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Zouhal H, Berro AJ, Maliha E, Khalil N, El Khoury G, Jayavel A, Laziri F, Saeidi A, Laher I, El Hage R. Team sports practice and bone health: A systematic review and meta- analysis. J Clin Densitom 2024; 27:101508. [PMID: 39068702 DOI: 10.1016/j.jocd.2024.101508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 06/27/2024] [Accepted: 07/10/2024] [Indexed: 07/30/2024]
Abstract
The primary aim of this study was to explore the effects of team sports practice on bone health indices in adults engaged in team sports. The secondary aim was to investigate the osteogenic effects of each type of team sport. This systematic literature search was conducted using common electronic databases from inception in June 2023, using key terms (and synonyms searched for by the MeSH database) that were combined using the operators "AND", "OR", "NOT": (``men'' OR ``man'' OR ``women'' OR ``woman'') AND (``bone mineral density'' OR ``BMD'' OR ``bone mineral content'' OR ``BMC'' OR ``peak bone mass'' OR ``mechanical loading'' OR ``osteoporosis'' OR ``bone geometry'' OR ``bone resistance'') AND (``team sport'' OR ``sport'' OR rugby OR basketball OR volleyball OR handball OR soccer OR football OR ``players''). After screening, 16 studies were included in the final analysis (5 continents, 2740 participants). The training duration lasted 1 to 13 years. Team sport training had a moderate impact on whole body bone mineral density (WB BMD) (1.07 SMD; 95 % [0.77, 1.37], p < 0.00) but a more significant impact on whole body bone mineral content (WB BMC) (1.3 SMD; 95 % [0.81, 1.79], p < 0.00). Subgroup analyses indicated that rugby training had a moderate but non-significant impact on WB BMD (1.19 SMD; 95 % [-0.13, 2.52], p = 0.08) but a greater impact on WB BMC (2.12 SMD; 95 % [0.84, 3.39], p < 0.00); basketball training had a moderate but significant impact on WB BMD (1 SMD; 95 % [0.35, 1.64], p < 0.00) and a trivial non-significant impact on WB BMC (0.18 SMD; 95 % [-1.09, 1.46], p = 0.78); volleyball training had a moderate but non-significant impact on WB BMD (0.63 SMD; 95 % [-0.22, 1.49], p = 0.15) and a significant impact on WB BMC (2.39 SMD; 95 % [1.45, 3.33], p < 0.00). Handball training produced a moderate significant impact on WB BMD (1.02 SMD; 95 % [0.33, 1.71], p < 0.00) and WB BMC (0.97 SMD; 95 % [0.47, 1.48], p < 0.00), and soccer training led to moderate but significant effects on WB BMD (1.16 SMD; 95 % [0.88, 1.44], p < 0.00) and a large effect on WB BMC (1.34 SMD; 95 % [0.92, 1.77], p < 0.00). Rugby training was associated with a higher WB BMC compared to basketball training (p = 0.03). Our systematic review and meta-analysis suggests that team sports, such as rugby, basketball, volleyball, handball and soccer have moderate to large effects on WB BMD and WB BMC. Specifically, our findings indicate that handball and soccer enhance WB BMD and WB BMC, whereas rugby only increases WB BMC. There is currently insufficient evidence indicating the superiority of any type of sport training that improves bone health in adults.
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Affiliation(s)
- Hassane Zouhal
- University of Rennes, M2S (Laboratoire Mouvement, Sport, Santé) - EA 1274, F-35000 Rennes, France; Institut International des Sciences du Sport (2I2S), 35850 Irodouer, France
| | - Abdel-Jalil Berro
- Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, PO Box 100, Tripoli, Lebanon
| | - Elie Maliha
- Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, PO Box 100, Tripoli, Lebanon
| | - Nour Khalil
- Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, PO Box 100, Tripoli, Lebanon
| | - Gisèle El Khoury
- Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, PO Box 100, Tripoli, Lebanon
| | - Ayyappan Jayavel
- SRM College of Physiotherapy, SRM Institute of Science and Technology, Kattankulathur, Kanchipuram, India
| | - Fatiha Laziri
- Laboratoire Ecologie, Environnement et Santé Equipe Santé Humaine et Environnement Faculté des Sciences de Université Moulay Ismail, Meknès, Morocco
| | - Ayoub Saeidi
- Department of Physical Education and Sport Sciences, University of Kurdistan, Sanandaj, Iran
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology and Therapeutics, The University of British Columbia, Vancouver, Canada
| | - Rawad El Hage
- Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, PO Box 100, Tripoli, Lebanon.
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Mikkilä S, Handegård BH, Johansson J, Hopstock LA, Van den Tillaar R, Emaus N, Morseth B, Welde B. Cross-sectional associations between accelerometer-measured physical activity and hip bone mineral density: the Tromsø Study 2015-2016. JBMR Plus 2024; 8:ziae061. [PMID: 38868594 PMCID: PMC11166893 DOI: 10.1093/jbmrpl/ziae061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/22/2024] [Accepted: 05/03/2024] [Indexed: 06/14/2024] Open
Abstract
Positive associations between physical activity and bone health have been found in population-based studies, however, mostly based on self-reported physical activity. Therefore, we investigated the association between accelerometer-measured physical activity, measured in steps per day and minutes of moderate to vigorous physical activity (MVPA) per day, and total hip areal BMD (aBMD) measured by DXA in a general population, utilizing multiple regression models. The study participants, 1560 women and 1177 men aged 40-84 yr, were part of the seventh survey of the Tromsø Study (2015-2016). In both genders, we found a positive association between the number of daily steps and aBMD adjusted for age, BMI, and smoking status (P < .001). In women, an increase of 1000 steps per day was associated with 0.005 g/cm2 higher aBMD. For men, a polynomial curve indicated a positive association with aBMD up to 5000 steps per day, plateauing between 5000 and 14 000 steps, and then increasing again. Additionally, MVPA duration was positively associated with aBMD in both women (P < .001) and men (P = .004) when adjusted for age, BMI, and smoking status. Specifically, each 60-min increase in daily MVPA was associated with 0.028 and 0.023 g/cm2 higher aBMD in women and men, respectively. Despite positive associations, the clinical impact of physical activity on aBMD in this general population of adults and older adults was relatively small, and a large increase in daily MVPA might not be achievable for most individuals. Therefore, further longitudinal population-based studies incorporating device-based measures of physical activity could add more clarity to these relationships.
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Affiliation(s)
- Saija Mikkilä
- School of Sport Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway
- Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Bjørn Helge Handegård
- The Regional Centre for Child and Adolescent Mental Health – North, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Jonas Johansson
- Department of Community Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Laila A Hopstock
- Department of Health and Care Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | | | - Nina Emaus
- Department of Health and Care Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway
| | - Boye Welde
- School of Sport Sciences, UiT The Arctic University of Norway, 9037 Tromsø, Norway
- Division of Mental and Physical Health, Department of Child and Adolescent Health Promotion Services, Norwegian Institute of Public Health, 0404 Oslo, Norway
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Hutson MJ, Varley I. An Opinion on the Interpretation of Bone Turnover Markers Following Acute Exercise or Nutrition Intervention and Considerations for Applied Research. Int J Sport Nutr Exerc Metab 2024:1-7. [PMID: 38925537 DOI: 10.1123/ijsnem.2024-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 05/24/2024] [Accepted: 05/24/2024] [Indexed: 06/28/2024]
Abstract
It is important for athlete and public health that we continue to develop our understanding of the effects of exercise and nutrition on bone health. Bone turnover markers (BTMs) offer an opportunity to accelerate the progression of bone research by revealing a bone response to exercise and nutrition stimuli far more rapidly than current bone imaging techniques. However, the association between short-term change in the concentration of BTMs and long-term bone health remains ambiguous. Several other limitations also complicate the translation of acute BTM data to applied practice. Importantly, several incongruencies exist between the effects of exercise and nutrition stimuli on short-term change in BTM concentration compared with long-term bone structural outcomes to similar stimuli. There are many potential explanations for these inconsistencies, including that short-term study designs fail to encompass a full remodeling cycle. The current article presents the opinion that data from relatively acute studies measuring BTMs may not be able to reliably inform applied practice aiming to optimize bone health. There are important factors to consider when interpreting or translating BTM data and these are discussed.
