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Freitas L, Bezerra A, Boppre G, Amorim T, Fernandes RJ, Fonseca H. Does Swimming Exercise Impair Bone Health? A Systematic Review and Meta-Analysis Comparing the Evidence in Humans and Rodent Models. Sports Med 2024:10.1007/s40279-024-02052-x. [PMID: 38900358 DOI: 10.1007/s40279-024-02052-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND The effect of swimming on bone health remains unclear, namely due to discrepant findings between studies in humans and animal models. OBJECTIVE The aim of this systematic review and meta-analysis is to identify the available evidence on the effects of swimming on bone mass, geometry and microarchitecture at the lumbar spine, femur and tibia in both humans and rodent animal models. METHODS The study followed PRISMA guidelines and was registered at PROSPERO (CRD4202236347 and CRD42022363714 for human and animal studies). Two different systematic literature searches were conducted in PubMed, Scopus and Web of Science, retrieving 36 and 16 reports for humans and animal models, respectively. RESULTS In humans, areal bone mineral density (aBMD) was similar between swimmers and non-athletic controls at the lumbar spine, hip and femoral neck. Swimmers' tibia diaphysis showed a higher cross-sectional area but lower cortical thickness. Inconsistent findings at the femoral neck cortical thickness were found. Due to the small number of studies, trabecular microarchitecture in human swimmers was not assessed. In rodent models, aBMD was found to be lower at the tibia, but similar at the femur. Inconsistent findings in femur diaphysis cross-sectional area were observed. No differences in femur and tibia trabecular microarchitecture were found. CONCLUSION Swimming seems to affect bone health differently according to anatomical region. Studies in both humans and rodent models suggest that tibia cortical bone is negatively affected by swimming. There was no evidence of a negative effect of swimming on other bone regions, both in humans and animal models.
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Affiliation(s)
- Laura Freitas
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Rua Dr. Plácido Costa 91, 4200-450, Porto, Portugal.
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal.
| | - Andrea Bezerra
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Rua Dr. Plácido Costa 91, 4200-450, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Giorjines Boppre
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Rua Dr. Plácido Costa 91, 4200-450, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Nucleus of Research in Human Movement Science, Universidad Adventista de Chile, Chillán, Chile
| | - Tânia Amorim
- Fame Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Ricardo J Fernandes
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, Porto, Portugal
| | - Hélder Fonseca
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Rua Dr. Plácido Costa 91, 4200-450, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
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Bezerra A, Freitas L, Maciel L, Fonseca H. Bone Tissue Responsiveness To Mechanical Loading-Possible Long-Term Implications of Swimming on Bone Health and Bone Development. Curr Osteoporos Rep 2022; 20:453-468. [PMID: 36401774 DOI: 10.1007/s11914-022-00758-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/29/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE OF REVIEW To revisit the bone tissue mechanotransduction mechanisms behind the bone tissue response to mechanical loading and, within this context, explore the possible negative influence of regular swimming practice on bone health, particularly during the growth and development period. RECENT FINDINGS Bone is a dynamic tissue, responsive to mechanical loading and unloading, being these adaptative responses more intense during the growth and development period. Cross-sectional studies usually report a lower bone mass in swimmers compared to athletes engaged in weigh-bearing sports. However, studies with animal models show contradictory findings about the effect of swimming on bone health, highlighting the need for longitudinal studies. Due to its microgravity characteristics, swimming seems to impair bone mass, but mostly at the lower limbs. It is unkown if there is a causal relationship between swimming and low BMD or if other confounding factors, such as a natural selection whithin the sport, are the cause.
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Affiliation(s)
- Andréa Bezerra
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADE/UP), 4200-450, Porto, Portugal.
