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M Fogelholm

Publications and source records attributed to M Fogelholm.

At least 19 recordsLinked to original sources
PubMed2001

Reduced oxidized low-density lipoprotein after weight reduction in obese premenopausal women.

BACKGROUND: Several studies support the hypothesis that oxidation of low-density lipoprotein (LDL) promotes atherogenesis. Obesity is one of the risk factors of atherosclerosis, but it is not known whether obesity is related to LDL oxidation. OBJECTIVE AND DESIGN: We investigated the effect of weight reduction and subsequent weight maintenance program on LDL oxidation in 77 obese premenopausal women (BMI 29-46 kg/m(2)). Another group of seven obese women served as a control group. Oxidized LDL was measured as baseline concentration of conjugated dienes in LDL lipids (ox-LDL). The weight reduction was performed in 12 weeks, using a very-low-energy diet. RESULTS: The mean weight loss was 13 kg (92 vs 79 kg). During weight reduction, the concentration of LDL cholesterol decreased by 11%, the concentration of ox-LDL decreased by 40%, and the ratio of ox-LDL to LDL by 33%. The concentration of LDL antioxidant capacity (LDL-TRAP) decreased by 8%, but the decrease was caused by the decrease in LDL. The concentration of LDL, ox-LDL or LDL-TRAP did not change in the control group. The weight reduction correlated with the decrease of ox-LDL. During the subsequent 9 month weight maintenance programme, the concentrations of serum LDL (10%), ox-LDL (11%), LDL-TRAP (29%), and the ratio of LDL-TRAP to LDL (21%) decreased. CONCLUSION: This study strengthens the evidence that the risk of atherogenesis is influenced favourably by weight reduction in obese women. This risk reduction is associated with a reduced oxidation of LDL.

Adult↗
PubMed2000

Effects of walking training on weight maintenance after a very-low-energy diet in premenopausal obese women: a randomized controlled trial.

BACKGROUND: Maintenance of weight loss is a core problem in the treatment of obesity. Physical activity may improve maintenance and metabolic risk factors associated with obesity. HYPOTHESES: (1) A walking training program of moderate intensity, started after weight reduction by a very-low-energy diet, improves maintenance of weight loss and obesity-related metabolic disorders; and (2) the effect of the training program is related to the prescribed amount of physical activity, ie, a higher amount (energy expenditure) leads to more favorable results. METHODS: The participants were premenopausal women with a mean body mass index of 34.0 kg/m(2). Eighty-two participants were randomized to this study; 74 participated in the follow-up assessment. A 12-week weight reduction by mostly a very-low-energy diet was followed by a 40-week maintenance program randomized in 3 groups: a control group with no increase in habitual exercise and with counseling on diet and relapse prevention; a walk-1 group, with a walking program targeted to expend 4.2 MJ/wk and diet counseling; and a walk-2 group, with a walking program of 8. 4 MJ/wk and diet counseling. Random permuted blocks within strata were used, with weight loss (in 3 classes) as the stratifying factor. After the intervention, the subjects were followed up for 2 years. MAIN OUTCOME MEASURES: Primary outcomes were body weight, fat mass, and waist circumference at the 2-year follow-up. Secondary outcomes were the levels of serum lipoproteins and lipids, plasma glucose, insulin, and blood pressure. RESULTS: The mean weight loss after weight reduction was 13.1 kg. The main outcome variables remained stable during the maintenance program, but increased during the follow-up period. Compared with the end of weight reduction, weight regain at the 2-year follow-up was 3.5 kg less (95% confidence interval, 0.2-6.8) and waist circumference regain 3.8 cm less (95% confidence interval, 0.3-7.3) in the walk-1 group vs controls. The secondary outcomes showed a partial relapse during the maintenance program, and a further regain during the follow-up period. CONCLUSIONS: Inclusion of a walking program of moderate training regimen into a weight maintenance program improved maintenance of losses in weight and waist circumference.

Adult↗
PubMed2000

Predictors of weight change in middle-aged and old men.

