scholarly journals Clinical application of monitoring indicators of female dancer health, including application of artificial intelligence in female hormone networks

2021 ◽  
Author(s):  
Nicola Keay ◽  
Martin Lanfear ◽  
Gavin Francis
Keyword(s):  
Artificial Intelligence ◽  
Menstrual Cycle ◽  
Clinical Application ◽  
Low Energy ◽  
List Type ◽  
Energy Availability ◽  
Clinical Tool ◽  
Female Hormone ◽  
Network Function ◽  
Low Energy Availability

AbstractObjectivesThe purpose of this study was to assess the effectiveness of monitoring professional female dancer health with a variety of subjective and objective monitoring methods, including application of artificial intelligence (AI) techniques to modelling menstrual cycle hormones and delivering swift personalised clinical advice.MethodsFemale dancers from a ballet company completed a published online dance-specific health questionnaire. Over the study period, dancers recorded wellbeing and training metrics, with menstrual cycle tracking and blood tests. For menstrual cycle hormones AI-based techniques modelled hormone variation over a cycle, based on capillary blood samples taken at two time points. At regular, virtual, clinical interviews with each dancer, findings were discussed, and personalised advice given.Results14 female dancers (mean age 25.5 years, SD 3.7) participated in the study. 10 dancers recorded positive scores on the dance health questionnaire, suggesting a low risk of relative energy deficiency in sport (RED-S). 2 dancers were taking hormonal contraception. Apart from 1 dancer, those not on hormonal contraception reported current eumenorrhoeic status. The initiative of monitoring menstrual cycles and application of AI to model menstrual cycle hormones found that subclinical hormone disruption was occurring in 6 of the 10 dancers reporting regular cycles. 4 of the 6 dancers who received personalised advice, showed improved menstrual hormone function, including one dancer who had planned pregnancy.ConclusionsMultimodal monitoring facilitated delivery of prompt personalised clinical medical feedback specific for dance. This strategy enabled the early identification and swift management of emergent clinical issues. These innovations received positive feedback from the dancers.Summary boxesWhat are the new findings?Monitoring female dancers with a variety of interactive methods – dance specific questionnaire, online tracking and blood testing – together with individual clinical discussion, facilitates comprehensive, personalised support for dancer health.The clinical application of artificial intelligence (AI) techniques to endocrine function provides the finer detail of female hormone network function.This novel approach to monitoring dynamic hormone function enabled the detection of subtle female hormone dysfunction as a result of changes in training and nutrition patterns, which occurred before change in menstruation pattern from menstrual tracking.This multifaceted clinical approach was also effective and helpful in supporting dancers restore full hormone network function through personalised training and nutritional strategies.How might this study impact on clinical practice in the future?Personalised, dance specific health advice based on subjective and objective measures can support sustainable individual dancer health.Clinical application of artificial intelligence (AI) to menstrual cycle hormones can provide a dynamic and complete picture of hormone network function, without the need to do daily blood tests to measure all four key menstrual cycle hormones.This AI approach to modelling hormones enables early detection of subtle, subclinical endocrine dysfunction due to low energy availability in female exercisers. This clinical tool can also facilitate the close clinical monitoring of the restoration of full hormone network function in recovery from low energy availability.Using AI to model female hormones can be an important clinical tool for female athletes, including those athletes where it is difficult to distinguish between perimenopause symptoms and those associated with low energy availability.

scholarly journals Awareness and indicators of low energy availability in male and female dancers

2020 ◽  
Author(s):  
Nicola Keay ◽  
AusDancers Overseas ◽  
Gavin Francis
Keyword(s):  
At Risk ◽  
Relative Energy ◽  
Low Energy ◽  
List Type ◽  
Energy Availability ◽  
Full Time ◽  
Male And Female ◽  
Dance Training ◽  
And Performance ◽  
Low Energy Availability