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Affiliation(s)
- Mark J Hutson
- School of Sport, Faculty of Life and Health Sciences, Ulster University, Coleraine, United Kingdom
| | - Ian Varley
- School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
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Oteo-Gómez D, Castellar-Otín C, Moreno-Azze A, Pradas de la Fuente F. Bone Mineral Density in Field Hockey Players: A Systematic Review. Life (Basel) 2024; 14:455. [PMID: 38672726 PMCID: PMC11051433 DOI: 10.3390/life14040455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/21/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
The aim of this study was to carry out a systematic review to compare and analyse the bone mineral density of field hockey players of both sexes and of different ages, with other sports and with a sedentary population. The search process was carried out using the PubMed, SPORTDiscus, Web of Science and Scopus databases. The search ended on 18 March 2024. We selected articles in which a comparison was made of bone mineral density of the whole body, lumbar spine, femoral neck, arms and legs, among field hockey players, and/or with other sports and/or with a sedentary population. The systematic review followed the guidelines described in the 2020 PRISMA statement. The initial search identified 220 articles. After applying the inclusion and exclusion criteria, the search was narrowed down to seven articles in total. It was observed that the field hockey group had better bone mineral density values than sedentary population and the low-impact sports population. Basketball players had better whole body and leg bone mineral density values than field hockey players. Causality could not be established due to the cross-sectional nature of the included studies. The better bone mineral density values in field hockey players compared to the sedentary population may be because people who participate in impact sports have a better bone mineral density. The differences in bone mineral density between field hockey and low-impact sports could be related to a lower impact during their practice in these disciplines.
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Affiliation(s)
- David Oteo-Gómez
- Faculty of Health and Sports Sciences, University of Zaragoza, 22001 Huesca, Spain; (D.O.-G.); (C.C.-O.); (F.P.d.l.F.)
| | - Carlos Castellar-Otín
- Faculty of Health and Sports Sciences, University of Zaragoza, 22001 Huesca, Spain; (D.O.-G.); (C.C.-O.); (F.P.d.l.F.)
- ENFYRED Research Group, Faculty of Health and Sports Sciences, University of Zaragoza, 22001 Huesca, Spain
| | - Alejandro Moreno-Azze
- Faculty of Health and Sports Sciences, University of Zaragoza, 22001 Huesca, Spain; (D.O.-G.); (C.C.-O.); (F.P.d.l.F.)
- ENFYRED Research Group, Faculty of Health and Sports Sciences, University of Zaragoza, 22001 Huesca, Spain
| | - Francisco Pradas de la Fuente
- Faculty of Health and Sports Sciences, University of Zaragoza, 22001 Huesca, Spain; (D.O.-G.); (C.C.-O.); (F.P.d.l.F.)
- ENFYRED Research Group, Faculty of Health and Sports Sciences, University of Zaragoza, 22001 Huesca, Spain
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Hughes L, Centner C. Idiosyncratic bone responses to blood flow restriction exercise: new insights and future directions. J Appl Physiol (1985) 2024; 136:283-297. [PMID: 37994414 PMCID: PMC11212818 DOI: 10.1152/japplphysiol.00723.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 11/14/2023] [Accepted: 11/21/2023] [Indexed: 11/24/2023] Open
Abstract
Applying blood flow restriction (BFR) during low-load exercise induces beneficial adaptations of the myotendinous and neuromuscular systems. Despite the low mechanical tension, BFR exercise facilitates a localized hypoxic environment and increase in metabolic stress, widely regarded as the primary stimulus for tissue adaptations. First evidence indicates that low-load BFR exercise is effective in promoting an osteogenic response in bone, although this has previously been postulated to adapt primarily during high-impact weight-bearing exercise. Besides studies investigating the acute response of bone biomarkers following BFR exercise, first long-term trials demonstrate beneficial adaptations in bone in both healthy and clinical populations. Despite the increasing number of studies, the physiological mechanisms are largely unknown. Moreover, heterogeneity in methodological approaches such as biomarkers of bone metabolism measured, participant and study characteristics, and time course of measurement renders it difficult to formulate accurate conclusions. Furthermore, incongruity in the methods of BFR application (e.g., cuff pressure) limits the comparability of datasets and thus hinders generalizability of study findings. Appropriate use of biomarkers, effective BFR application, and befitting study design have the potential to progress knowledge on the acute and chronic response of bone to BFR exercise and contribute toward the development of a novel strategy to protect or enhance bone health. Therefore, the purpose of the present synthesis review is to 1) evaluate current mechanistic evidence; 2) discuss and offer explanations for similar and contrasting data findings; and 3) create a methodological framework for future mechanistic and applied research.
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Affiliation(s)
- Luke Hughes
- Department of Sport Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Christoph Centner
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
- Praxisklinik Rennbahn, Muttenz, Switzerland
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6
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Logan G, Somers C, Baker G, Connell H, Gray S, Kelly P, McIntosh E, Welsh P, Gray CM, Gill JMR. Benefits, risks, barriers, and facilitators to cycling: a narrative review. Front Sports Act Living 2023; 5:1168357. [PMID: 37795314 PMCID: PMC10546027 DOI: 10.3389/fspor.2023.1168357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 09/05/2023] [Indexed: 10/06/2023] Open
Abstract
There is large potential to increase cycling participation worldwide. Participation in cycling is associated with lower risk of mortality from any cause, and incidence of cardiovascular disease and type 2 diabetes, as well as positive mental health and well-being. The largest potential for health gains likely to come from increasing participation amongst those who do not currently cycle regularly, rather than encouraging those who already cycle regularly to cycle more. Replacing car journeys with cycling can lead to reductions in air pollution emissions and lower pollutant exposure to the general population. Important gaps and uncertainties in the existing evidence base include: the extent to which the health benefits associated with cycling participation are fully causal due to the observational nature of much of the existing evidence base; the real-world economic cost-benefits of pragmatic interventions to increase cycling participation; and the most effective (combination of) approaches to increase cycling participation. To address these uncertainties, large-scale, long-term randomised controlled trials are needed to: evaluate the effectiveness, and cost-effectiveness, of (combinations of) intervention approaches to induce sustained long-term increases in cycling participation in terms of increases in numbers of people cycling regularly and number of cycling journeys undertaken, across a range of population demographic groups; establish the effects of such interventions on relevant outcomes related to health and wellbeing, economic productivity and wider societal impacts; and provide more robust quantification of potential harms of increasing cycling participation, such as collision risks.
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Affiliation(s)
- Greig Logan
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Camilla Somers
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Graham Baker
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Hayley Connell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Stuart Gray
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Paul Kelly
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Emma McIntosh
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Paul Welsh
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Cindy M. Gray
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Jason M. R. Gill
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
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7
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Martínez-Noguera FJ, Alcaraz PE, Ortolano-Ríos R, Marín-Pagán C. One Season in Professional Cycling Is Enough to Negatively Affect Bone Health. Nutrients 2023; 15:3632. [PMID: 37630821 PMCID: PMC10458969 DOI: 10.3390/nu15163632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/14/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Cycling is a very popular sport worldwide, and several studies have already indicated that cycling at various levels has a negative impact on bone health. This is of concern to both performance and health managers of many cycling teams at different levels because of its economic and social impact. Based on the scientific literature, we hypothesize that a single season at the professional level can negatively affect bone health status. The aim of this study was to assess how professional cycling affects bone health markers after one season. Densitometry was used to measure the bone mineral density (BMD), bone mineral content (BMC), bone area (BA), fat mass (FM), fat-free mass (FFM), T-score and Z-score in professional cyclists after one season. After one season at the professional level, cyclists' BMD decreased significantly in the legs, trunk, ribs and pelvis (p ≤ 0.05). BMC decreased in the arms and spine (p ≤ 0.05). BA decreased significantly in the arms and spine (p ≤ 0.05). In addition, a significant decrease in Z-score (p ≤ 0.05) and a decreasing trend in T-score and total BMD (p = 0.06) were observed. One season of professional cycling is enough to negatively affect bone health status.