OBJECTIVE: Studies on weight change and mortality have yielded inconclusive results. This 10-year prospective study was undertaken to improve understanding of factors affecting weight change. RESEARCH METHODS AND PROCEDURES: The subjects were 1,143 men, aged 36 to 88 years (mean, 53.3 years) at entry. A questionnaire was filled in at entry and at the end of the follow-up with queries on weight, height, weight at the age of 20, physician-diagnosed diseases, smoking, alcohol use, dietary habits, leisure physical activity, occupation, present occupational activity, living conditions (living alone or cohabiting), and former athletic status. Further information on morbidity was obtained from selected national registers. Factors predicting weight change during the study were identified by stepwise linear multiple regression analysis. RESULTS: The mean 10-year weight change was 0.8 (range, -29 to +24) kg. Age at entry (beta-coefficient, -0.17, SE 0.02), weight at entry (beta, -0.03, SE 0.01), diabetes at entry (beta, -3.55, SE 1.02), diabetes diagnosed after entry (beta, -3.94, SE 0.96), malignant cancer (beta, -1.60, SE 0.70), being a smoker (beta, - 1.59, SE 0.48), and increased physical activity (beta, - 1.27, SE 0.54) were significantly (p < 0.05) associated with weight loss in the final model. The model explained 13% of the variance of weight change. DISCUSSION: The results emphasize the complexity of weight change. Some factors associated with weight change are apparently negatively, and some positively, associated with health. This could explain the equivocal findings on weight change and mortality in the literature.

Adult↗
PubMed2000

Growth, dietary intake, and trace element status in pubescent athletes and schoolchildren.

PURPOSE: To examine interactions between club-level sports training, dietary intake, and nutritional status during puberty. METHODS: A 2-yr prospective study was undertaken with 64 boys (40 ice hockey players, 24 controls) and 71 girls (28 gymnasts, figure skaters, and runners, 43 controls). The boys' age in the beginning of the study was 12-13 yr, whereas the girls were 11-12 yr. The following variables were measured in the beginning, and after 1 and 2 yr: physical activity level (record), dietary intake (record), blood hemoglobin concentration, serum ferritin, zinc and copper concentration, anthropometric indices (height, weight, skinfolds, upper arm muscle girth), and biological maturation (self-report). RESULTS AND CONCLUSIONS: The changes in the anthropometric variables throughout the study period were not different between the athletes and controls (P = 0.09). The athlete boys had higher mean energy, iron and zinc intakes, and higher mean serum zinc concentration than the controls (P < or = 0.003). The athlete and control girls' dietary intakes and biochemical indices of trace element status were not different from each other (P < or = 0.13). Moreover, sports participation was not associated with the longitudinal changes in trace element status (P > or = 0.08). These data suggest that club-level sports training does not affect growth, maturation or nutritional status during puberty.

Adolescent↗
PubMed1999

Micronutrients: interaction between physical activity, intakes and requirements.

The present literature review examines the following questions: (a) What is the evidence that micronutrient requirements are increased in physically active people? (b) Is there an association between physical activity and micronutrient intake? (c) Are there any significant differences between indices of micronutrient status between physically active and inactive people? The available data suggest that micronutrient requirements are increased in physically active people because of increased losses through sweat, urine and faeces, and an increased need for defence against free radicals. However the evidence is controversial, and it is not possible to make any quantitative estimations. Micronutrient requirements in moderately active people are not likely to be very much above the levels recommended for the general population. The intake of micronutrients increases with increasing energy intake. Therefore, physically highly active people (athletes) have higher micronutrient intakes than untrained subjects. However, moderate physical activity does not necessarily affect daily micronutrient intake. The available indices of micronutrient status do not support the belief that micronutrient status is compromised in highly trained athletes, even without use of dietary supplements. Hence, there are no reasons to believe that the situation would be different in people who are only moderately active. The results suggest that micronutrient status is adequate for health and functional performance in physically active people who follow a normal, mixed Western diet.

Dietary Supplements↗
PubMed1999

Eating control and physical activity as determinants of short-term weight maintenance after a very-low-calorie diet among obese women.

