Jeff- can you help me interpret this study?

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Jeff- can you help me interpret this study?

Postby lfwfv » Sun Oct 30, 2011 11:37 am

Hi Jeff,

I am working to recover from hypothalamic amenorrhea. I have already restored my weight to a BMI of about 20.5 (a weight i used to cycle at), but am still not fully recovered.

I have done my own research about amenorrhea and its causes, and have asked you, Dr. Esselstyn, and Dr. McDougall for their advice. (My doctor believes HA is incurable and that I should be taking hormones...a route I am resisting).

Both Dr. E and Dr. M determined that I should gain weight and eat more calories, and that the dietary fat level of my diet (9-11% usually, eating a whole foods, low fat, starch-based, plant diet) did not contribute to amenorrhea. I have followed their advice, am eating according to hunger/fullness, and my weight gain has plateaued at this spot now. I eat plenty of whole, unrefined starches, and supplement with legumes, fruit, and veggies as hunger dictates. I am only slowly walking (3m/hr), no running at all.

I uncovered this article at pubmed about dietary fat intake and its link to HA.

Functional hypothalamic amenorrhoea: a partial and reversible gonadotrophin deficiency of nutritional origin.
http://www.ncbi.nlm.nih.gov/pubmed/10396367

It clearly states that low dietary fat intakes can be responsible for HA. Is this a faulty conclusion? It certainly disagrees with Dr. McDougall's and Dr. Esselstyn's conclusions.

Could you help me to interpret this article? Is their conclusion valid?

Thank you so much
lfwfv
Last edited by lfwfv on Sun Oct 30, 2011 5:13 pm, edited 1 time in total.
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Re: Jeff- can you help me interpret this study?

Postby pinkrose » Sun Oct 30, 2011 3:39 pm

lfwfv, what article? :?:
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Re: Jeff- can you help me interpret this study?

Postby lfwfv » Sun Oct 30, 2011 5:15 pm

:roll: sorry! forgot to add the link. Just edited my post to include it. Thanks pinkrose!!
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Re: Jeff- can you help me interpret this study?

Postby erin » Mon Oct 31, 2011 5:16 pm

Hi lfwfv :),

I'm not Jeff but while you are waiting on his input I hope you don't mind if I share my thoughts.

After reading the abstract you linked to I tried to find the full text but I wasn't able to. I did find another study related to your condition and from what I can gather HPA is due to either prolonged severe food restricting (overall caloric deficit) intensive exercising (long distance runners and professional cyclists were mentioned in the study), or some combination of the two. Fat intake was not discussed as a variable.

http://jcem.endojournals.org/content/87/2/500.full

On a personal note, I did a research project when I was in college on female infertility and BMI was a HUGE factor. Basically anytime BMI falls below 20 or goes above 30 there is a possibility that it will affect endocrine hormonal systems.

I think a low fat diet in and of itself is not a worry unless it is accompanied by some other extreme factor such as prolonged under-eating or sustained over-exercising. An easy way to understand this is if for example you are consuming 1600 calories/day and 5 % is from fat that is 80 calories from fat or roughly 9 grams. But if you are eating only 1000 calories/day and 5% is from fat that is only 50 calories or less than 6 grams of fat. If you are running 5 miles or cycling 10 miles (the women in the study worked out much more than this!) you can see how even the 1600 calorie diet would not be sufficient to meet your needs for fat, carbohydrate, or protein and the 1000 calories would equal starvation.

The study you linked did say that the women with amennorhea did not consume enough fat but it also noted they were not eating enough carbohydrate so they could have just left it at "not eating enough".

If eating low fat were enough to cause the condition you would see it occurring in women of normal weight and body fat levels who are eating a 5-10% fat diet (such as myself and many on this forum) but from what I can uncover this is rarely or never the case.

On a positive note, 75% of the women in the study I linked to experienced a full recovery! :)

Wishing you the best!

~ Erin
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Re: Jeff- can you help me interpret this study?

Postby lfwfv » Mon Oct 31, 2011 8:40 pm

Erin,

I cannot thank you enough for taking the time to read the abstract, find the other article, and respond to me based on your past research and experience. I truly found the article helpful, and it reassured me that I am likely on the right path to getting well.

I think I may just need more time. I am being careful not to run right now, and I am eating plenty of starches as hunger dictates. My weight is holding steady, with no restriction of starches, at a BMI of around 20.5-20.8, so hopefully I will fully recover soon.

Again, thank you so much for your kind and helpful response!
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