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Affiliation(s)
- Francisco Javier Martínez-Noguera
- Research Center for High-Performance Sport, University of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain; (P.E.A.); (C.M.-P.)
| | - Pedro E. Alcaraz
- Research Center for High-Performance Sport, University of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain; (P.E.A.); (C.M.-P.)
| | - Raquel Ortolano-Ríos
- Sports Physiology Department, Faculty of Health Sciences, UCAM Universidad Católica San Antonio de Murcia, 30107 Murcia, Spain;
| | - Cristian Marín-Pagán
- Research Center for High-Performance Sport, University of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain; (P.E.A.); (C.M.-P.)
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Oliveira TP, Espada MC, Massini DA, Robalo RAM, Almeida TAF, Hernández-Beltrán V, Gamonales JM, Castro EA, Pessôa Filho DM. Effects of Exercise and Sports Intervention and the Involvement Level on the Mineral Health of Different Bone Sites in the Leg, Hip, and Spine: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6537. [PMID: 37569078 PMCID: PMC10419061 DOI: 10.3390/ijerph20156537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/11/2023] [Accepted: 07/14/2023] [Indexed: 08/13/2023]
Abstract
The current study analysed whether the osteogenic stimuli of exercises and sports have an independent effect on bone mineral density (BMD). Studies with a design having two different cohorts were searched and selected to distinguish the effect due to long-term involvement (i.e., athletes vs. non-active young with good bone health) and due to the planning of intervention (i.e., pre- vs. post-training) with exercises and sports. Moreover, only studies investigating the bone sites with a body-weight support function (i.e., lower limb, hip, and spine regions) were reviewed, since the osteogenic effects have incongruous results. A meta-analysis was performed following the recommendations of PRISMA. Heterogeneity (I2) was determined by combining Cochran's Q test with the Higgins test, with a significance level of α = 0.05. The studies reporting the effect of involvement in exercise and sports showed high heterogeneity for the lower limb, total hip, and spine (I2 = 90.200%, 93.334%, and 95.168%, respectively, with p < 0.01) and the effect size on sports modalities (Hedge's g = 1.529, 1.652, and 0.417, respectively, with p < 0.05) ranging from moderate to high. In turn, the studies reporting the effect of the intervention planning showed that there was no heterogeneity for the lower limb (I2 = 0.000%, p = 0.999) and spine (I2 = 77.863%, p = 0.000); however, for the hip, it was moderate (I2 = 49.432%, p = 0.054), with a low effect between the pre- and post-training moments presented only for the hip and spine (Hedge's g = 0.313 and 0.353, respectively, with p < 0.05). The current analysis supported the effect of involvement in exercise and sports by evidencing the effect of either weight-bearing or non-weight-bearing movements on BMD at the femoral, pelvic, and lumbar bones sites of the athletes when comparing to non-athletes or non-active peers with healthy bones. Moreover, the effect of different exercise and sports interventions highlighted the alterations in the BMD in the spine bone sites, mainly with long-term protocols (~12 months) planned with a stimulus with high muscle tension. Therefore, exercise and sport (mainly systematic long-term practice) have the potential to increase the BMD of bones with body-weight support beyond the healthy values reached during life phases of youth and adulthood.
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Affiliation(s)
- Thiago P. Oliveira
- Graduate Programme in Human Development and Technology, São Paulo State University (UNESP), Rio Claro 13506-900, Brazil; (T.P.O.); (D.A.M.); (T.A.F.A.); (E.A.C.)
| | - Mário C. Espada
- Instituto Politécnico de Setúbal, Escola Superior de Educação, 2914-504 Setúbal, Portugal; (M.C.E.); (R.A.M.R.)
- Life Quality Research Centre (LQRC-CIEQV, Leiria), Complexo Andaluz, Apartado, 2040-413 Rio Maior, Portugal
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Lisboa, Portugal
| | - Danilo A. Massini
- Graduate Programme in Human Development and Technology, São Paulo State University (UNESP), Rio Claro 13506-900, Brazil; (T.P.O.); (D.A.M.); (T.A.F.A.); (E.A.C.)
- Department of Physical Education, School of Sciences (FC), São Paulo State University (UNESP), Bauru 17033-360, Brazil
| | - Ricardo A. M. Robalo
- Instituto Politécnico de Setúbal, Escola Superior de Educação, 2914-504 Setúbal, Portugal; (M.C.E.); (R.A.M.R.)
- Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002 Lisboa, Portugal
| | - Tiago A. F. Almeida
- Graduate Programme in Human Development and Technology, São Paulo State University (UNESP), Rio Claro 13506-900, Brazil; (T.P.O.); (D.A.M.); (T.A.F.A.); (E.A.C.)
- Department of Physical Education, School of Sciences (FC), São Paulo State University (UNESP), Bauru 17033-360, Brazil
| | - Víctor Hernández-Beltrán
- Research Group in Optimization of Training and Performance Sports, Faculty of Sport Science, University of Extremadura, 10005 Cáceres, Spain; (V.H.-B.); (J.M.G.)
| | - José M. Gamonales
- Research Group in Optimization of Training and Performance Sports, Faculty of Sport Science, University of Extremadura, 10005 Cáceres, Spain; (V.H.-B.); (J.M.G.)
- Faculty of Health Sciences, University of Francisco de Vitoria, 28223 Madrid, Spain
| | - Eliane A. Castro
- Graduate Programme in Human Development and Technology, São Paulo State University (UNESP), Rio Claro 13506-900, Brazil; (T.P.O.); (D.A.M.); (T.A.F.A.); (E.A.C.)
- LFE Research Group, Universidad Politécnica de Madrid (UPM), 28040 Madrid, Spain
| | - Dalton M. Pessôa Filho
- Graduate Programme in Human Development and Technology, São Paulo State University (UNESP), Rio Claro 13506-900, Brazil; (T.P.O.); (D.A.M.); (T.A.F.A.); (E.A.C.)
- Department of Physical Education, School of Sciences (FC), São Paulo State University (UNESP), Bauru 17033-360, Brazil
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Hilkens L, Boerboom M, van Schijndel N, Bons J, van Loon LJC, van Dijk JW. Bone turnover following high-impact exercise is not modulated by collagen supplementation in young men: A randomized cross-over trial. Bone 2023; 170:116705. [PMID: 36804484 DOI: 10.1016/j.bone.2023.116705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 01/23/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023]
Abstract
INTRODUCTION We assessed whether collagen supplementation augments the effects of high-impact exercise on bone turnover and whether a higher exercise frequency results in a greater benefit for bone metabolism. METHODS In this randomized, cross-over trial, 14 healthy males (age 24 ± 4 y, BMI 22.0 ± 2.1 kg/m2) performed 5-min of high-impact exercise once (JUMP+PLA and JUMP+COL) or twice daily (JUMP2+COL2) during a 3-day intervention period, separated by a 10-day wash out period. One hour before every exercise bout participants ingested 20 g hydrolysed collagen (JUMP+COL and JUMP2+COL2) or a placebo control (JUMP+PLA). Blood markers of bone formation (P1NP) and resorption (CTXI) were assessed in the fasted state before the ingestion of the initial test drinks and 24, 48, and 72 h thereafter. In JUMP+PLA and JUMP+COL, additional blood samples were collected in the postprandial state at 1, 2, 3, 4, 5 and 13 h after ingestion of the test drink. RESULTS In the postprandial state, serum P1NP concentrations decreased marginally from 99 ± 37 to 93 ± 33 ng/mL in JUMP+COL, and from 97 ± 32 to 92 ± 31 ng/mL in JUMP+PLA, with P1NP levels having returned to baseline levels after 13 h (time-effect, P = 0.053). No differences in serum P1NP concentrations were observed between JUMP+PLA and JUMP+COL (time x treatment, P = 0.58). Serum CTX-I concentrations showed a ~ 50 % decline (time, P < 0.001) in the postprandial state in JUMP+COL (0.9 ± 0.3 to 0.4 ± 0.2 ng/mL) and JUMP+PLA (0.9 ± 0.3 to 0.4 ± 0.2 ng/mL), with no differences between treatments (time x treatment, P = 0.17). Fasted serum P1NP concentrations increased ~8 % by daily jumping exercise (time-effect, P < 0.01), with no differences between treatments (time x treatment, P = 0.71). Fasted serum CTX-I concentrations did not change over time (time-effect, P = 0.41) and did not differ between treatments (time x treatment, P = 0.58). CONCLUSIONS Five minutes of high-impact exercise performed daily stimulates bone formation during a 3-day intervention period. This was indicated by an increase in fasted serum P1NP concentrations, rather than an acute increase in post-exercise serum P1NP concentrations. Collagen supplementation or an increase in exercise frequency does not further increase serum P1NP concentrations. The bone resorption marker CTX-I was not affected by daily short-duration high-impact exercise with or without concurrent collagen supplementation.
