search
Back to results

Energy Restriction and Hormones in Premenopausal Women

Primary Purpose

Menstruation Disturbances, Luteal Phase Defect

Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Exercise+CR
Light Conditioning
Sponsored by
Penn State University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Menstruation Disturbances focused on measuring Energy Balance, Menstrual Cycle Disturbance, Luteal Phase Defect, Menstruation Disturbances, Pathologic Processes

Eligibility Criteria

25 Years - 40 Years (Adult)FemaleAccepts Healthy Volunteers

Inclusion Criteria:

  • Weight 50-90 kg
  • BMI 18-35 kg/m2
  • Nonsmoking
  • <1 hour/week of purposeful aerobic exercise for the past 6 months
  • Gynecological age ≥10 years
  • Documentation of at least two ovulatory menstrual cycles during screening.

Exclusion Criteria:

  • History of serious medical conditions
  • Medication use that would alter metabolic hormone levels
  • Significant weight loss/gain (±2.3 kg) in the last year
  • Current evidence of disordered eating or history of an eating disorder
  • Taking exogenous hormonal contraceptives for the past 6 month
  • Smoking

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    Exercise with caloric-restriction

    Light Conditioning (reference group)

    Arm Description

    Exercise: Participants engaged in supervised exercise training sessions (to expend ~20% of baseline energy needs) in Noll Laboratory; 4 times per week. Diet: Participants consumed meals in the General Clinical Research Center metabolic kitchen that reduced dietary intake 20-35% of baseline energy needs. Diet composition was 55% carbohydrates, 30% fat, and 15% protein.

    Exercise: Participants engaged in supervised exercise training sessions (to expend ~10% of baseline energy needs) in Noll Laboratory; 1-2 times per week. Diet: Participants consumed meals in the General Clinical Research Center metabolic kitchen that had calories sufficient to maintain body weight and additional calories to remain in energy balance. Diet composition was 55% carbohydrates, 30% fat, and 15% protein.

    Outcomes

    Primary Outcome Measures

    Change in estrogen and IGF-1
    Change in urine estrone-1-glucuronide (E1G ng/mL) and serum IGF-1 (ng/mL)

    Secondary Outcome Measures

    Change in body composition
    Change in percent body fat (%)
    Change in body composition
    fat mass (kg) and fat free mass (kg)
    Change in reproductive hormones
    Change in reproductive hormones sex hormone binding globulin (SHBG nmol/L)
    Change in reproductive hormones
    Change in reproductive hormones pregnanediol glucuronide (PdG ng/mL)
    Change in metabolic hormones
    Change in metabolic hormones leptin (ng/mL) and insulin-like growth factor binding protein 3 (ng/mL)
    Change in metabolic hormones
    Change in metabolic hormone insulin (μIU/mL)
    Change in metabolic hormones
    Change in metabolic hormone sex hormone binding globulin (nmol/L)
    Change in metabolic hormones
    Change in metabolic hormone total triiodothyronine (ng/dL)
    Change in menstrual cycle phase length
    Change in follicular phase length (days) and luteal phase length (days)

    Full Information

    First Posted
    October 6, 2021
    Last Updated
    October 25, 2021
    Sponsor
    Penn State University
    Collaborators
    National Institutes of Health (NIH), United States Department of Defense, National Center for Research Resources (NCRR)
    search

    1. Study Identification

    Unique Protocol Identification Number
    NCT05107804
    Brief Title
    Energy Restriction and Hormones in Premenopausal Women
    Official Title
    Effects of Moderate Aerobic Exercise Combined With Caloric Restriction on Circulating Estrogens and IGF-I in Premenopausal Women
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2021
    Overall Recruitment Status
    Completed
    Study Start Date
    March 2001 (Actual)
    Primary Completion Date
    November 2006 (Actual)
    Study Completion Date
    November 2006 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Penn State University
    Collaborators
    National Institutes of Health (NIH), United States Department of Defense, National Center for Research Resources (NCRR)