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600, Porto, Portugal.
| | - Laura Freitas
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADE/UP), 4200-450, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600, Porto, Portugal
| | - Leonardo Maciel
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADE/UP), 4200-450, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600, Porto, Portugal
- Department of Physiotherapy, Federal University of Sergipe, Campus Lagarto, Lagarto, Brazil
| | - Hélder Fonseca
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADE/UP), 4200-450, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600, Porto, Portugal
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Freitas L, Bezerra A, Amorim T, Fernandes RJ, Duarte J, Fonseca H. Is competitive swimming training a risk factor for osteoporosis? A systematic review of the literature and quality of evidence. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2022. [DOI: 10.1007/s12662-022-00849-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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The Relationship between Vitamin D Status and the Menstrual Cycle in Young Women: A Preliminary Study. Nutrients 2018; 10:nu10111729. [PMID: 30423869 PMCID: PMC6265788 DOI: 10.3390/nu10111729] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 11/08/2018] [Accepted: 11/09/2018] [Indexed: 01/06/2023] Open
Abstract
Background: The aim of this study was to evaluate serum vitamin D levels and to compare these with the menstrual cycle in young women with different body weights. Methods: Eighty-four students were recruited into the study of which 77 remained at the study’s completion. Women were assigned to one of two subgroups, according to their 25-hydroxy vitamin D test level [25(OH)D] in which 60 women had low 25(OH)D levels (LD < 30 ng/mL) and 17 had normal levels (ND > 30 ng/mL ≤ 80 ng/mL). Results: In the LD group, 40% of participants reported having long cycles, 27% were classified as having oligomenorrhoea, and 13% as having amenorrhoea. In the ND group, only 12% reported menstrual cycle disorders, 6% had oligomenorrhoea, and 6% had amenorrhoea. Women who did not meet the recommended level of 30 ng/mL of 25(OH)D had almost five times the odds of having menstrual cycle disorders as women who were above the recommended vitamin D level. Conclusion: A relationship was demonstrated between the frequency of menstrual disorders and low levels of vitamin D. Supplementation is necessary in women with low levels of vitamin D in order to compensate for this deficiency and to assess its effect in regulating menstrual disorders.
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Gómez-Bruton A, González-Agüero A, Matute-Llorente A, Julián C, Lozano-Berges G, Gómez-Cabello A, Casajús JA, Vicente-Rodríguez G. Do 6 months of whole-body vibration training improve lean mass and bone mass acquisition of adolescent swimmers? Arch Osteoporos 2017; 12:69. [PMID: 28733931 DOI: 10.1007/s11657-017-0362-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 07/10/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED Swimming has little effect on bone mass. Therefore, adolescent swimmers should complement their water training with a short and intense weight-bearing training, aiming to increase their bone acquisition. Forty swimmers performed a six-month whole-body vibration (WBV) training. WBV had no effect on adolescent swimmers' bone mass or lean mass. PURPOSE The aims of the present study were to evaluate the effects of a whole-body vibration (WBV) intervention on bone mineral density (BMD), bone mineral content (BMC) and lean mass (LM) in adolescent swimmers. METHODS Forty male and female adolescent swimmers (VIB; mean age 14.2 ± 1.9 years) completed the WBV protocol that consisted of 15 min of training 3 days per week during a 6-month period (ranging from 3.6 to 11.6 g), while 23 swimmers (SWI; mean age 15.0 ± 2.2 years) continued with their regular swimming training alone. VIB were divided into tertiles according to training compliance in order to evaluate if any dose-effect relation existed. BMD, BMC and LM were measured longitudinally by dual energy X-ray at the whole body, lumbar-spine and hip. RESULTS No group by time interactions and no differences in change percentage were found for BMD, BMC or LM in any of the measured variables. The mean change percentage of the subtotal body (whole body minus the head) for VIB and SWI, respectively, was 2.3 vs. 2.4% for BMD, 5.7 vs 5.7% for BMC and 7.3 vs. 8.0% for lean mass. Moreover, no indication for dose-response was observed. CONCLUSIONS The proposed WBV protocol had no effect on BMD, BMC and LM in adolescent swimmers. Other types of training should be used in this population to improve both bone and lean mass.
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Affiliation(s)
- A Gómez-Bruton
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Grupo GENUD Edificio SAI 2ª planta, Zaragoza, Spain.,Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - A González-Agüero
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Grupo GENUD Edificio SAI 2ª planta, Zaragoza, Spain.,Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - A Matute-Llorente
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Grupo GENUD Edificio SAI 2ª planta, Zaragoza, Spain.,Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - C Julián
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Grupo GENUD Edificio SAI 2ª planta, Zaragoza, Spain.,Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - G Lozano-Berges
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Grupo GENUD Edificio SAI 2ª planta, Zaragoza, Spain.,Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - A Gómez-Cabello
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Grupo GENUD Edificio SAI 2ª planta, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain.,Centro Universitario de la Defensa, Zaragoza, Spain
| | - J A Casajús
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Grupo GENUD Edificio SAI 2ª planta, Zaragoza, Spain.,Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
| | - G Vicente-Rodríguez
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health and Sport Sciences, University of Zaragoza, Grupo GENUD Edificio SAI 2ª planta, Zaragoza, Spain. .,Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain. .,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain. .,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain.
