the Impact of Low Weight on Menstrual Health and Nutrition

The concerns of being underweight?

Hello, I am currently 163 cm tall and weigh around 45 kg.
Over the past six months, I have lost about 6 kg, and I have not had my period for the past five months.
I know my BMI is considered underweight, but I have not engaged in any extreme dieting.
I would like to know if the absence of my period is related to being underweight or having low body fat.
Although I have considered gaining weight back to a normal range, I do not want the areas I worked hard to slim down to become larger or bulkier.
Below are my eating habits, and I would appreciate your feedback on any issues and suggestions for my daily caloric intake (I have a light workload), as well as ways to maintain my current state while restoring my menstrual cycle:
Breakfast: 1-2 types of fruit, two tablespoons of oatmeal, about a cup of low-fat milk, 10-20 nuts, toast or other bread (I usually eat more for breakfast).
Lunch and dinner are less fixed; generally, I eat mostly vegetables, with chicken and fish as the main proteins, and I also include eggs and legumes.
For staple foods, I typically do not eat more than half a bowl at each meal.
For afternoon snacks, I have some fruit or a small snack with tea.
I do not eat out, and I try to avoid fried foods or sugary drinks, and I do not eat late-night snacks.
I find it a bit challenging to measure the portions of the six major food groups, so I tend to regulate my intake based on how I feel.
I have a couple of other questions:
1.
Is it better to eat fruit on an empty stomach for better absorption, or does it not make a difference if eaten with other foods?
2.
If I drink skim milk powder before bed to help with sleep, will it really not cause weight gain?
I have been troubled by these questions for a long time and would greatly appreciate your help.
Thank you!

ai, 20~29 year old female. Ask Date: 2009/02/02

Dr. Cai Xiuwen reply Nutrition

Hello! Your current weight is classified as underweight, with a BMI of 16.9.
It is important to pay attention to your dietary habits; ensure that your intake of staple foods is sufficient, with carbohydrates ranging from 160 to 200 grams.
Each meal should include at least two servings of staple foods.
Your dietary principles are correct, but you should also monitor the portion sizes and caloric content of snacks and fruits.
Caloric intake and expenditure should be viewed in terms of daily caloric balance, so the timing of fruit consumption and the amount of milk before bedtime can be adjusted according to personal preference, as there are no strict rules.
In addition to maintaining a controlled diet, incorporating aerobic exercise can be more effective in sustaining weight and increasing muscle and skin elasticity, resulting in a more aesthetically pleasing overall physique.
Wishing you health and beauty.
This message is provided by Dietitian Tsai Hsiu-Wen from Nantou Hospital, Department of Health.

Reply Date: 2009/02/02

More Info

The concerns you have regarding your weight, menstrual health, and nutritional intake are quite common among individuals who have experienced significant weight loss, especially when it leads to a body mass index (BMI) that falls into the underweight category. Your current height of 163 cm and weight of 45 kg gives you a BMI of approximately 16.9, which is indeed classified as underweight. This can have various implications for your health, particularly concerning your menstrual cycle and overall nutritional status.

Firstly, it is important to understand that low body weight and insufficient body fat can significantly impact hormonal balance, which is crucial for maintaining regular menstrual cycles. The absence of menstruation, known as amenorrhea, can occur when the body perceives itself to be in a state of starvation or when it is not receiving enough energy to support reproductive functions. This is often seen in individuals who have lost a considerable amount of weight or who maintain a very low-calorie diet. Your experience of having missed your period for five months is likely related to your low weight and possibly insufficient caloric intake.

Regarding your dietary habits, it seems that while you are making efforts to eat healthily, your overall caloric intake may still be too low for your body's needs, especially given your activity level. As a light worker, your energy requirements may be higher than what you are currently consuming. It is essential to ensure that you are eating enough to not only maintain your weight but also to support your body's functions, including hormonal health.

To maintain your current weight while working towards restoring your menstrual cycle, consider the following recommendations:
1. Increase Caloric Intake: Aim to gradually increase your daily caloric intake. A rough estimate for a light worker might be around 1,800 to 2,200 calories per day, depending on your activity level. Focus on nutrient-dense foods that provide a good balance of carbohydrates, proteins, and healthy fats.

2. Balanced Meals: Ensure that each meal contains a source of protein (like chicken, fish, eggs, or legumes), healthy fats (such as nuts, seeds, or avocados), and carbohydrates (whole grains, fruits, and vegetables). This balance will help provide the necessary nutrients for your body.

3. Regular Eating Schedule: Try to establish a regular eating pattern that includes three meals and two to three snacks throughout the day. This can help stabilize your energy levels and support metabolic functions.

4. Monitor Nutrient Intake: Pay attention to the six food groups and try to incorporate a variety of foods from each group. This will help ensure that you are getting a wide range of vitamins and minerals necessary for overall health.

5. Hydration: Continue to drink plenty of water, but be cautious with beverages that may contribute to weight loss, such as those that are low in calories or high in caffeine.

6. Consult a Healthcare Professional: It may be beneficial to consult with a registered dietitian or a healthcare provider who specializes in nutrition and women's health. They can provide personalized advice and help you create a meal plan that meets your specific needs.

As for your questions regarding fruit consumption and the timing of eating, it is generally acceptable to eat fruit at any time of the day. While some people prefer to eat fruit on an empty stomach for better digestion, others find it perfectly fine to include it with meals. The key is to listen to your body and see what feels best for you.

Regarding drinking skim milk powder before bed, it can be a healthy option as it is low in calories and high in protein, which may help with satiety and muscle recovery overnight. However, it is essential to ensure that this does not lead to an overall caloric deficit.

In summary, addressing your low weight and its impact on your menstrual health requires a balanced approach to nutrition and possibly an increase in caloric intake. By focusing on a well-rounded diet and consulting with professionals, you can work towards restoring your menstrual cycle while maintaining a healthy weight.

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