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Affiliation(s)
- Luuk Hilkens
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, the Netherlands; Department of Human Biology, NUTRIM, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Marleen Boerboom
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, the Netherlands
| | - Nick van Schijndel
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, the Netherlands
| | - Judith Bons
- Central Diagnostic Laboratory, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Luc J C van Loon
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, the Netherlands; Department of Human Biology, NUTRIM, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Jan-Willem van Dijk
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, the Netherlands.
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10
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HILKENS LUUK, VAN SCHIJNDEL NICK, WEIJER VERA, BOERBOOM MARLEEN, VAN DER BURG ESTHER, PETERS VELIBOR, KEMPERS ROBERT, BONS JUDITH, VAN LOON LUCJC, VAN DIJK JANWILLEM. Low Bone Mineral Density and Associated Risk Factors in Elite Cyclists at Different Stages of a Professional Cycling Career. Med Sci Sports Exerc 2023; 55:957-965. [PMID: 36595659 PMCID: PMC10090358 DOI: 10.1249/mss.0000000000003113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE This study aimed to assess the prevalence of low bone mineral density (BMD) in male and female elite cyclists at different stages of a professional cycling career and to identify potential risk factors of low BMD. METHODS In this cross-sectional study, 93 male and female early career, advanced career, and postcareer elite cyclists completed dual-energy x-ray absorptiometry at the hip, femoral neck, lumbar spine, and total body; blood sampling; assessment of training history and injuries; and the bone-specific physical activity questionnaire. Backward stepwise multiple regression analyses were conducted to explore associations between BMD and its potential predictors in early and advanced career (i.e., active career) cyclists. RESULTS With a mean Z -score of -0.3 ± 0.8, -1.5 ± 1.0, and -1.0 ± 0.9, low BMD ( Z -score < -1) at the lumbar spine was present in 27%, 64%, and 50% of the early, advanced, and postcareer elite male cyclists, respectively. Lumbar spine Z -scores of -0.9 ± 1.0, -1.0 ± 1.0, and 0.2 ± 1.4 in early, advanced, and postcareer elite female cyclists, respectively, indicated low BMD in 45%, 45%, and 20% of these female subpopulations. Regression analyses identified body mass index, fracture incidence, bone-specific physical activity, and triiodothyronine as the main factors associated with BMD. CONCLUSIONS Low BMD is highly prevalent in elite cyclists, especially in early career females and advanced career males and females. These low BMD values may not fully recover after the professional cycling career, given the substantial prevalence of low BMD in retired elite cyclists. Exploratory analyses indicated that low BMD is associated with low body mass index, fracture incidence, lack of bone-specific physical activity, and low energy availability in active career elite cyclists.
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Affiliation(s)
- LUUK HILKENS
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, THE NETHERLANDS
- Department of Human Biology, NUTRIM, Maastricht University Medical Centre+, Maastricht, THE NETHERLANDS
| | - NICK VAN SCHIJNDEL
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, THE NETHERLANDS
| | - VERA WEIJER
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, THE NETHERLANDS
- Department of Human Biology, NUTRIM, Maastricht University Medical Centre+, Maastricht, THE NETHERLANDS
| | - MARLEEN BOERBOOM
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, THE NETHERLANDS
| | - ESTHER VAN DER BURG
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, THE NETHERLANDS
| | - VELIBOR PETERS
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, THE NETHERLANDS
| | | | - JUDITH BONS
- Central Diagnostic Laboratory, Maastricht University Medical Centre+, Maastricht, THE NETHERLANDS
| | - LUC J. C. VAN LOON
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, THE NETHERLANDS
- Department of Human Biology, NUTRIM, Maastricht University Medical Centre+, Maastricht, THE NETHERLANDS
| | - JAN-WILLEM VAN DIJK
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, THE NETHERLANDS
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11
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Schinzel E, Kast S, Kohl M, von Stengel S, Jakob F, Kerschan-Schindl K, Kladny B, Lange U, Peters S, Thomasius F, Clausen J, Uder M, Kemmler W. The effect of aquatic exercise on bone mineral density in older adults. A systematic review and meta-analysis. Front Physiol 2023; 14:1135663. [PMID: 36994417 PMCID: PMC10042290 DOI: 10.3389/fphys.2023.1135663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 02/28/2023] [Indexed: 03/14/2023] Open
Abstract
Introduction: Aquatic or water-based exercise is a very popular type of exercise in particular for people with physical limitations, joint problems and fear of falling. The present systematic review and meta-analysis aimed to provide evidence for the effect of aquatic exercise on Bone Mineral Density (BMD) in adults.Methods: A systematic literature search of five electronic databases (PubMed/MEDLINE, Cochrane Library, Scopus, Web of Science and CINAHL) according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was conducted until 2022/01/30, with an update to 2022/10/07. We included controlled trials with a duration of more than 6 months and at least two study groups, aquatic exercise (EG) versus non-training controls (CG) with no language restrictions. Outcome measures were standardized mean differences (SMD) with 95%-confidence intervals (95%-CI) for BMD changes at the lumbar spine (LS) and femoral neck (FN). We applied a random-effects meta-analysis and used the inverse heterogeneity (IVhet) model to analyze the data.Results: Excluding an outlier study with an exceptionally high effect size for LS-BMD, we observed a statistically significant (p = .002) effect (EG vs. CG) of aquatic exercise for the LS-BMD (n = 10; SMD: 0.30; 95%-CI: 0.11–0.49). In parallel, the effect of aquatic exercise on FN-BMD was statistically significant (p = .034) compared to the CG (n = 10; SMD: 0.76, 95%-CI: 0.06–1.46). Of importance, heterogeneity between the trial results was negligible for LS (I2: 7%) but substantial for FN-BMD (I2: 87%). Evidence for risks of small study/publication bias was low for LS-BMD and considerable for FN-BMD.Discussion: In summary, the present systematic review and meta-analysis provides further evidence for the favorable effect of exercise on bone health in adults. Due to its safety and attractiveness, we particularly recommend water-based exercise for people unable, afraid or unmotivated to conduct intense land-based exercise programs.
