 who had sustained stress fractures within the past year, and 10 who had not sustained stress fractures during the previous three years. They were compared with a third group of 10 women who were not dancers and had no stress fractures. The three groups were matched for age and weight-for-height (thinness). Dietary patterns and disorders, menstrual history, bone density, and activity levels were compared. Among the three groups, average intake of calories was not different. However, the group with stress fractures had a significantly greater tendency to restrict food intake (especially high-fat dairy foods) and to consume low-calorie foods and saccharin, and this group also had a higher incidence of eating disorders such as anorexia and bulimia. Diet soda consumption was eight-fold higher in the group with stress fractures, compared with the other dancers. Percent of calories from carbohydrate, fat, and protein did not differ among the groups, but 70 percent of the stress-fracture group consumed less than 85 percent of the recommended dietary allowance (RDA) of calories. Sixty percent of dancers were vegetarian, while only 20 percent of nondancers were vegetarian. Both groups of dancers took more vitamins than non-dancers, but the group with fractures had less iron in the diet. Bone density of the wrist and spine did not differ among the groups, but that of the feet was greater in dancers. Incidence of amenorrhea was not different among groups. The study suggests that although no weaknesses in bone density were seen, the altered nutritional status and aberrant eating patterns which were observed in some dancers may be contributing to stress fractures. This finding is of considerable clinical importance because poor nutrition in young adulthood can have lifelong effects on bone health. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Eating disorders, Ballet dancers, Dancing, Dance, Stress fractures

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Gastrointestinal and cardiac response to refeeding after low-calorie semistarvation

Article Abstract:

Very-low-calorie, semistarvation diets are followed by many people in the United States despite warnings about adverse health effects. The risks include cardiac arrhythmia (irregular heart beat), loss of essential body proteins and metabolic abnormalities. The period of refeeding after severe caloric restriction may be the time of greatest risk for heart failure; a study of 32 young men found that even after 20 weeks of refeeding when all weight lost had been regained, heart function was 10 percent below normal. A study of animals put on semi-starvation diets (23 percent of caloric requirements) showed that they experienced severe depletion of protein in the heart, pancreas and intestinal lining. This follow-up study examined the response to refeeding in six rats that had been semistarved; they were compared with six well-fed rats and six rats that were semistarved but not refed. After 21 days of refeeding, the rats had gained back all the weight lost but continued to show a reduced number of cells in certain essential organs, namely the heart, liver, pancreas and small intestine. The degree to which protein losses were replaced was variable, and it was concluded that very-low-calorie diets and the refeeding process affect protein metabolism in certain body organs. The duration of caloric restriction, given the life expectancy of the rat, was similar to the long-term starvation seen in the eating disorders anorexia nervosa and bulimia.

Research, Models, Causes of, Physiological aspects, Anorexia nervosa, Arrhythmia, Starvation, Low-calorie diet, Low calorie diet, Fasting

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Aggressive oral refeeding in hospitalized patients

Article Abstract:

Thirty to fifty percent of the patients hospitalized in medical and surgical wards are malnourished. Patients with poor nutritional status, especially elderly, have an increased risk for morbidity and mortality. Oral feeding of acutely ill and malnourished patients often fails because the patients refuse to eat or take dietary supplements. An aggressive oral feeding program involving high-caloric foods was developed and tested in severely anorectic patients. They were provided with their favorite sweet, such as chocolate. In many cases the sweets were the patients' only food intake for several weeks. Gradually, appetites returned and other foods were included in the diet. In addition, there was an improvement in clinical comorbid conditions. These results suggest that aggressive oral feeding with high-caloric foods may be a useful therapy for severely impaired elderly patients with malnutrition. (Consumer Summary produced by Reliance Medical Information, Inc.)

Aged patients, Elderly patients, Diet therapy, Malnutrition

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