OBJECTIVE: To test the hypothesis that eating control and physical activity help maintain weight and waist circumference after a very-low-calorie diet. DESIGN: A 12 week weight reduction (WR) phase, followed by a 40 week weight maintenance (WM) phase. For the latter, the subjects were randomised into a no-exercise group and one of two groups with a walking program. SUBJECTS: Eighty-five obese (body mass index 29-46, mean 34), clinically healthy, premenopausal women. MEASUREMENTS: Body weight, waist circumference, body composition, the measuring restrained eating, disinhibition and hunger, measured by Three Factor Eating Questionnaire (TFEQ), binge eating measured by the Bulimic Investigatory Test of Edinburgh (BITE), and number of daily steps measured by a pedometer. RESULTS: The change (delta) in weight during WM was predicted by the following regression: deltaweight (kg)=5.23+0.45 deltaweight during WR+0.66 disinhibition during WM0.00039 daily steps during WM, r2=0.46, SEE 3.3 kg. The change in waist circumference during WM was predicted as deltawaist (cm)=0.76+0.75 deltaweight during WM0.00021 daily steps during WM, r2=0.67, SEE 2.6 cm. Exercise group assignment did not affect the changes in weight, waist circumference, or indicators of eating control during the maintenance program. CONCLUSIONS: Control of overeating, as indicated by a lower disinhibition factor of the TFEQ, and daily physical activity, as indicated by a higher number of daily steps, were positive and independent predictors of weight maintenance after a very-low-calorie diet. The number of daily steps showed an independent association with change in waist circumference during weight maintenance, even after adjustment for weight change.

Adult↗
PubMed1999

Parent-child relationship of physical activity patterns and obesity.

OBJECTIVE: To study differences in physical activity between normal-weight and obese children, as well as parent-child associations of obesity and physical activity. DESIGN: Cross-sectional study. SUBJECTS: 129 obese children (67 girls and 62 boys), 142 normal-weight controls (81 boys and 61 girls), and mothers (n = 245) and fathers (n = 222) of the children. METHODS: Physical activity was assessed by a 3-day physical activity record (children and parents), by a questionnaire (children), and by one question on habitual physical activity (parents). The data were analysed by stepwise linear and logistic regressions. Obesity was assessed from relative weight (children) and BMI (parents). RESULTS: Parent inactivity was a strong and positive predictor of child inactivity (beta-coefficients 0.25 and 0.16, P<0.001, for mother and father inactivity, respectively). Scores of parent activity were somewhat weaker predictors of child vigorous activity hours and total physical activity level (beta-coefficients 0.13-0.25, P = 0.003-0.08). Child obesity was negatively associated with child habitual physical activity (odds ratio 0.88, P<0.001). In addition, parent obesity (body mass index > or =30 kg/m2) was another strong predictor of child obesity (odds ratio 2.38-3.50, P<0.002). CONCLUSIONS: The present study underscores the parents' role in childhood activity patterns and obesity. A novel finding was that the parent-child relationship of inactivity appeared to be stronger than that of vigorous activity. Hence, parents who want to reduce their children's inactivity may have to pay attention to their own lifestyle.

Adult↗
PubMed1999

Factors affecting the relation between heart rate and energy expenditure during exercise.

This study evaluated the ability to use the relationship between heart rate (HR) and oxygen uptake (VO2) to estimate energy expenditure during physical activity (AEE). General prediction equations were established based on the individual relations between HR and AEE. Forty-two women, (mean age 38.1 [SD 9.8] years, BMI 23.9 [SD 4.4]), and 45 men (40.3 [SD 9.2] years, BMI 24.7 [SD 2.9]), carried out two incremental tests, one with a cycle ergometer and another on a treadmill. Subjects also performed a 10 minute steady-state exercise, cycling and walking. Respiratory gases were obtained from indirect calorimetry. AEE was calculated from VO2 and carbon dioxide production (VCO2). The predicted AEE was compared with the AEE measured during the steady-state exercise. Using the generalised linear model, two alternative models were found to predict AEE and HR. The first showed a three-way interaction between HR, body weight and gender (p = 0.022) and also between HR age and gender (p=0.083). The second produced a three-way interaction between HR, body weight and gender (p=0.057). For cycling and walking, respectively, the predicted AEE overestimated the actual AEE by 17.7 (SD 23.2)% and 6.2 (SD 19.3)% in the first model and by 17.9 (SD 22.7)% and 6.6 (SD 19.8)% in the second during the steady-state exercise. It was concluded that at least gender and body weight should be included when HR is used to predict AEE.

Adult↗
PubMed1999

Weight and diet concerns in Finnish female and male athletes.