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Affiliation(s)
- Eileen Schinzel
- Institute of Radiology, FAU-Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
| | - Stephanie Kast
- Institute of Radiology, FAU-Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
| | - Matthias Kohl
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
- Department of Medical and Life Sciences, University of Furtwangen, Schwenningen, Germany
| | - Simon von Stengel
- Institute of Radiology, FAU-Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
| | - Franz Jakob
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
- Bernhard-Heine-Centrum für Bewegungsforschung, University of Würzburg, Würzburg, Germany
| | - Katharina Kerschan-Schindl
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
- Austrian Society for Bone and Mineral Research, Vienna, Austria
| | - Bernd Kladny
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
- German Society for Orthopaedics and Trauma (DGOU), Berlin, Germany
| | - Uwe Lange
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
- German Society for Physical and Rehabilitative Medicine, Leipzig, Germany
| | - Stefan Peters
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
- German Association for Health-Related Fitness and Exercise Therapy (DVGS), Hürth, Germany
| | - Friederike Thomasius
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
- Osteology Umbrella Association Germany, Austria, Switzerland
- Frankfurt Center of Bone Health, Frankfurt, Germany
| | - Jürgen Clausen
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
- Deutsche Rheuma-Liga Bundesverband eV, Bonn, Germany
| | - Michael Uder
- Institute of Radiology, FAU-Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
| | - Wolfgang Kemmler
- Institute of Radiology, FAU-Erlangen-Nürnberg and University Hospital Erlangen, Erlangen, Germany
- Research Group on Guideline “Exercise and Fracture Prevention”, Frankfurt, Germany
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
- *Correspondence: Wolfgang Kemmler,
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12
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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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13
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The Bone Biomarker Response to an Acute Bout of Exercise: A Systematic Review with Meta-Analysis. Sports Med 2022; 52:2889-2908. [DOI: 10.1007/s40279-022-01718-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2022] [Indexed: 10/16/2022]
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14
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Jamka M, Piotrowska-Brudnicka SE, Karolkiewicz J, Skrypnik D, Bogdański P, Cielecka-Piontek J, Sultanova G, Walkowiak J, Mądry E. The Effect of Endurance and Endurance-Strength Training on Bone Health and Body Composition in Centrally Obese Women-A Randomised Pilot Trial. Healthcare (Basel) 2022; 10:821. [PMID: 35627958 PMCID: PMC9140472 DOI: 10.3390/healthcare10050821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/24/2022] [Accepted: 04/26/2022] [Indexed: 12/04/2022] Open
Abstract
There is no consensus exercise programme to reduce body weight and improve body composition simultaneously preventing bone loss or stimulating osteogenesis. This pilot study compared the effect of endurance and endurance-strength training on body composition and bone metabolism in centrally obese women. Recruited subjects were randomly assigned to three-month endurance (n = 22) or endurance-strength training (n = 22). Body composition, bone mineral density (BMD) and content (BMC) were assessed before and after the intervention and markers of bone formation and resorption were measured. Both training significantly decreased fat mass; however, endurance-strength training had a more favourable effect on lean mass for the gynoid area (p = 0.0211) and legs (p = 0.0381). Endurance training significantly decreased total body BMC and BMD (p = 0.0440 and p = 0.0300), whereas endurance-strength training only reduced BMD (p = 0.0063). Changes in densitometric parameters did not differ between the groups but endurance training increased osteocalcin levels (p = 0.04845), while endurance-strength training increased tartrate-resistant acid phosphatase 5b concentrations (p = 0.00145). In conclusion, both training programmes were effective in the reduction of fat mass simultaneously negatively affecting bone health. However, endurance-strength training seemed to be more effective in increasing lean mass. The study protocol was registered in the ClinicalTrials.gov database under the number NCT03444207, date of registration: 23 February 2018 (retrospective registration).
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Affiliation(s)
- Małgorzata Jamka
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Szpitalna Str. 27/33, 60-572 Poznań, Poland; (M.J.); (J.W.)
| | - Sylwia E. Piotrowska-Brudnicka
- Department of Physiology, Poznan University of Medical Sciences, Święcickiego Str. 6, 61-781 Poznań, Poland;
- Department of Clinical Biomechanics and Physiotherapy in Motor System Disorders, Faculty of Health Science, Wroclaw Medical University, Grunwaldzka Str. 2, 50-355 Wrocław, Poland
| | - Joanna Karolkiewicz
- Department of Food and Nutrition, Poznan University of Physical Education, Królowej Jadwigi Str. 27/39, 61-871 Poznań, Poland;
| | - Damian Skrypnik
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, Szamarzewskiego Str. 82, 60-569 Poznań, Poland; (D.S.); (P.B.)
| | - Paweł Bogdański
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, Szamarzewskiego Str. 82, 60-569 Poznań, Poland; (D.S.); (P.B.)
| | - Judyta Cielecka-Piontek
- Department of Pharmacognosy, Poznan University of Medical Sciences, Rokietnicka 3, 60-806 Poznań, Poland;
| | - Gulnara Sultanova
- West Kazakhstan Marat Ospanov Medical University, Maresyev Str. 68, Aktobe 030019, Kazakhstan;
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Szpitalna Str. 27/33, 60-572 Poznań, Poland; (M.J.); (J.W.)
| | - Edyta Mądry
- Department of Physiology, Poznan University of Medical Sciences, Święcickiego Str. 6, 61-781 Poznań, Poland;
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15
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Chen Z, Sherk VD, Sharma-Ghimire P, Bemben MG, Bemben DA. Site-Specific Bone Differences and Energy Status in Male Competitive Runners and Road Cyclists. J Clin Densitom 2022; 25:150-159. [PMID: 34952789 DOI: 10.1016/j.jocd.2021.11.002] [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] [Received: 05/28/2021] [Revised: 10/27/2021] [Accepted: 11/08/2021] [Indexed: 11/18/2022]
Abstract
The interaction between mechanical loading and energy availability on bone health in male endurance athletes merits further investigation. The purpose of this study was to compare bone status in male competitive runners and road cyclists and to investigate the influence of energy availability (EA) on bone mineral density (BMD). 18 competitive runners and 19 road cyclists (20-50 years) participated in this study. Areal BMD and body composition were assessed by dual energy x-ray absorptiometry. Volumetric bone variables at the 4% and 66% tibia sites were assessed by peripheral quantitative computed tomography. Energy availability (EA, 7-day dietary and exercise logs) and resting metabolic rate (RMR, open circuit spirometry) were measured as indicators of energy status. Bone loading history, calcium intake, and training history were assessed by questionnaires. After adjusting for age, runners had significantly greater (p < 0.05) areal BMD (femoral neck, left total hip), Z-scores (total body, hips sites), total bone mineral content and trabecular variables (bone mineral content, volumetric BMD, bone strength index) at tibia 4% site, and total volumetric BMD at tibia 66% site than the cyclists (p ≤ 0.05). At the tibia 66% site, cyclists had significantly greater (p < 0.05) total area, periosteal circumference, endosteal circumference, and strength-strain index than runners. Energy variables were similar for runners and cyclists; however, RMR and RMR ratio (measured RMR/predicted RMR) were significantly lower in cyclists (p < 0.001). In conclusion, there were site-specific differences in hip and tibia bone characteristics between runners and cyclists. RMR was associated with several bone outcomes; however, EA was not related to bone health in runners or to dual energy x-ray absorptiometry bone variables in cyclists.
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Affiliation(s)
- Zhaojing Chen
- Department of Kinesiology, California State University, San Bernardino, CA, USA.
| | - Vanessa D Sherk
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Pragya Sharma-Ghimire
- Department of Physical Education and Exercise Science, Lander University, Greenwood, SC, USA
| | - Michael G Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
| | - Debra A Bemben
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
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16
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Jonvik KL, Torstveit MK, Sundgot-Borgen JK, Mathisen TF. Do we need to change the guideline values for determining low bone mineral density in athletes? J Appl Physiol (1985) 2022; 132:1320-1322. [PMID: 35060767 PMCID: PMC9126212 DOI: 10.1152/japplphysiol.00851.2021] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Kristin L. Jonvik
- Department of Physical Performance, Norwegian School of Sport Sciences, Norway
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17
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Martínez-Noguera FJ, Alcaraz PE, Ortolano-Ríos R, Dufour S, Marín-Pagán C. Professional cyclists have lower levels of bone markers than amateurs. Is there a risk of osteoporosis in cyclist? Bone 2021; 153:116102. [PMID: 34245935 DOI: 10.1016/j.bone.2021.116102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 06/02/2021] [Accepted: 06/30/2021] [Indexed: 10/20/2022]
Abstract
Currently, there is a greater number of amateurs that practice cycling. However, there is no clear evidence regarding bone health in amateur cyclists compared to professional cyclists, as the latter has shown to have lower bone mineral content and density. Therefore, the aim of this study was to identify the differences in bone variables between professional (PRO) and amateur (AMA) road cyclists, and to see if these differences were related to differences in cycling performance. A parallel trial was carried out with 15 AMA and 10 PRO cyclists. All cyclists visited the laboratory twice: 1) in a fasted state, body composition measured by dual-energy X-ray absorptiometry (DXA) and 2) physiological variables measured using an incremental test until exhaustion. Significantly lower values were found in bone mineral density, bone mineral content and fat free mass in PRO compared to AMA (p < 0.05). In addition, significantly higher power was produced in ventilatory thresholds 1 and 2 (VT1 and VT2) and VO2MAX in PRO compared to AMA (p < 0.05). Overall, PRO cyclists had lower values in bone health and muscle mass but better results in performance compared to AMA.