AbstractObjectivesTo investigate awareness and indicators of low energy availability (LEA) in male and female dancersMethodsA dance-specific energy availability questionnaire (DEAQ) was developed and administered online internationally to dancers in full time training. The DEAQ drew on current validated, published questionnaires for LEA, linked to the clinical outcomes of relative energy deficiency in sport (RED-S). Questions addressed recognised physiological indicators and consequences of LEA in the context of dance, together with psychological drivers and aetiological factors specific to dance training. LEA was quantified using a scoring system to include these characteristics.Results247 responses to the DEAQ were analysed (225 female and 22 male), mean age 20.7 years (SD 7.9) with transition to full time training at 15.0 years (SD 7.9) and 85% practising ballet. Psychological, physiological and physical characteristics consistent with LEA were reported by 57% of the female dancers and 29% of male dancers, indicating a risk of RED-S. The unique nature of dance training, in terms of demands and environment, was found to be potentially influential in development of this situation. Less than a third (29%) of dancers were aware of RED-S.ConclusionThis study found dancers to be a specific group of high-level exercisers displaying indicators of LEA and consequently at risk of developing the adverse clinical health and performance consequences of RED-S. Awareness of RED-S was low. The DEAQ has the potential to raise awareness and be a practical, objective screening tool to identify dancers in LEA, at risk of developing RED-S.Summary boxesWhat are the new findings?Dancers reported many recognised indicators of low energy availability (LEA) and consequently are at risk of developing the adverse health and performance outcomes of relative energy deficiency in sport (RED-S).Few dancers in this study demonstrated an awareness of RED-S.The unique nature of dance training, in terms of demands and environment, was found to be influential in the development of LEA in dancersThe DEAQ is the first questionnaire specific to dancers. Applying a scoring system to the responses from the DEAQ can provide an objective assessment of LEAHow might this study impact on clinical practice in the future?As LEA and subsequent risk of RED-S is not matched by awareness, providing educational resources for dancers is important. A British Association of Sport and Exercise Medicine website has been developed by the research team for both athletes and dancers www.health4performance.co.ukThe DEAQ has the potential to be a practical, objective, screening tool to identify male and female dancers worldwide in LEA. By identifying these dancers, support could be targeted to modify dancer behaviours to reduce the risk of dancers developing the adverse health and performance sequelae of RED-SEarly identification of dancers at risk of developing RED-S is of particular importance when situations arise out of dancers’ control, such as lock down in pandemics COVID-19 or time off dancing due to illness/injury. Targeted support may be required as a dancer’s tendencies towards exercise dependence and disordered eating patterns may increase as a way to seek control and combat uncertainty.

Evidence for a Causal Role of Low Energy Availability in the Induction of Menstrual Cycle Disturbances During Strenuous Exercise Training

2002 ◽  
Vol 57 (7) ◽  
pp. 440-442
Author(s):  
Nancy I. Williams ◽  
Dana L. Helmreich ◽  
David B. Parfitt ◽  
Anne Caston-Balderrama ◽  
Judy L. Cameron
Keyword(s):  
Menstrual Cycle ◽  
Exercise Training ◽  
Low Energy ◽  
Causal Role ◽  
Strenuous Exercise ◽  
Energy Availability ◽  
Low Energy Availability

scholarly journals Evidence for a Causal Role of Low Energy Availability in the Induction of Menstrual Cycle Disturbances during Strenuous Exercise Training

2001 ◽  
Vol 86 (11) ◽  
pp. 5184-5193 ◽  
Author(s):  
Nancy I. Williams ◽  
Dana L. Helmreich ◽  
David B. Parfitt ◽  
Anne Caston-Balderrama ◽  
Judy L. Cameron
Keyword(s):  
Menstrual Cycle ◽  
Exercise Training ◽  
Low Energy ◽  
Causal Role ◽  
Strenuous Exercise ◽  
Energy Availability ◽  
Low Energy Availability

scholarly journals Body Composition, Dietary Intake and the Risk of Low Energy Availability in Elite-Level Competitive Rhythmic Gymnasts