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Kambas A, Leontsini D, Avloniti A, Chatzinikolaou A, Stampoulis T, Makris K, Draganidis D, Jamurtas AZ, Tournis S, Fatouros IG. Physical activity may be a potent regulator of bone turnover biomarkers in healthy girls during preadolescence. J Bone Miner Metab 2017; 35:598-607. [PMID: 27838794 DOI: 10.1007/s00774-016-0794-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 09/25/2016] [Indexed: 10/20/2022]
Abstract
This study investigated the effects of different levels of habitual physical activity (PA) assessed by pedometry on bone turnover markers of preadolescent girls according to a cross-sectional experimental design. Sixty prepubertal girls of similar chronological age, bone age, maturity level, and nutritional status were assigned to a low PA (LPA; n = 25), a moderate PA (MPA; n = 17), or a high PA (HPA; n = 18) group. Dual-energy X-ray absorptiometry was used to measure areal bone mineral density (BMD) and bone mineral content (BMC) of the lumbar spine (L2-L4) and dominant hip (femoral neck and trochanter). Blood was collected for the measurement of alkaline phosphatase (ALP), bone-specific ALP (BSAP), procollagen type I N-terminal propeptide (PINP), C-terminal telopeptide of collagen I (CTX), parathyroid hormone (PTH), osteocalcin, thyroid-stimulating hormone, estradiol, testosterone, luteinizing hormone, and follicle-stimulating hormone concentrations. ANOVA revealed that the HPA group (18,695 ± 1244 steps per day) had a lower daily energy intake and body mass than the MPA group (10,774 ± 521 steps per day) and the LPA group (7633 ± 1099 steps per day). The HPA group had higher (P < 0.05) lumbar and hip BMD and hip BMC than the LPA group and higher (P < 0.05) lumbar BMD than the MPA group. The MPA group had higher (P < 0.05) hip BMC than the LPA group. The HPA group had greater (P < 0.05) values of BSAP, PINP, and ALP and lower (P < 0.05) values of PTH and CTX than the LPA group but not the MPA group. A partial correlation analysis (adjusted for body mass index) revealed a positive correlation of steps per day with BMD and BSAP concentration and a negative correlation with PTH and CTX concentration. In conclusion, PA increases BMD and BMC of premenarcheal girls by favoring bone formation over bone resorption.
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Affiliation(s)
- Antonis Kambas
- Department of Physical Education and Sport Science, Democritus University of Thrace, Komotini, Greece
| | - Diamanda Leontsini
- Department of Physical Education and Sport Science, Democritus University of Thrace, Komotini, Greece
| | - Alexandra Avloniti
- Department of Physical Education and Sport Science, Democritus University of Thrace, Komotini, Greece
| | - Athanasios Chatzinikolaou
- Department of Physical Education and Sport Science, Democritus University of Thrace, Komotini, Greece
| | - Theodoros Stampoulis
- Department of Physical Education and Sport Science, Democritus University of Thrace, Komotini, Greece
| | | | - Dimitrios Draganidis
- School of Physical Education and Sports Sciences, University of Thessaly, Karies, Trikala, 42100, Greece
| | - Athanasios Z Jamurtas
- School of Physical Education and Sports Sciences, University of Thessaly, Karies, Trikala, 42100, Greece
- Institute of Human Performance and Rehabilitation, Center for Research and Technology, Thessaly, Trikala, Greece
| | - Symeon Tournis
- Laboratory of Research of Musculoskeletal System "Th. Garofalidis", University of Athens, KAT Hospital, Athens, Greece
| | - Ioannis G Fatouros
- School of Physical Education and Sports Sciences, University of Thessaly, Karies, Trikala, 42100, Greece.