UNLABELLED: PURPOSES AND METHODS: Factors related to eating disorders were studied in five groups of female (N = 173) and male (N = 190) athletes, and in female (N = 79) and male (N = 61) controls. Factors associated with menstrual status were also examined. RESULTS: The sum of drive for thinness and body dissatisfaction subscales in the Eating Disorders Inventory was higher (P < 0.05) in female controls (median: 5; 25th and 75th percentiles: 1 and 14) than in endurance athletes (0; 0 and 2). The male groups did not differ from each other (P = 0.08) or from female subjects (P = 0.62). The preferred weight loss in the female controls (-4.0 kg; -6.2 and -2.0) was larger (P < 0.05) than in most athletic groups. Males, on average, did not want to lose weight (different from females, P < 0.001). The prevalence of weight reduction attempts (85%) in female weight-class athletes was higher (P < 0.05) compared with endurance and ballgame athletes and the controls (29-58%). In males, the frequency (93%) of weight reduction attempts was also highest in the weight-class athletes (P < 0.05). The prevalence of menstrual disturbances was 27-37% in aesthetic, endurance, and weight-class athletes, and 5% in controls (P = 0.06). CONCLUSIONS: The results confirmed that the risk for eating disorders is dependent on the type of sport. The claim that some female athlete groups are at greater risk than controls did not receive evidence.

Adolescent↗
PubMed1999

Physical activity in the prevention and treatment of other morbid conditions and impairments associated with obesity: current evidence and research issues.

PURPOSE: To evaluate the current status of knowledge concerning the effects of physical activity in the treatment and prevention of obesity- related problems, including cancers of the colon, breast, uterus, and prostate; gallstones; osteoarthritis; back pain; sleep apnea; reproductive abnormalities; and impaired health-related quality of life. DESIGN: A Medline literature search on the effects of physical activity in the above conditions was conducted. Only studies with some measure of weight and a description of the type of physical activity were included. RESULTS: No controlled randomized trials of exercise in the treatment of any of the studied conditions in obese patients were identified. Most of the epidemiologic studies reviewed were beset with severe methodological weaknesses. Most of the 18 studies on physical activity and colon cancer risk showed a protective effect that in some studies appeared to be greater than expected by weight loss alone. Some but not all studies of hormone-dependent cancers and gallstones showed a protective effect for physical activity. There were insufficient data on the role of exercise for the other morbid conditions studied. CONCLUSION: The scarce data available on the role of physical activity in the prevention of obesity-related chronic conditions listed above suggest a protective role that needs to be examined further in studies with improved methodologies. Well-designed intervention trials are needed to assess the role of physical activity in the treatment and long-term outcome of obese patients with these co-morbid conditions.

Back Pain↗
PubMed1999

Increased extracellular water compartment, relative to intracellular water compartment, after weight reduction.

The hydration of fat free mass (FFM) and extracellular (ECW) and intracellular water (ICW) compartments were studied in 30 obese premenopausal women before and after a 3-mo weight-reduction program and again after a 9-mo weight-maintenance program. Body fat was determined by a four-compartment model. Total body water and ECW were determined by deuterium dilution and bromide dilution, respectively. After the weight-reduction period, mean weight loss was 12.8 kg, and body fat was reduced on average by 10.9 kg. During weight maintenance, changes in body mass and body fat were not significant. Before weight reduction, mean ECW/ICW ratio was relatively high (0.78 +/- 0.10). During the the study, total body water and ICW did not change significantly. ECW did not change significantly after weight reduction, but 12 mo after the start ECW was significantly increased by 1 liter. The ECW/ICW ratio increased to 0.87 +/- 0.12 (month 12). The hydration of the FFM increased from 74 +/- 1 to 77 +/- 2% during the weight reduction and remained elevated during weight maintenance. In conclusion, the ECW/ICW ratio and the hydration of the FFM, did not normalize during weight reduction and weight maintenance.

Adipose Tissue↗
PubMed1998

Assessment of energy expenditure in overweight women.