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2083
Author(s):  
María Villa ◽  
José G. Villa-Vicente ◽  
Jesus Seco-Calvo ◽  
Juan Mielgo-Ayuso ◽  
Pilar S. Collado
Keyword(s):  
Body Composition ◽  
Dietary Intake ◽  
Body Fat ◽  
Low Energy ◽  
Energy Availability ◽  
Future Health ◽  
Elite Level ◽  
Low Energy Availability ◽  
Rhythmic Gymnasts ◽  
Recommended Level

The aim of this study was to analyze dietary intake and body composition in a group of elite-level competitive rhythmic gymnasts from Spain. We undertook body composition and nutritional analysis of 30 elite gymnasts, divided into two groups by age: pre-teen (9–12 years) (n = 17) and teen (13–18 years) (n = 13). Measures of height, weight, and bioimpedance were used to calculate body mass index and percent body fat. Energy and nutrient intakes were assessed based on 7-day food records. The two groups had similar percentages of total body fat (pre-teen: 13.99 ± 3.83% vs. teen: 14.33 ± 5.57%; p > 0.05). The energy availability values for pre-teens were above the recommended values (>40 kcal/FFM/day) 69.38 ± 14.47 kcal/FFM/day, while those for the teens were much lower (34.7 ± 7.5 kcal/FFM/day). The distribution of the daily energy intake across the macronutrients indicates that both groups ingested less than the recommended level of carbohydrates and more than the recommended level of fat. Very low intakes of calcium and vitamin D among other micronutrients were also noted. The main finding is that teenage gymnasts do not consume as much energy as they need each day, which explains their weight and development. Moreover, they are at a high risk of developing low energy availability that could negatively impact their performance and future health.

Low energy availability surrogates correlate with health and performance consequences of Relative Energy Deficiency in Sport

2018 ◽  
Vol 53 (10) ◽  
pp. 628-633 ◽  
Author(s):  
Kathryn E Ackerman ◽  
Bryan Holtzman ◽  
Katherine M Cooper ◽  
Erin F Flynn ◽  
Georgie Bruinvels ◽  
...  
Keyword(s):  
Female Athletes ◽  
Relative Energy ◽  
Low Energy ◽  
Clinical Population ◽  
Energy Availability ◽  
Energy Deficiency ◽  
Increased Risk ◽  
Performance Consequences ◽  
And Performance ◽  
Low Energy Availability

Low energy availability (EA) is suspected to be the underlying cause of both the Female Athlete Triad and the more recently defined syndrome, Relative Energy Deficiency in Sport (RED-S). The International Olympic Committee (IOC) defined RED-S as a syndrome of health and performance impairments resulting from an energy deficit. While the importance of adequate EA is generally accepted, few studies have attempted to understand whether low EA is associated with the health and performance consequences posited by the IOC.ObjectiveThe purpose of this cross-sectional study was to examine the association of low EA with RED-S health and performance consequences in a large clinical population of female athletes.MethodsOne thousand female athletes (15–30 years) completed an online questionnaire and were classified as having low or adequate EA. The associations between low EA and the health and performance factors listed in the RED-S models were evaluated using chi-squared test and the odds ratios were evaluated using binomial logistic regression (p<0.05).ResultsAthletes with low EA were more likely to be classified as having increased risk of menstrual dysfunction, poor bone health, metabolic issues, haematological detriments, psychological disorders, cardiovascular impairment and gastrointestinal dysfunction than those with adequate EA. Performance variables associated with low EA included decreased training response, impaired judgement, decreased coordination, decreased concentration, irritability, depression and decreased endurance performance.ConclusionThese findings demonstrate that low EA measured using self-report questionnaires is strongly associated with many health and performance consequences proposed by the RED-S models.

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