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Maïmoun L, Paris F, Coste O, Sultan C. [Intensive training and menstrual disorders in young female: Impact on bone mass]. ACTA ACUST UNITED AC 2016; 44:659-663. [PMID: 27751748 DOI: 10.1016/j.gyobfe.2016.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 09/09/2016] [Indexed: 10/20/2022]
Abstract
Participation in recreational physical activity is widely acknowledged to provide significant health benefits. Conversely, intense training imposes several constraints, such as intermittent or chronic metabolic and psychogenic training stressors and maintenance of very low body fat to maximize performance. Adolescent and adult athletic women are therefore at risk of overtraining and/or poor dietary intake, which may have several consequences for endocrine function particularly on hypothalamic-pituitary-gonadal axis. Female athletes, particularly those participating in sports needing leanness or low body weight, present a high prevalence of menstrual disorders with clinical manifestations ranging from delayed menarche, oligomenorrhea to primary and secondary amenorrhea. A high degree of variability according to the type of sport and the intensity of the practice is however observed. Exercise-related reproductive dysfunction may have some consequences for growth velocity and peak bone mass acquisition during adolescence and bone pathologies in adults. Recent findings highlight the endocrine role of adipose tissue and energy balance in the regulation of homeostasis and reproductive function. A better understanding of the mechanisms whereby intense training affects the endocrine systems may orient research to develop innovative strategies probably based on individualized nutritional approach to improve the medical care of these female athletes and protect their reproductive function.
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Affiliation(s)
- L Maïmoun
- Service de médecine nucléaire, hôpital Lapeyronie, université de Montpellier 1 (UM1), CHRU de Montpellier, 34295 Montpellier, France; PhyMedExp, University of Montpellier, Inserm U1046, CNRS UMR 9214, 34295 Montpellier cedex 5, France.
| | - F Paris
- Unité d'endocrinologie et gynécologie pédiatrique, département de pédiatrie, hôpital A.-de-Villeneuve, UMI, CHRU de Montpellier, 34295 Montpellier, France
| | - O Coste
- Direction régionale de la jeunesse, des sports et de la cohésion sociale Languedoc Roussillon/Midi-Pyrénées, France
| | - C Sultan
- Unité d'endocrinologie et gynécologie pédiatrique, département de pédiatrie, hôpital A.-de-Villeneuve, UMI, CHRU de Montpellier, 34295 Montpellier, France
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Mohr M, Helge EW, Petersen LF, Lindenskov A, Weihe P, Mortensen J, Jørgensen NR, Krustrup P. Effects of soccer vs swim training on bone formation in sedentary middle-aged women. Eur J Appl Physiol 2015; 115:2671-9. [DOI: 10.1007/s00421-015-3231-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 07/29/2015] [Indexed: 11/30/2022]
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Łagowska K, Kapczuk K. Testosterone concentrations in female athletes and ballet dancers with menstrual disorders. Eur J Sport Sci 2015; 16:490-7. [PMID: 25951882 DOI: 10.1080/17461391.2015.1034786] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Menstrual disorders are common among female athletes and ballet dancers. Endocrine changes, such as high testosterone (HT) levels and high luteinizing hormone (LH)/follicle-stimulating hormone (FSH) ratios, may suggest functional ovarian hyperandrogenism which may induce such dysfunction. The aim of this study was therefore to evaluate endocrine status in female athletes and ballet dancers with menstrual disorders. Their nutritional status and dietary habits were analysed in relation to the testosterone levels. In a cross-sectional approach, 31 female athletes (18.1 ± 2.6 years) and 21 ballerinas (17.1 ± 0.9) with menstrual disorders participated in the study. The levels of serum LH, FSH, progesterone (P), estradiol (E2), prolactin (PRL), thyroid-stimulating hormone, testosterone (T) and sex hormone-binding globulinwere measured to assess hormonal status. In addition, the free androgen index (FAI) was calculated. Nutritional status, total daily energy expenditure and nutritional habits were evaluated. Girls were assigned to one of the following groups: low testosterone (LT) level, normal testosterone level or HT level. There were significant differences between ballerinas and other female athletes in terms of testosterone levels, FAI, age at the beginning of training, length of training period and age at menarche. The PRL level was lowest in the LT group while the FAI index was highest in the HT group. Daily energy and carbohydrate intakes were significantly lower in the HT group. T levels in the study subjects were found to be associated with nutritional factors, energy availability, age at the beginning of training and frequency of training. This is the first report of HT levels being associated with the status of a female ballet dancer, the age of menarche and the length of the training history. Further research is necessary to confirm the results in a larger study group.