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Affiliation(s)
| | - Pedro E Alcaraz
- Research Center for High Performance Sport, Catholic University of Murcia, Murcia, Spain.
| | - Raquel Ortolano-Ríos
- Research Center for High Performance Sport, Catholic University of Murcia, Murcia, Spain
| | - Stéphane Dufour
- University of Strasbourg, Faculty of Medicine, Translational Medicine Federation (FMTS), UR 3072, France; University of Strasbourg, Faculty of Sport Sciences, France.
| | - Cristian Marín-Pagán
- Research Center for High Performance Sport, Catholic University of Murcia, Murcia, Spain.
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18
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Exercise Effects on Bone Mineral Density in Men. Nutrients 2021; 13:nu13124244. [PMID: 34959796 PMCID: PMC8707095 DOI: 10.3390/nu13124244] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/20/2021] [Accepted: 11/19/2021] [Indexed: 02/07/2023] Open
Abstract
In contrast to postmenopausal women, evidence for a favorable effect of exercise on Bone Mineral Density (BMD) is still limited for men. This might be due to the paucity of studies, but also to the great variety of participants and study characteristics that may dilute study results. The aim of the present systematic review and meta-analysis was to evaluate the effect of exercise on BMD changes with rational eligibility criteria. A comprehensive search of six electronic databases up to 15 March 2021 was conducted. Briefly, controlled trials ≥6 months that determined changes in areal BMD in men >18 years old, with no apparent diseases or pharmacological therapy that relevantly affect bone metabolism, were included. BMD changes (standardized mean differences: SMD) of the lumbar spine (LS) and femoral neck (FN) were considered as outcomes. Twelve studies with 16 exercise and 12 control groups were identified. The pooled estimate of random-effect analysis was SMD = 0.38, 95%-CI: 0.14–0.61 and SMD = 0.25, 95%-CI: 0.00–0.49, for LS and FN, respectively. Heterogeneity between the trials was low–moderate. Funnel plots and rank and regression correlation tests indicate evidence for small study publication bias for LS but not FN-BMD. Subgroup analyses that focus on study length, type of exercise and methodologic quality revealed no significant difference between each of the three categories. In summary, we provided further evidence for a low but significant effect of exercise on BMD in men. However, we are currently unable to give even rough exercise recommendations for male cohorts.
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The Effect of Endurance and Endurance-Strength Training on Bone Mineral Density and Content in Abdominally Obese Postmenopausal Women: A Randomized Trial. Healthcare (Basel) 2021; 9:healthcare9081074. [PMID: 34442211 PMCID: PMC8391265 DOI: 10.3390/healthcare9081074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/11/2021] [Accepted: 08/18/2021] [Indexed: 01/21/2023] Open
Abstract
The optimal type of exercise that simultaneously decreases body weight and preserves bone health in people with obesity is unknown. This parallel randomized trial aimed to compare the effect of endurance and endurance-strength training on bone mineral density (BMD) and content (BMC) in abdominally obese postmenopausal women. A total of 101 women were recruited and randomly assigned to endurance or endurance-strength training groups. Participants trained for 60 min per day, three times per week for 12 weeks. The endurance exercises were performed at an intensity of 50–75% of the maximum heart rate, whereas the strength exercises were at 50–60% of the one-repetition maximum. Pre- and post-intervention BMD and BMC of the total body, lumbar spine, and femoral neck and physical capacity were measured. There were no differences among the densitometric parameters in the endurance group, but a significant increase in whole-body BMD in the endurance-strength group was found. Moreover, there was a significant difference between the groups in the changes in the lumbar spine BMC. Furthermore, both training programs significantly improved physical capacity with no differences between groups. Endurance training was more effective in maintaining BMC at the lumbar spine. However, both groups did not differ in effect on BMD. Further studies with a long-term follow-up should be considered to confirm these findings. The study was registered with the German Clinical Trials Register within the number DRKS00019832, and the date of registration was 26 February 2020 (retrospective registration).
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Reduced Endurance Capacity and Suboptimal Energy Availability in Top-Level Female Cyclists. Int J Sports Physiol Perform 2021; 16:1194–1203. [PMID: 33626509 DOI: 10.1123/ijspp.2020-0513] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/11/2020] [Accepted: 09/14/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE Women's professional cycling has grown in popularity, and this increase is also apparent in Brazil, which has increased its female cycling calendar in recent years. The aim of this observational study was to (1) determine training and competition loads of a top-level Brazilian female cycling team, (2) evaluate nutrition and clinical health, and (3) measure whether exercise capacity changed throughout the season. METHODS Training and competition data were collected over the season using global positioning system monitors, while laboratory-based physiological and performance measures (incremental cycling test, 30-s Wingate, 4-km time trial) and clinical and nutritional analyses were performed at time points throughout the season. RESULTS Total distance covered over the year was 11,124 (2895) km (7382-14,698 km). Endurance capacity was reduced over the season (P = .005) but not anaerobic power (all P > .05). Nutrition and stress markers remained largely unchanged throughout the season, although there were some individual fluctuations in some measures, and testosterone concentration was low for some. Median estimated energy availability ranged between 32.3 and 56.8 kcal·kgLBM-1·d-1 during training and 26.4 and 53.8 kcal·kgLBM-1·d-1 during competition. Percentage of training spent in optimal estimated energy availability was generally low, with 3 athletes spending <35% within the optimal intake. CONCLUSIONS Substantial training and competition loads of the monitored professional Brazilian female cyclists may have reduced exercise capacity toward the end of the season, indicative of a grueling yearlong schedule. Several athletes may have had suboptimal energy availability during the season, potentially affecting testosterone concentration. These data demonstrate the difficulties in maintaining optimal nutrition, health, and performance throughout a season in professional female cycling and highlight the need for quality sport-science support for this type of top-level athlete.
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On- Versus Off-Bike Power Training in Professional Cyclists: A Randomized Controlled Trial. Int J Sports Physiol Perform 2021; 16:674-681. [PMID: 33547263 DOI: 10.1123/ijspp.2020-0305] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/29/2020] [Accepted: 06/16/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE To compare the effectiveness of resistance power training (RPT, training with the individualized load and repetitions that maximize power output) and cycling power training (CPT, short sprint training) in professional cyclists. METHODS The participants (20 [2] y, peak oxygen uptake 78.0 [4.4] mL·kg-1·min-1) were randomly assigned to perform CPT (n = 8) or RPT (n = 10) in addition to their usual training regime for 7 weeks (2 sessions/wk). The training loads were continuously registered using the session rating of perceived exertion. The outcomes included endurance performance (8-min time trial and incremental test), as well as measures of muscle strength/power (1-repetition maximum and mean maximum propulsive power on the squat, hip thrust, and lunge exercises) and body composition (assessed by dual-energy X-ray absorptiometry). RESULTS No between-group differences were found for training loads or for any outcome (P > .05). Both interventions resulted in increased time-trial performance, as well as in improvements in other endurance-related outcomes (ie, ventilatory threshold, respiratory compensation point; P < .05). A significant or quasi-significant increase (P = .068 and .047 for CPT and RPT, respectively) in bone mineral content was observed after both interventions. A significant reduction in fat mass (P = .017), along with a trend (P = .059) toward a reduced body mass, was observed after RPT, but not CPT (P = .076 for the group × time interaction effect). Significant benefits (P < .05) were also observed for most strength-related outcomes after RPT, but not CPT. CONCLUSION CPT and RPT are both effective strategies for the improvement of endurance performance and bone health in professional cyclists, although the latter tends to result in greater improvements in body composition and muscle strength/power.
