Despite the severity and prevalence of iron deficiency in exercising women, few published reports have explored how iron deficiency interacts with another prevalent and severe condition in exercising women: the 'female athlete triad.' This review aims to describe how iron deficiency may interact with each component of the female athlete triad, that is, energy status, reproductive function, and bone health. The effects of iron deficiency on energy status are discussed in regards to thyroid function, metabolic fuel availability, eating behaviors, and energy expenditure. The interactions between iron deficiency and reproductive function are explored by discussing the potentially impaired fertility and hyperprolactinemia due to iron deficiency and the alterations in iron metabolism due to menstrual blood loss and estrogen exposure. The interaction of iron deficiency with bone health may occur via dysregulation of the growth hormone/insulin-like growth factor-1 axis, hypoxia, and hypothyroidism. Based on these discussions, several future directions for research are presented.

O ne-third of adults worldwide are physically inactive (16). The period of transition from high school to college is frequently accompanied by increased inactivity leading to weight gain, with most studies showing a gain of about 4 lb in the first year of college, which may mark the beginning of a trend (15). In 2014, 51% of women attending college in the United States did not meet the physical activity guidelines set by the American College of Sports Medicine (ACSM), and 31% were estimated to be overweight or obese (1). Among the multitude of established ramifications of low fitness, suboptimal cognitive performance secondary to low fitness may jeopardize learning and academic success in college-attending women (19).The bidirectional association between physical and mental health has been acknowledged for millennia (46). Within research relating fitness to brain and behavior, a focus on life stage extremes-periods during which rapid brain changes occur-has predominated, and little is known about this association during young adulthood. It is now widely recognized that lifelong brain remodeling occurs (14), which has generated interest in how to optimize brain function in young adults. Evidence for an association between fitness and cognition has been identified at the neural level in studies using electroencephalography to examine event-related potentials, suggesting that fitness promotes neural plasticity (34). However, limited evidence at the behavioral level prevents forming implications for real-life scenarios. The lack of data to support behavioral effects also makes it difficult to distinguish whether fitness benefits the whole brain or only certain systems underlying certain behaviors, that is, whether the effects of fitness are general or specific. Furthermore, previous investigations in young adults have involved methodological constraints such as small sample size, assessment of fitness using self-reported or indirect measures, or aggregation of data across different age groups or sexes (18,21,45). Given the changes in fitness and high dependence on optimal cognition in university settings, we sought to better understand relations between cardiorespiratory fitness (CRF) level and executive function in young adult women. Our purpose was to test whether and older adults. Women attending college live in a cognitively demanding setting where optimal cognition matters but often experience declines in CRF. Our aim was to test whether CRF is associated with executive function in young adult women. Methods: Participants in this cross-sectional study included 120 healthy women age 18-35 yr in a university setting. Each woman completed a maximal treadmill-based exercise test to determine peak oxygen uptake (V O 2peak ), computerized tests of executive function, and questionnaires to assess motivation and other factors with potential to influence physical and cognitive performance. Results: Overall CRF was excellent, with a sample mean V O 2peak of 44.6 mL·min -1 ·kg -1 . After adjusting for covariates, higher V...

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Purpose: Combined hormonal contraceptive therapy has been associated with negative bone mineral density outcomes that may be route-dependent [i.e., combined oral contraception (COC) vs. contraceptive vaginal ring (CVR)] and involve the hepatic growth hormone (GH)/insulin-like growth factor-I (IGF-I) axis. The objective of the pilot study was to assess the impact of route of contraceptive administration on IGF-I and procollagen type I N-terminal propeptide (PINP) responses to an IGF-I Generation Test. We hypothesized that the peak rise in IGF-I and PINP concentration and area under the curve (AUC) would be attenuated following COC, but not CVR, use. Methods: Healthy, premenopausal women not taking hormonal contraception were recruited. Women were enrolled in the control group (n = 8) or randomly assigned to COC (n = 8) or CVR (n = 8) for two contraceptive cycles. IGF-I Generation Tests were used as a probe to stimulate IGF-I release and were completed during the pre-intervention and intervention phases. Serum IGF-I and PINP were measured during both IGF-I Generation Tests. The study was registered at ClinicalTrials.gov (NCT02367833). Results: Compared to the pre-intervention phase, peak IGF-I concentration in response to the IGF-I Generation Test in the intervention phase was suppressed in the COC group (p < 0.001), but not the CVR or Control groups (p > 0.090). Additionally, compared to the pre-intervention phase, PINP AUC during the intervention phase was suppressed in both COC and CVR groups (p < 0.001), while no difference was observed in the control group (p = 0.980). Conclusion: These data suggest that changes in recombinant human GH-stimulated hepatic IGF-I synthesis in response to combined hormonal contraception (CHC) use are dependent on route of CHC administration, while the influence on PINP is route-independent. Future research is needed to expand these results with larger randomized control trials in all age ranges of women who utilize hormonal contraception.