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Affiliation(s)
- Karolina Łagowska
- a Department of Human Nutrition and Hygiene, Dietetic Division , Poznan University of Life Sciences , Poznań , Poland
| | - Karina Kapczuk
- b Department of Perinatology and Gynecology, Division of Gynecology , Karol Marcinkowski University of Medical Sciences , Poznań , Poland
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Maïmoun L, Georgopoulos NA, Sultan C. Endocrine disorders in adolescent and young female athletes: impact on growth, menstrual cycles, and bone mass acquisition. J Clin Endocrinol Metab 2014; 99:4037-50. [PMID: 24601725 DOI: 10.1210/jc.2013-3030] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
CONTEXT Puberty is a crucial period of dramatic hormonal changes, accelerated growth, attainment of reproductive capacity, and acquisition of peak bone mass. Participation in recreational physical activity is widely acknowledged to provide significant health benefits in this period. Conversely, intense training imposes several constraints, such as training stress and maintenance of very low body fat to maximize performance. Adolescent female athletes are therefore at risk of overtraining and/or poor dietary intake, which may have several consequences for endocrine function. The "adaptive" changes in the hypothalamic-pituitary-gonadal, -adrenal, and somatotropic axes and the secretory role of the adipose tissue are reviewed, as are their effects on growth, menstrual cycles, and bone mass acquisition. DESIGN A systematic search on Medline between 1990 and 2013 was conducted using the following terms: "intense training," "physical activity," or "exercise" combined with "hormone," "endocrine," and "girls," "women," or "elite female athletes." All articles reporting on the endocrine changes related to intense training and their potential implications for growth, menstrual cycles, and bone mass acquisition were considered. RESULTS AND CONCLUSION Young female athletes present a high prevalence of menstrual disorders, including delayed menarche, oligomenorrhea, and amenorrhea, characterized by a high degree of variability according to the type of sport. Exercise-related reproductive dysfunction may have consequences for growth velocity and peak bone mass acquisition. Recent findings highlight the endocrine role of adipose tissue and energy balance in the regulation of homeostasis and reproductive function. A better understanding of the mechanisms whereby intense training affects the endocrine system may orient research to develop innovative strategies (ie, based on nutritional or pharmacological approaches and individualized modalities of training and competition) to improve the medical care of these adolescents and protect their reproductive function.
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Affiliation(s)
- Laurent Maïmoun
- Service de Médecine Nucléaire (L.M.), Hôpital Lapeyronie, Centre Hospitalier Régional Universitaire (CHRU) de Montpellier and Université Montpellier 1 (UM1), 34295 Montpellier, France; Département d'Hormonologie (L.M., C.S.), Hôpital Lapeyronie, CHRU Montpellier, 34295 Montpellier, France; Physiologie et Médecine Expérimentale du Cœur et des Muscles (L.M.), INSERM Unité 1046, Université Montpellier 1 (UM1) and Université Montpellier 2 (UM2), 34295 Montpellier, France; Division of Reproductive Endocrinology (N.A.G.), Department of Obstetrics and Gynecology, University of Patras Medical School, University Hospital, Patras 265 04, Greece; and Unité d'Endocrinologie et Gynécologie Pédiatrique (C.S.), Département de Pédiatrie, Hôpital Arnaud de Villeneuve, CHRU Montpellier et UM1, 34295 Montpellier, France
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Gómez-Bruton A, Gónzalez-Agüero A, Gómez-Cabello A, Casajús JA, Vicente-Rodríguez G. Is bone tissue really affected by swimming? A systematic review. PLoS One 2013; 8:e70119. [PMID: 23950908 PMCID: PMC3737199 DOI: 10.1371/journal.pone.0070119] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 06/14/2013] [Indexed: 11/18/2022] Open
Abstract
Background Swimming, a sport practiced in hypogravity, has sometimes been associated with decreased bone mass. Aim This systematic review aims to summarize and update present knowledge about the effects of swimming on bone mass, structure and metabolism in order to ascertain the effects of this sport on bone tissue. Methods A literature search was conducted up to April 2013. A total of 64 studies focusing on swimmers bone mass, structure and metabolism met the inclusion criteria and were included in the review. Results It has been generally observed that swimmers present lower bone mineral density than athletes who practise high impact sports and similar values when compared to sedentary controls. However, swimmers have a higher bone turnover than controls resulting in a different structure which in turn results in higher resistance to fracture indexes. Nevertheless, swimming may become highly beneficial regarding bone mass in later stages of life. Conclusion Swimming does not seem to negatively affect bone mass, although it may not be one of the best sports to be practised in order to increase this parameter, due to the hypogravity and lack of impact characteristic of this sport. Most of the studies included in this review showed similar bone mineral density values in swimmers and sedentary controls. However, swimmers present a higher bone turnover than sedentary controls that may result in a stronger structure and consequently in a stronger bone.
