Adolescent Girls and Lifestyle:
Why some are more vulnerable than others to certain diseases
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Josephine Kasa-Vubu
Photo: Martin Vloet |
Josephine Kasa-Vubu, M.D. (Residency 1988), a pediatric endocrinologist at
Michigan, views health disparities through the lenses of age, gender and lifestyle.
She studies the ways in which exercise or obesity can affect adolescent girls'
reproductive function, bone density and other health outcomes.
"Excessive exercise, on one end of the spectrum, and inactivity and obesity
on the other, can cause menstrual irregularities," she says. "There is no question
that exercise is beneficial to all; however, adolescent girls are unique as
they may be more vulnerable to the consequences of exercise even if they are
a normal weight."
Kasa-Vubu is interested in the point at which over-training causes amenorrhea
and an increased long-term risk of osteoporosis. She studies endocrine changes
associated with exercise that may have an impact on bone health. But weight
and exercise (or their lack) are linked, and she also studies the point where
obesity triggers type 2 diabetes, impaired fertility and a long-term risk of
heart disease. Her research explores why these points vary among young women
and seeks to identify factors — such as body composition or pituitary hormones
— which indicate whether a girl's lifestyle places her at risk of an 'energy
imbalance.'
Who tolerates and benefits from intense exercise and who suffers from it?
Why do some obese, inactive adolescents get diabetes while others do not? "I'm
interested in the adolescent girl across the weight spectrum, from lean to
overweight," she says. "What is the impact of energy balance on her menstrual
cycle and her bone health, on one hand, or her risk for type 2 diabetes on
the other? How does that happen? This information is particularly important
at a time when more girls will need to be counseled in weight control strategies
to curb the growing obesity epidemic in youth.
"Girls who over-train typically don't realize they have crossed a line to
a place where exercise can be detrimental," she says. But at the other end
of the spectrum, the perception of physical activity can also be a problem,
and parents of Kasa-Vubu's obese adolescent patients often don't view their
daughters as sedentary and overweight. "As I started recruiting for my study,
I noted that adolescent girls, in general, are very interested in their health,
nutrition and exercise. I had mothers inquire about the study and wonder how
and why their daughter's menstrual cycle was affected by training," she says. "But
we need a better way to guide them through this process. There's not a one-size-fits-all
solution."
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