PURPOSE: To compare field measures of average daily energy expenditure (ADEE) against criterion data by the doubly labeled water method (DLW) in overweight women. METHODS: The subject were 20 overweight (BMI 29.9 +a- 3.0 kg.m-2) premenopausal women. Energy expenditure was measured by DLW and by the factorial method (activity diary, two techniques differing by method to obtain resting energy expenditure, REE), heart-rate monitoring (HR, two techniques differing by the FLEX-point to discriminate sedentary and activity HR), accelerometer, and pedometer. RESULTS: The ADEE(DLW) was 10.26 +a- 1.1 MJ.d-1. The mean bias (ADEE by the alternative minus ADEE(DLW) was smallest for the accelerometer (+ 0.08 +a- 1.63 MJ) and HR-FLEX10 (+ 0.11 +a- 1.67 MJ). The HR-FLEX(0) technique (lower FLEX-point) overestimated ADEE by + 1.18 (+a- 1.97 MJ). However, the random error (SD of bias) was smaller for both factorial techniques (REE measured: -0.48 +2- 0.81 MJ; REE calculated from the WHO equation: -0.22 +2- 0.88 MJ). CONCLUSION: The results show that simple factorial methods may assess ADEE with small random errors in population with a rather narrow range of physical activity. The accelerometer and HR with the higher FLEX-point have comparable results with smaller bias but larger random error compared with the factorial techniques.

Adult↗
PubMed1998

Additive effects of the mutations in the beta3-adrenergic receptor and uncoupling protein-1 genes on weight loss and weight maintenance in Finnish women.

This study examined whether the Trp64Arg mutation in the beta3-adrenergic receptor (beta3AR) and the A-->G mutation in the uncoupling protein-1 (UCP-1) genes have associations with weight loss and subsequent weight maintenance. Seventy-seven obese (body mass index range, 29-46 kg/m2), clinically healthy, premenopausal women were studied. A 12-wk weight reduction by very low calorie diet (VLCD) was followed by a 40-wk weight maintenance phase. The subjects were divided into four groups according to their beta3AR and UCP-1 genotype: no mutation (control; n=37), only Trp64Arg mutation in the beta3AR gene (n=12), only A-->G mutation in the UCP-1 gene (n=23), and both mutations (n=5). Subjects with both mutations had a lower weight reduction during VLCD than the controls [-10.5+/-0.6 (+/-SEM) vs. -14.0+/-0.5 kg; P=0.051, by ANOVA]. During the maintenance phase, weight in subjects with both mutations increased by 5.8+/-1.5 kg, but remained unchanged in the controls (-0.5+/-0.8 kg; P=0.041). The changes in weight in subjects with only one of the mutation were close to the results in the controls. Resting energy expenditure, adjusted for fat mass, fat-free mass, and maximal aerobic power, did not change differently between the groups throughout the study. The results suggest that a combination of the Trp64Arg mutation in the beta3AR and the A-->G mutation in the UCP-1 genes may be associated with faster weight gain after a VLCD.

Adult↗
PubMed1997

Association between weight cycling history and bone mineral density in premenopausal women.

The hypothesis that a history of one or more weight reductions and regains (weight cycling) is associated with lower site-specific bone mineral density (BMD) was examined in 169 premenopausal women, aged 29-46 years. Data on the previous 10-years' weight cycling history, present weight-bearing physical exercise, number of deliveries, present use of contraceptive pills or hormone-releasing coils, age at menarche and present menstrual status were collected by a self-administered questionnaire. Dietary intake was calculated from food records. The areal BMD (g/cm2) was measured with dual-energy X-ray absorptiometry (Norland XR-26). The lumbar spine (L2-4) BMD, adjusted to weight and age at menarche (ANCOVA), was 0.062 g/cm2 (95% confidence interval: 0.015 to 0.011 g/cm2; p = 0.01) higher in the non-cyclers (n = 68) than in subjects with reported weight-cycling history (n = 101). The corresponding difference for femoral neck BMD was 0.019 g/cm2 (-0.018 to 0.056; p = 0.30), for trochanter BMD 0.013 g/cm2 (-0.025 to 0.05 g/cm2; p = 0.50) and for distal radius BMD 0.022 g/cm2 (0.006 to 0.397 g/cm2; p = 0.008). A pairwise comparison of 34 weight-matched subjects (non-cycler vs cycler) gave similar BMD differences as found in the above (ANCOVA) analyses. The results suggest that weight cycling might be associated with lower spine and distal radius BMD.

Adult↗
PubMed1997

Alcohol beverage drinking, diet and body mass index in a cross-sectional survey.