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    A growing body of epidemiological and biological evidence strongly suggests that physical activity may reduce the risk of breast cancer. Although the mechanism remains unclear, possible links between reduced risk and exercise include favorable alterations in body composition and positive changes in the hormonal milieu. One hormonal biomarker of breast cancer, circulating estrogen, is postulated to be reduced by chronic physical activity, presumably due to disruptive effects of exercise upon menstrual cyclicity, and the potential for loss of body fat with subsequent reductions in the peripheral biosynthesis of circulating estrogens. Although studies have shown that chronic exercise can reduce circulating estrogen, we know little about the magnitude and duration of exposure to an energy deficit required for these changes. Additionally, no studies have addressed the degree to which peripheral production of estrone, versus the ovarian production of estradiol, is altered with exercise that promotes weight/fat loss. A second biomarker of breast cancer, insulin-like growth factor-1 (IGF-1), is presumably increased with exercise but reduced with exercise if energy balance is negative. No prospective studies have addressed whether a moderate aerobic exercise program that results in weight loss will lead to significant changes in IGF-I levels, particularly in individuals of differing initial energy stores. Metabolic energy availability is an important contributing factor in the development of reproductive cancers. However, current methods for assessing energy availability, which include anthropometric measures, calculations of energy balance, evaluation of various serum and urinary biomarkers are prone to measurement error, not sensitive to alterations in energy availability, and are sometimes affected by disease states. The current project includes the introduction of a novel approach to estimating energy status by measuring metabolic hormones in plasma: insulin, IGF-I, insulin-like growth factor binding protein-3 (IGFBP-3) and leptin. This study tested whether a program of moderate aerobic exercise that is combined with a moderate level of dietary restriction would result in significant decreases in two biomarkers of breast cancer, circulating estrogens and IGF-I.
    Detailed Description
    This study used a randomized prospective design (block; 3:1 allocation) to test the effects of a four month (four menstrual cycles) intervention of moderate aerobic exercise (4 times per week, 60 minutes/session) combined with caloric restriction designed to produce a weekly energy deficit of -20%. The aims of the study were: 1) To test the hypothesis that a moderate level of low energy availability created through a combination of exercise and caloric restriction will lower circulating estrogens and IGF-I; 2) To test the hypothesis that exercise-induced decreases in body fat will contribute substantially to the lowering of circulating estrogens changes with training; 3) To validate a novel method of assessing energy status that represents an improvement of existing. Eumenorrheic, untrained women between 25-40 years (n=47) were randomly assigned to one of two treatments groups: exercise with caloric-restriction (EX+CR; n=36) or light conditioning reference (LC; n=11) groups. To determine treatment effects on circulating estrogens, reproductive function and IGF-I, both serum and urinary levels of hormones were monitored for a control period of 2 months (2 menstrual cycles), i.e., Screening and Baseline, followed the 4 month (4 menstrual cycles: intervention 1-4) experimental period. The exercise/diet intervention began on the first day of the third month (menstrual cycle) and continue for four menstrual cycles thereafter (intervention 1, 2, 3, and 4). A post-study measurement was taken during cycles days 1-7 of the seventh menstrual cycle. Baseline energy needs were assessed during the baseline cycle. Resting metabolic rate and non-exercise physical activity were added to determine a caloric need for the day. Caloric intake was supervised throughout the entire study, and meals were comprised of 55% carbohydrates, 30% fat, and 15% protein. Exercise training was supervised, and maximal aerobic capacity (VO2max) was calculated. Menstrual status was assessed through analysis of daily urinary metabolites of estrone-1-glucuronide (E1G), pregnanediol glucuronide (PdG), and midcycle luteinizing hormone (LH). Underwater weighing and a digital scale were used to assess body composition, and fasting blood samples were collected to assess metabolic hormones.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Menstruation Disturbances, Luteal Phase Defect
    Keywords
    Energy Balance, Menstrual Cycle Disturbance, Luteal Phase Defect, Menstruation Disturbances, Pathologic Processes

