The purpose of this study was to investigate the prevalence of self-reported restrictive eating, current or past eating disorder, and menstrual dysfunction and their relationships with injuries. Furthermore, we aimed to compare these prevalences and associations between younger (aged 15–24) and older (aged 25–45) athletes, between elite and non-elite athletes, and between athletes competing in lean and non-lean sports. Data were collected using a web-based questionnaire. Participants were 846 female athletes representing 67 different sports. Results showed that 25%, 18%, and 32% of the athletes reported restrictive eating, eating disorders, and menstrual dysfunction, respectively. Higher rates of lean sport athletes compared with non-lean sport athletes reported these symptoms, while no differences were found between elite and non-elite athletes. Younger athletes reported higher rates of menstrual dysfunction and lower lifetime prevalence of eating disorders. Both restrictive eating (OR 1.41, 95% CI 1.02–1.94) and eating disorders (OR 1.89, 95% CI 1.31–2.73) were associated with injuries, while menstrual dysfunction was associated with more missed participation days compared with a regular menstrual cycle (OR 1.79, 95% CI 1.05–3.07). Our findings indicate that eating disorder symptoms and menstrual dysfunction are common problems in athletes that should be managed properly as they are linked to injuries and missed training/competition days.

Suboptimal diets increase morbidity and mortality risk. Epigenetic clocks are algorithms that can assess health and lifespan, even at a young age, before clinical manifestations of diseases. We investigated the association between dietary patterns and biological aging in young adult twins. The data were drawn from the population-based FinnTwin12 study and consisted of twins aged 21-25 years (n = 826). Food and beverage intakes were assessed using a food frequency questionnaire. Biological aging was estimated using the epigenetic clocks GrimAge and DunedinPACE. Latent class analysis was used to identify dietary patterns. The association between dietary patterns and biological aging was assessed using linear regression modeling at the individual level, followed by within-twin pair analyses to account for genetic liabilities and shared familial confounders. Six dietary patterns were identified: 1) High fast food, low fruits and vegetables (F&V), 2) Plant-based, 3) Health-conscious, 4) Western with infrequent fish, 5) Western with regular fish, and 6) Balanced average. At the individual level, GrimAge acceleration was slower in the Plant-based, Health-conscious, and Balanced-average patterns compared to the High fast food, low F&V, and faster in the Western with infrequent fish pattern compared to the Balanced average, regardless of sex, nonalcoholic energy intake, smoking, and alcohol consumption. After further adjustment for BMI and sports participation, the strengths of the associations modestly decreased; however, the difference between the Balanced-average and High fast food, low F&V patterns remained significant. The pace of aging (DunedinPACE) was slower in the Plant-based pattern compared to the High fast food, low F&V and the Western with infrequent fish patterns after adjustment for sex, nonalcoholic energy intake, smoking, and alcohol. The effect sizes were attenuated and reached a non-significant level when BMI and sports participation were added to the model. Most of the associations were replicated in the within-pair analyses among all twin pairs and among dizygotic twin pairs, but the effect sizes tended to be smaller among monozygotic twin pairs. This suggests that genetics, but not a shared environment, may partially explain the observed associations between diet and biological aging. Diets high in fast food, processed red meat, and sugar-sweetened beverages and low in fruits and vegetables are associated with accelerated biological aging in young adulthood. The clustering effect of lifestyle factors and genetic confounders should be considered when interpreting the findings.

This study aimed to investigate the associations of competitive sport participation in adolescence and age at menarche (AAM) with body composition, femoral neck bone mineral density (BMD), physical performance, and physical activity (PA) in middle-aged women. 1098 women aged 47–55 years formed the sample of this retrospective study. Participants self-reported their PA level at age 13–16 years and AAM. The protocol also included dual-energy X-ray absorptiometry, physical performance tests, and accelerometer-measured PA. Participants were divided into three groups according to their PA level at the age of 13–16 (no exercise, regular PA, and competitive sport) and according to their AAM (≤12, 13, and ≥14 years). After adjusting for potential confounding factors, participation in competitive sport at age 13–16 was associated with higher midlife lean mass and BMD, and better physical performance compared to groups with no exercise or regular PA. Individuals with AAM ≥ 14 years had lower midlife BMI and fat mass than participants in the other AAM groups and pre- and perimenopausal women with AAM ≥ 14 years had lower BMD than those with AAM ≤ 12. The findings indicate that participation in competitive sport in adolescence is associated with healthier body composition, higher BMD, and better physical performance in midlife, but BMD might be impaired if menarche occurs late.

