Energy availability modulates regional blood flow via estrogen-independent pathways in regularly menstruating young women

Purpose: This study aimed to investigate the impact of short-term low energy availability (LEA) on vascular function in young, regularly menstruating women. Methods: Participants were 19 women, aged 22.9 ± 4.2 years, with body mass index 18–30 kg·m ². They were divided into two groups and completed two conditions in a crossover design: a 3-day control condition (CON) with an energy availability of 45 kcals·kgFFM ⁻¹·day ⁻¹ and a 3-day LEA condition of 15 kcals·kgFFM ⁻¹ day ^–1. Assessments were conducted during the early follicular phase of the menstrual cycle. Outcome measures included forearm blood flow (FBF), heart rate, blood pressure, arterial stiffness, resting energy expenditure (REE), metabolic blood markers and body composition. Results: Significant time-by-condition interactions were found for resting FBF (p =.004), REE (p =.042), triiodothyronine (p =.006), β-hydroxybutyrate (p =.002) and body mass (p <.001). Resting FBF was 1.43 ± 1.01 and 1.31 ± 0.61 (arbitrary units) at pre and post, respectively, in LEA and 1.52 ± 0.7 and 1.76 ± 0.57 at pre and post in CON. The LEA condition led to a decrease in triiodothyronine (pre: 1.54 ± 0.28, post: 1.29 ± 0.27 ng ml ⁻¹), REE (pre: 1588 ± 165, post: 1487 ± 160 kcals day ⁻¹) and body mass (pre: 61.4 ± 7.5, post: 59.6 ± 7.3 kg). Changes in resting FBF were significantly correlated with changes in REE in the LEA condition (r = 0.53; p = 0.02). Conclusion: Short-term LEA modifies regional blood flow and this might contribute to the observed decreased in REE. Findings emphasize the need for careful management of energy availability in populations at risk of LEA.