Association of diet quality and hormonal status in exercising women with menstrual disturbances

Abstract
Diet plays a role in the pathophysiology and treatment of women with hyperandrogenic menstrual disturbances; however, limited research exists examining components of dietary intake in women with subclinical menstrual disturbances. The aim of this investigation was to evaluate the relationship between diet quality and hormonal status in exercising women with menstrual disturbances. Eighty exercising women with ovulatory menstrual cycles (OV; n=32), women with oligo/amenorrhea without evidence of hyperandrogenism (Oligo/Amen-LowFAI n=28), and women with oligo/amenorrhea and evidence of subclinical hyperandrogenism (Oligo/Amen-HighFAI; n=32) participated in the cross-sectional observational study (Clinical Trial Number NCT00392873). Self-reported menstrual history, resting energy expenditure, body composition, hormonal and metabolic hormone concentrations determined reproductive and metabolic status. Serum androgens and calculated free androgen index (FAI) determined androgen status. The Diet Quality Index International (DQI-I) and the Dietary Inflammatory Index (DII) evaluated quality of diet. Oligo/Amen-HighFAI group had the highest androgen concentrations (p<0.05) and lower DQI-I score compared to OV group and Oligo/Amen-LowFAI (p<0.05). The Oligo/Amen-HighFAI group consumed less of vitamin A, B2, B6, B12, magnesium, and potassium compared to the Oligo/Amen-LowFAI group (all p<0.05). In the women with menstrual disturbances with subclinically elevated androgens, poor diet quality is related to altered hormonal parameters which may have implications for future nutritional treatment strategies.