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    47 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Exercise with caloric-restriction
    Arm Type
    Experimental
    Arm Description
    Exercise: Participants engaged in supervised exercise training sessions (to expend ~20% of baseline energy needs) in Noll Laboratory; 4 times per week. Diet: Participants consumed meals in the General Clinical Research Center metabolic kitchen that reduced dietary intake 20-35% of baseline energy needs. Diet composition was 55% carbohydrates, 30% fat, and 15% protein.
    Arm Title
    Light Conditioning (reference group)
    Arm Type
    Active Comparator
    Arm Description
    Exercise: Participants engaged in supervised exercise training sessions (to expend ~10% of baseline energy needs) in Noll Laboratory; 1-2 times per week. Diet: Participants consumed meals in the General Clinical Research Center metabolic kitchen that had calories sufficient to maintain body weight and additional calories to remain in energy balance. Diet composition was 55% carbohydrates, 30% fat, and 15% protein.
    Intervention Type
    Other
    Intervention Name(s)
    Exercise+CR
    Intervention Description
    Exercise with caloric-restriction
    Intervention Type
    Other
    Intervention Name(s)
    Light Conditioning
    Intervention Description
    Light Conditioning Exercise
    Primary Outcome Measure Information:
    Title
    Change in estrogen and IGF-1
    Description
    Change in urine estrone-1-glucuronide (E1G ng/mL) and serum IGF-1 (ng/mL)
    Time Frame
    Baseline Menstrual Cycle (MC) (28 days (d) or the length of 1 MC, intervention 1 (28 d or 1 MC), intervention 2 (28 d or 1 MC), intervention 3 (28 d or 1 MC), intervention 4 (28 d or 1 MC), and Post Study (days 1-7 last MC)
    Secondary Outcome Measure Information:
    Title
    Change in body composition
    Description
    Change in percent body fat (%)
    Time Frame
    Baseline Menstrual Cycle (MC) (28 days (d) or the length of 1 MC, intervention 1 (28 d or 1 MC), intervention 2 (28 d or 1 MC), intervention 3 (28 d or 1 MC), intervention 4 (28 d or 1 MC), and Post Study (days 1-7 last MC)
    Title
    Change in body composition
    Description
    fat mass (kg) and fat free mass (kg)
    Time Frame
    Baseline Menstrual Cycle (MC) (28 days (d) or the length of 1 MC, intervention 1 (28 d or 1 MC), intervention 2 (28 d or 1 MC), intervention 3 (28 d or 1 MC), intervention 4 (28 d or 1 MC), and Post Study (days 1-7 last MC)
    Title
    Change in reproductive hormones
    Description
    Change in reproductive hormones sex hormone binding globulin (SHBG nmol/L)
    Time Frame
    Baseline Menstrual Cycle (MC) (28 days (d) or the length of 1 MC, intervention 1 (28 d or 1 MC), intervention 2 (28 d or 1 MC), intervention 3 (28 d or 1 MC), intervention 4 (28 d or 1 MC), and Post Study (days 1-7 last MC)
    Title
    Change in reproductive hormones
    Description
    Change in reproductive hormones pregnanediol glucuronide (PdG ng/mL)
    Time Frame
    Baseline Menstrual Cycle (MC) (28 days (d) or the length of 1 MC, intervention 1 (28 d or 1 MC), intervention 2 (28 d or 1 MC), intervention 3 (28 d or 1 MC), intervention 4 (28 d or 1 MC), and Post Study (days 1-7 last MC)
    Title
    Change in metabolic hormones
    Description
    Change in metabolic hormones leptin (ng/mL) and insulin-like growth factor binding protein 3 (ng/mL)
    Time Frame
    Baseline Menstrual Cycle (MC) (28 days (d) or the length of 1 MC, intervention 1 (28 d or 1 MC), intervention 2 (28 d or 1 MC), intervention 3 (28 d or 1 MC), intervention 4 (28 d or 1 MC), and Post Study (days 1-7 last MC)
    Title
    Change in metabolic hormones
    Description
    Change in metabolic hormone insulin (μIU/mL)
    Time Frame
    Baseline Menstrual Cycle (MC) (28 days (d) or the length of 1 MC, intervention 1 (28 d or 1 MC), intervention 2 (28 d or 1 MC), intervention 3 (28 d or 1 MC), intervention 4 (28 d or 1 MC), and Post Study (days 1-7 last MC)
    Title
    Change in metabolic hormones
    Description
    Change in metabolic hormone sex hormone binding globulin (nmol/L)
    Time Frame
    Baseline Menstrual Cycle (MC) (28 days (d) or the length of 1 MC, intervention 1 (28 d or 1 MC), intervention 2 (28 d or 1 MC), intervention 3 (28 d or 1 MC), intervention 4 (28 d or 1 MC), and Post Study (days 1-7 last MC)
    Title
    Change in metabolic hormones
    Description
    Change in metabolic hormone total triiodothyronine (ng/dL)
    Time Frame
    Baseline Menstrual Cycle (MC) (28 days (d) or the length of 1 MC, intervention 1 (28 d or 1 MC), intervention 2 (28 d or 1 MC), intervention 3 (28 d or 1 MC), intervention 4 (28 d or 1 MC), and Post Study (days 1-7 last MC)
    Title
    Change in menstrual cycle phase length
    Description
    Change in follicular phase length (days) and luteal phase length (days)
    Time Frame
    Baseline Menstrual Cycle (MC) (28 days (d) or the length of 1 MC, intervention 1 (28 d or 1 MC), intervention 2 (28 d or 1 MC), intervention 3 (28 d or 1 MC), intervention 4 (28 d or 1 MC)

    10. Eligibility

    Sex
    Female
    Minimum Age & Unit of Time
    25 Years
    Maximum Age & Unit of Time
    40 Years
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion Criteria: Weight 50-90 kg BMI 18-35 kg/m2 Nonsmoking <1 hour/week of purposeful aerobic exercise for the past 6 months Gynecological age ≥10 years Documentation of at least two ovulatory menstrual cycles during screening. Exclusion Criteria: History of serious medical conditions Medication use that would alter metabolic hormone levels Significant weight loss/gain (±2.3 kg) in the last year Current evidence of disordered eating or history of an eating disorder Taking exogenous hormonal contraceptives for the past 6 month Smoking
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Nancy Williams, ScD
    Organizational Affiliation
    Penn State University
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No
    Citations:
    PubMed Identifier
    20605898
    Citation
    Williams NI, Reed JL, Leidy HJ, Legro RS, De Souza MJ. Estrogen and progesterone exposure is reduced in response to energy deficiency in women aged 25-40 years. Hum Reprod. 2010 Sep;25(9):2328-39. doi: 10.1093/humrep/deq172. Epub 2010 Jul 6.
    Results Reference
    result

    Learn more about this trial

    Energy Restriction and Hormones in Premenopausal Women

    We'll reach out to this number within 24 hrs