OBJECTIVE: The study was carried out to determine the associations of alcohol beverage drinking with macronutrients, antioxidants, and body mass index. SETTING: Dietary subsample of the 1992 Finmonica cardiovascular risk factor survey in Finland; a cross-sectional study. SUBJECTS: 985 women and 863 men were drawn from the population register in the four monitoring areas. All subjects were 25-64 y of age. METHODS: The mailed questionnaire included questions covering socioeconomic factors, physical activity, smoking, and alcohol consumption. The diet was assessed using a three-day food record. RESULTS: The dietary differences between abstainers and alcohol consumers were more significant than between consumers of different alcoholic beverages. Among drinkers, fat intake as a percentage of energy was higher and carbohydrate intake was lower than among abstainers. Those who preferred wine, however, had the highest vitamin C intake; female wine drinkers also had the highest carotenoid intake. With the exception of those who mainly preferred spirits, alcohol energy was not added to the diet but seemed to substitute food items both in men and women. Despite the similar total daily energy intakes, daily energy expenditure, and physical activity index, male drinkers were leaner than abstainers. In women, the proportion of underreporters of energy intake increased with increasing alcohol consumption, and the association between alcohol and body mass index was similar to that in men after the exclusion of underreporters. CONCLUSIONS: Alcohol consumers were leaner than abstainers, and wine drinkers in particular had more antioxidants in their diet.

Adult↗
PubMed1997

Comparison of body composition methods: a literature analysis.

OBJECTIVE: To examine the comparability of different methods to assess percentage body fat (BF%) against underwater weighing (UWW). DESIGN: A meta-analysis on 54 papers, published in 1985-96, on healthy, adult Caucasians. METHODS: The mean BF% from different studies were treated as single data points. In addition to UWW, the studies included one or more of the following methods: 3- or 4-component model, dual-energy X-ray absorptiometry (DXA), dual-energy photon absorptiometry, isotope dilution, bioimpedance (BIA), skinfolds or near-infrared interactance (NIR). Within each of the methods, the analyses were done separately for different mathematical functions, techniques or instruments. MAIN OUTCOME MEASURES: Bias (mean difference) and error (s.d. of difference) between BF% measured by UWW and the other methods. RESULTS: The 4-component model gave 0.6 (95% confidence interval for the mean, CI: 0.1 to 1.2) BF% higher results than UWW. Also the 3-component model with body density and total body water (+1.4 BF%, 95% CI: +0.3 to +2.6), deuterium dilution (+1.5 BF%, 95% CI: +0.7 to +2.3), DXA by Norland (+7.2 BF%, 95% CI: 2.6 to 11.8) and BIA by Lukaski et al. (+2.0 BF%, 95% CI: 0.2 to 3.8) overestimated BF%, whereas BIA by Valhalla Scientific (-2.6 BF%, 95% CI: -4.5 to -0.6) and skinfold equations by Jackson et al. (-1.20, 95% CI: -2.3 to -0.1) showed a relative underestimation. The mean bias for the skinfold equation by Durnin & Womersley, against UWW, was 0.0 BF% (95% CI: -1.3 to 1.3). The correlation between the size of measurement and the mean difference was significant for only NIR (r = -0.77, P = 0.003). CONCLUSIONS: The difference between any method and UWW is dependent on the study. However, some methods have a systematical tendency for relative over- or underestimation of BF%.

Absorptiometry, Photon↗
PubMed1996

Amenorrhea in ballet dancers in the Netherlands.

The prevalence of amenorrhea was studied among 113 professional and student ballet dancers in the Netherlands (mean age 23.3 yr, SD 4.8). Sixty-one dancers not on oral contraceptives were included in the subsequent analyses. Six cases (prevalence 9.8 percent, 95 percent confidence interval: 2.4-17.2) with secondary amenorrhea (< or = 4 cycles per year; previous menstruation > or = 3 months prior to the study; menarche > or = 1 yr prior to the study) were found. Two dancers had primary amenorrhea (no menarche at the age of > or = 16). There was a negative correlation between the age of menarche and the number of menstrual cycles during the 12 months preceding the study (r = -0.46, P = 0.001). Body composition (four-compartment model), amount of dancing (recorded), resting energy expenditure (ventilated hood), dietary intake (recorded), and indices of eating disorders (Eating Disorders Inventory, EDI) were studied in 15 of the dancers, 5 amenorrheic and 10 eumenorrheic. No significant differences were found between the amenorrheic and eumenorrheic dancers. An explanation for the lower prevalence of amenorrhea in ballet dancers in the Netherlands, compared with U.S. dancers, was not obvious. Relatively low EDI scores (25.8, SD 14.5) in a subsample of 24 dancers could indicate less rigid emphasis on leanness and dieting.

Adult↗