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Oosthuyse T, Bosch AN, Kariem N, Millen AME. Mountain Bike Racing Stimulates Osteogenic Bone Signaling and Ingesting Carbohydrate-Protein Compared With Carbohydrate-Only Prevents Acute Recovery Bone Resorption Dominance. J Strength Cond Res 2021; 35:292-299. [PMID: 33337693 DOI: 10.1519/jsc.0000000000003928] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Oosthuyse, T, Bosch, AN, Kariem, N, and Millen, AME. Mountain bike racing stimulates osteogenic bone signaling and ingesting carbohydrate-protein compared with carbohydrate-only prevents acute recovery bone resorption dominance. J Strength Cond Res 35(2): 292-299, 2021-Mountain biking, unlike road cycling, includes vibrational accelerations but whether it stimulates osteogenic signaling remains unknown. Furthermore, exercise nutrition influences bone turnover, and the effect of ingesting protein during multiday racing was investigated. We measured plasma bone turnover markers, C-terminal telopeptide of type1-collagen (β-CTX) and N-terminal propeptides of type1-procollagen (P1NP), and osteocyte mechanosensory signaling factor, sclerostin (SOST), corrected for plasma volume change, before (pre-day 1) and 20-60 minutes after (post-day 3) a multiday mountain bike race in 18 male cyclists randomly assigned to ingest carbohydrate-only (CHO-only) or carbohydrate-with-casein protein hydrolysate (CHO-PRO) during racing. Fourteen cyclists (n = 7 per group) completed the race, and data were analyzed with p < 0.05 accepted as significant. Plasma SOST decreased similarly in both groups (mean ± SD, CHO-only: 877 ± 451 to 628 ± 473 pg·ml-1, p = 0.004; CHO-PRO: 888 ± 411 to 650 ± 443 pg·ml-1, p = 0.003), suggesting that osteocytes sense mountain biking as mechanical loading. However, the bone formation marker, P1NP, remained unchanged in both groups, whereas the bone resorption marker, β-CTX, increased in CHO-only (0.19 ± 0.034 to 0.31 ± 0.074 ng·ml-1, p = 0.0036) but remained unchanged in CHO-PRO (0.25 ± 0.079 to 0.26 ± 0.074 ng·ml-1, p = 0.95). Mountain bike racing does stimulate osteogenic bone signaling but bone formation is not increased acutely after multiday mountain biking; investigation for a delayed effect is warranted. The acute recovery increase in bone resorption with CHO-only is prevented by ingesting CHO-PRO during racing.
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Affiliation(s)
- Tanja Oosthuyse
- School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Medical School, Johannesburg, South Africa ; and
| | - Andrew N Bosch
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Neezaam Kariem
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa
| | - Aletta M E Millen
- School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Medical School, Johannesburg, South Africa ; and
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Abstract
PURPOSE Individuals with cerebral palsy (CP), ambulatory or not, have less bone strength and density than their peers. Aging individuals with CP are at a higher risk for nontraumatic fractures, progressive deformity, pain, and spinal stenosis. Critical periods for skeletal formation are during prepuberty and adolescence. Applying mechanostat theory to exercise design for individuals with CP may be beneficial. METHODS Principles of mechanostat theory, particularly the osteogenic index, is applied to guide the design of exercise programs based on varying levels of physical capacity. RESULTS Recommendations are made for optimizing dosing of a variety of interventions for improving bone health among individuals with CP based on mechanostat theory with specific type, number of repetitions, and frequency. CONCLUSIONS Researchers and clinicians are called to action to consider the role of exercise throughout the lifespan for all individuals with CP, regardless of level of severity.
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Dolan E, Dumas A, Keane KM, Bestetti G, Freitas LHM, Gualano B, Kohrt W, Kelley GA, Pereira RMR, Sale C, Swinton P. The influence of acute exercise on bone biomarkers: protocol for a systematic review with meta-analysis. Syst Rev 2020; 9:291. [PMID: 33308281 PMCID: PMC7733242 DOI: 10.1186/s13643-020-01551-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/30/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Bone is a plastic tissue that is responsive to its physical environment. As a result, exercise interventions represent a potential means to influence the bone. However, little is currently known about how various exercise and participant characteristics interact to influence bone metabolism. Acute, controlled, interventions provide an in vivo model through which the acute bone response to exercise can be investigated, typically by monitoring circulating bone biomarkers. Currently, substantial heterogeneity in factors such as study design, quality, exercise, and participant characteristics render it difficult to synthesize and evaluate the available evidence. Using a systematic review and meta-analytic approach, the aim of this investigation is to quantify the effect of an acute exercise bout on circulating bone biomarkers as well as examine the potential factors that may moderate this response, e.g., variation in participant, exercise, and sampling characteristics. METHODS This protocol was designed in accordance with the PRISMA-P guidelines. Seven databases (MEDLINE, Embase, Sport Discus, Cochrane CENTRAL, PEDro, LILACS, and Ibec) will be systematically searched and supplemented by a secondary screening of the reference lists of all included articles. The PICOS (Population, Intervention, Comparator, Outcomes and Study Design) approach was used to guide the determination of the eligibility criteria. Participants of any age, sex, training, or health status will be considered for inclusion. We will select studies that have measured the bone biomarker response before and after an acute exercise session. All biomarkers considered to represent the bone metabolism will be considered for inclusion, and sensitivity analyses will be conducted using reference biomarkers for the measurement of bone resorption and formation (namely β-CTX-1 and P1NP). Multi-level, meta-regression models within a Bayesian framework will be used to explore the main effect of acute exercise on bone biomarkers as well as potential moderating factors. The risk of bias for each individual study will be evaluated using a modified version of the Downs and Black checklist while certainty in resultant outcomes will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. DISCUSSION A better understanding of the bone metabolic response to an acute bout of exercise has the potential to advance our understanding of the mechanisms through which this stimulus impacts bone metabolism, including factors that may moderate this response. Additionally, we will identify current gaps in the evidence base and provide recommendations to inform future research. SYSTEMATIC REVIEW REGISTRATION This protocol was prospectively registered in the Open Science Framework Registry ( https://osf.io/6f8dz ).
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Affiliation(s)
- E Dolan
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Faculdade de Medicina FMUSP, University of Sao Paulo, Sao Paulo, Brazil.
| | - A Dumas
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Faculdade de Medicina FMUSP, University of Sao Paulo, Sao Paulo, Brazil
| | - K M Keane
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - G Bestetti
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Faculdade de Medicina FMUSP, University of Sao Paulo, Sao Paulo, Brazil
| | - L H M Freitas
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Faculdade de Medicina FMUSP, University of Sao Paulo, Sao Paulo, Brazil
| | - B Gualano
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Faculdade de Medicina FMUSP, University of Sao Paulo, Sao Paulo, Brazil.,Food Research Centre, University of São Paulo, Sao Paulo, SP, Brazil
| | - W Kohrt
- Centre for Women's Health Research, School of Medicine, University of Colorado, Aurora, USA
| | - G A Kelley
- Department of Biostatistics, West Virginia University, Morgantown, USA
| | - R M R Pereira
- Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - C Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - P Swinton
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
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Schofield KL, Thorpe H, Sims ST. Where are all the men? Low energy availability in male cyclists: A review. Eur J Sport Sci 2020; 21:1567-1578. [PMID: 33108971 DOI: 10.1080/17461391.2020.1842510] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Most of the low energy availability (LEA) research has been conducted in female populations. The occurrence of LEA in male athletes is not well known, even with an understanding of the components involved in and contributing to LEA. Cycling is a major risk factor for LEA due to inherent sports characteristics: low impact, high energy demands, and a common perception that leanness is a performance advantage. The purpose of this review is to discuss the cycling-specific studies that have documented components of RED-S. The review demonstrates male cyclists (1) experience energy deficits daily, weekly and throughout a season; (2) exhibit lower bone mineral density at the spine compared to the hip, and low bone mineral density correlating with LEA and; (3) demonstrate downregulation of the endocrine system with elevated cortisol, reduced testosterone and insulin-like growth factor 1. The complexity of LEA is further explored by the socio-psychological contribution that may impact eating behaviours, and therefore increase the risk of developing LEA. Future research directions include applying multifaceted research methods to gain a greater understanding of this syndrome and the effect of LEA on male cyclists.Highlights Competitive male cyclists tend to train and compete in low energy availability states, increasing the risk of developing low bone mineral density.The metabolic and hormonal changes in competitive male cyclists demonstrate a multifaceted downregulation of the endocrine system.The socio-psychological contributions may impact eating behaviours, therefore increase the risk of developing low energy availability in competitive male cyclists.Future research using mixed-method approaches will contribute to more multidimensional understandings of the risks and effects of LEA on male cyclists.