Aim To evaluate differences in menstrual and pubertal history and trends in eating behaviours among women with and without a competitive sports background. Additionally, we investigated if menstrual history and eating behaviours are associated with sports career-related factors. Methods This retrospective study was conducted on 100 women with a competitive endurance sports background and their age-matched, gender-matched and municipality-matched controls (n=98). Data were collected using a questionnaire using previously validated instruments. Generalised estimating equations were used to calculate associations of menstrual history and eating behaviours with outcome variables (career length, participation level, injury-related harms and career termination due to injury). Results Athletes reported higher rates of delayed puberty and menstrual dysfunction than controls. No differences between the groups were observed in the Eating Disorder Examination Questionnaire short form (EDE-QS) scores at any age. Previous disordered eating (DE) was associated with current DE in both groups. Among athletes, higher EDE-QS scores during the sports career were associated with a shorter career (B=−0.15, 95% CI −0.26 to –0.05). Secondary amenorrhoea was associated with lower participation level (OR 0.51, 95% CI 0.27 to 0.95), injury-related harms during the career (OR 4.00, 95% CI 1.88 to 8.48) and career termination due to injury (OR 1.89, 95% CI 1.02 to 3.51). Conclusion The findings indicate that DE behaviours and menstrual dysfunction, specifically secondary amenorrhoea, have a disadvantageous relationship with a sports career in women competing in endurance sports. DE during the sports career is associated with DE after the career.

Background & aims Suboptimal diets increase morbidity and mortality risk. Epigenetic clocks are algorithms that can assess health and lifespan, even at a young age, before clinical manifestations of diseases. We investigated the association between dietary patterns and biological aging in young adult twins. Methods The data were drawn from the population-based FinnTwin12 study and consisted of twins aged 21–25 years (n=826). Food and beverage intakes were assessed using a food frequency questionnaire. Biological aging was estimated using the epigenetic clocks GrimAge and DunedinPACE. Latent class analysis was used to identify dietary patterns. The association between dietary patterns and biological aging was assessed using linear regression modeling at the individual level, followed by within–twin pair analyses to account for genetic liabilities and shared familial confounders. Results Six dietary patterns were identified: 1) High fast food, low fruits and vegetables (F&V), 2) Plant-based, 3) Health-conscious, 4) Western with infrequent fish, 5) Western with regular fish, and 6) Balanced average. At the individual level, GrimAge acceleration was slower in the Plant-based, Health-conscious, and Balanced-average patterns compared to the High fast food, low F&V, and faster in the Western with infrequent fish pattern compared to the Balanced average, regardless of sex, nonalcoholic energy intake, smoking, and alcohol consumption. After further adjustment for BMI and sports participation, the strengths of the associations modestly decreased; however, the difference between the Balanced-average and High fast food, low F&V patterns remained significant. The pace of aging (DunedinPACE) was slower in the Plant-based pattern compared to the High fast food, low F&V and the Western with infrequent fish patterns after adjustment for sex, nonalcoholic energy intake, smoking, and alcohol. The effect sizes were attenuated and reached a non-significant level when BMI and sports participation were added to the model. Most of the associations were replicated in the within-pair analyses among all twin pairs and among dizygotic twin pairs, but the effect sizes tended to be smaller among monozygotic twin pairs. This suggests that genetics, but not a shared environment, may partially explain the observed associations between diet and biological aging. Conclusion Diets high in fast food, processed red meat, and sugar-sweetened beverages and low in fruits and vegetables are associated with accelerated biological aging in young adulthood. The clustering effect of lifestyle factors and genetic confounders should be considered when interpreting the findings.