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Affiliation(s)
- Alejandro Gómez-Bruton
- GENUD “Growth, Exercise, NUtrition and Development” Research Group, Universidad de Zaragoza, Zaragoza, Spain
| | - Alejandro Gónzalez-Agüero
- GENUD “Growth, Exercise, NUtrition and Development” Research Group, Universidad de Zaragoza, Zaragoza, Spain
- Department of Sport and Exercise Science, Aberystwyth University, Aberystwyth, United Kingdom
| | - Alba Gómez-Cabello
- GENUD “Growth, Exercise, NUtrition and Development” Research Group, Universidad de Zaragoza, Zaragoza, Spain
| | - José A. Casajús
- GENUD “Growth, Exercise, NUtrition and Development” Research Group, Universidad de Zaragoza, Zaragoza, Spain
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, Huesca, Spain
| | - Germán Vicente-Rodríguez
- GENUD “Growth, Exercise, NUtrition and Development” Research Group, Universidad de Zaragoza, Zaragoza, Spain
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, Huesca, Spain
- * E-mail:
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Maïmoun L, Coste O, Mura T, Philibert P, Galtier F, Mariano-Goulart D, Paris F, Sultan C. Specific bone mass acquisition in elite female athletes. J Clin Endocrinol Metab 2013; 98:2844-53. [PMID: 23666974 DOI: 10.1210/jc.2013-1070] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
CONTEXT Cross-sectional studies have demonstrated that physical activity can improve bone mass acquisition. However, this design is not adequate to describe the specific kinetics of bone mass gain during pubertal development. OBJECTIVE To compare the kinetics of bone mass acquisition in female adolescent athletes of sports that impose different mechanical loads and untrained controls throughout puberty. STUDY PARTICIPANTS A total of 72 girls with ages ranging from 10.8 to 18.0 years were recruited: 24 rhythmic gymnasts (RG, impact activity group), 24 swimmers (SW, no-impact activity), and 24 age-matched controls (CON). MAIN OUTCOME MEASURES Areal bone mineral density (aBMD) was determined using dual-energy x-ray absorptiometry and bone turnover markers were analyzed. All the investigations were performed at baseline and after 1 year. RESULTS At baseline and after 1 year of follow-up, RG presented significantly greater aBMD adjusted for age, fat-free soft tissue, and fat mass compared with CON and SW, only at the femoral region. When aBMD variation throughout the pubertal period was modeled for each group from individual values, the aBMD at the femoral region was significantly higher in RG compared with the other 2 groups from 12.5 to 14 years, and this difference lasted up to 18 years. Moreover, the mean annual aBMD gain tended to be higher in RG compared with SW and CON only at the femoral region and this gain lasted longer in RG. Bone remodeling markers decreased similarly with age in the 3 groups. CONCLUSIONS This study, which was based on linear mixed models for longitudinal data, demonstrated that the osteogenic effect of gymnastics is characterized by greater bone mass gain localized at mechanically loaded bone (ie, the proximal femur) principally around the menarcheal period. Moreover, the bone mass gain lasts longer in gymnasts, which may be explained by the delay in sexual maturation.
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Affiliation(s)
- Laurent Maïmoun
- Département d'Hormonologie, Hôpital Lapeyronie, Centre Hospitalier Régional Universitaire Montpellier et Université Montpellier I, Montpellier, 34295 Montpellier, France
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