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Affiliation(s)
| | - Holly Thorpe
- Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand
| | - Stacy T Sims
- Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand
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Dolan E, Varley I, Ackerman KE, Pereira RMR, Elliott-Sale KJ, Sale C. The Bone Metabolic Response to Exercise and Nutrition. Exerc Sport Sci Rev 2020; 48:49-58. [PMID: 31913188 DOI: 10.1249/jes.0000000000000215] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Bone (re)modeling markers can help determine how the bone responds to different types, intensities, and durations of exercise. They also might help predict those at risk of bone injury. We synthesized evidence on the acute and chronic bone metabolic responses to exercise, along with how nutritional factors can moderate this response. Recommendations to optimize future research efforts are made.
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Affiliation(s)
| | - Ian Varley
- Musculoskeletal Physiology Research Group, Sport, Health, and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Kathryn E Ackerman
- Division of Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Rosa Maria R Pereira
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Kirsty Jayne Elliott-Sale
- Musculoskeletal Physiology Research Group, Sport, Health, and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Craig Sale
- Musculoskeletal Physiology Research Group, Sport, Health, and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
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27
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Shojaa M, von Stengel S, Kohl M, Schoene D, Kemmler W. Effects of dynamic resistance exercise on bone mineral density in postmenopausal women: a systematic review and meta-analysis with special emphasis on exercise parameters. Osteoporos Int 2020; 31:1427-1444. [PMID: 32399891 PMCID: PMC7360540 DOI: 10.1007/s00198-020-05441-w] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 04/28/2020] [Indexed: 12/25/2022]
Abstract
This systematic review and meta-analysis set out to determine the effect of dynamic resistance exercise (DRT) on areal bone mineral density (aBMD) in postmenopausal women and derive evidence-based recommendations for optimized training protocols. A systematic review of the literature according to the PRISMA statement included (a) controlled trials, (b) of isolated DRT with at least one exercise and one control group, (c) with intervention durations ≥ 6 months, (d) aBMD assessments at lumbar spine or proximal femur, (e) in cohorts of postmenopausal women. We searched eight electronic databases up to March 2019 without language restrictions. The meta-analysis was performed using a random-effects model. Standardized mean differences (SMD) for BMD changes at lumbar spine (LS), femoral neck (FN), and total hip (TH) were defined as outcome measures. Moderators of the exercise effects, i.e., "intervention length," "type of DRT," "training frequency," "exercise intensity," and "exercise volume," were addressed by sub-group analyses. The study was registered in the international prospective register of systematic reviews (PROSPERO) under ID: CRD42018095097. Seventeen articles with 20 exercise and 18 control groups were eligible. SMD average is 0.54 (95% CI 0.22-0.87) for LS-BMD, 0.22 (0.07-0.38) for FN-BMD, and 0.48 (0.22-0.75) for TH-BMD changes (all p ≤ 0.015). While sub-group analysis for FN-BMD revealed no differences within categories of moderators, lower training frequency (< 2 sessions/week) resulted in significantly higher BMD changes at LS and TH compared to higher training frequency (≥ 2 sessions/week). Additionally, free weight training was significantly superior to DRT devices for improving TH-BMD. This work provided further evidence for significant, albeit only low-moderate, effects of DRT on LS-, FN-, and TH-BMD. Unfortunately, sub-analysis results did not allow meaningful exercise recommendations to be derived. This systematic review and meta-analysis observed a significant low-moderate effect of dynamic resistance exercise on bone mineral density changes in postmenopausal women. However, sub-group analyses focusing on exercise characteristics found no results that enable the derivation of meaningful exercise recommendations in the area of exercise and osteoporosis prevention or therapy.
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Affiliation(s)
- M Shojaa
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Henkestrasse 91, 91052, Erlangen, Germany
| | - S von Stengel
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Henkestrasse 91, 91052, Erlangen, Germany
| | - M Kohl
- Department of Medical and Life Sciences, University of Furtwangen, Schwenningen, Germany
| | - D Schoene
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Henkestrasse 91, 91052, Erlangen, Germany
| | - W Kemmler
- Institute of Medical Physics, Friedrich-Alexander University Erlangen-Nürnberg, Henkestrasse 91, 91052, Erlangen, Germany.
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Physical Activity-Dependent Regulation of Parathyroid Hormone and Calcium-Phosphorous Metabolism. Int J Mol Sci 2020; 21:ijms21155388. [PMID: 32751307 PMCID: PMC7432834 DOI: 10.3390/ijms21155388] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/09/2020] [Accepted: 07/23/2020] [Indexed: 12/14/2022] Open
Abstract
Exercise perturbs homeostasis, alters the levels of circulating mediators and hormones, and increases the demand by skeletal muscles and other vital organs for energy substrates. Exercise also affects bone and mineral metabolism, particularly calcium and phosphate, both of which are essential for muscle contraction, neuromuscular signaling, biosynthesis of adenosine triphosphate (ATP), and other energy substrates. Parathyroid hormone (PTH) is involved in the regulation of calcium and phosphate homeostasis. Understanding the effects of exercise on PTH secretion is fundamental for appreciating how the body adapts to exercise. Altered PTH metabolism underlies hyperparathyroidism and hypoparathyroidism, the complications of which affect the organs involved in calcium and phosphorous metabolism (bone and kidney) and other body systems as well. Exercise affects PTH expression and secretion by altering the circulating levels of calcium and phosphate. In turn, PTH responds directly to exercise and exercise-induced myokines. Here, we review the main concepts of the regulation of PTH expression and secretion under physiological conditions, in acute and chronic exercise, and in relation to PTH-related disorders.
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Lehrskov LL, Kjeldsen S, Lyngbæk MP, Chirstensen RH, Wedell-Neergaard AS, Søderlund L, Jørgensen NR, Krogh-Madsen R, Wewer Albrechtsen NJ, Ellingsgaard H. Interleukin-6 May Not Affect Bone Resorption Marker CTX or Bone Formation Marker P1NP in Humans. J Endocr Soc 2020; 4:bvaa093. [PMID: 32793846 PMCID: PMC7414920 DOI: 10.1210/jendso/bvaa093] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/03/2020] [Indexed: 01/21/2023] Open
Abstract
Context Interleukin 6 (IL-6) contributes to bone remodeling in preclinical studies. Clinical trials investigating the role of IL-6 in bone remodeling are limited. Objective To investigate if IL-6 regulates bone remodeling in humans. Design Plasma concentrations of the bone resorption marker carboxy-terminal type I collagen crosslinks (CTX) and of the bone formation marker procollagen type 1 N-terminal propeptide (P1NP) were measured during a mixed-meal tolerance test (MMTT) in 3 placebo-controlled human studies. Participants Five healthy individuals participated in study 1; 52 obese individuals, in study 2; and 10 healthy individuals, in study 3. Interventions Study 1 was a single-blinded crossover study consisting of a 1-h infusion of saline (placebo) or the IL-6 receptor antibody tocilizumab followed by an exercise bout. Study 2 was a randomized, double-blinded 12-week exercise training intervention study. Participants received infusions of saline or tocilizumab. Study 3 was a randomized, double-blinded, crossover study consisting of 30 min infusion of saline or IL-6. Main outcomes measures Effect of IL-6 on CTX levels. Results CTX was significantly (P < 0.01) decreased during MMTTs in all 3 studies. Treatment with tocilizumab did not affect exercise or meal induced changes in plasma CTX or P1NP concentrations acutely (study 1) or after a 12-week treatment period (study 2). Exogenous IL-6 had no effect on CTX or P1NP plasma concentrations (study 3). Conclusions IL-6 may not regulate bone remodeling in humans.
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Affiliation(s)
- Louise L Lehrskov
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Sasha Kjeldsen
- Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mark P Lyngbæk
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Regitse Højgaard Chirstensen
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Sophie Wedell-Neergaard
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Line Søderlund
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rikke Krogh-Madsen
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Nicolai J Wewer Albrechtsen
- Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Helga Ellingsgaard
- The Centre of Inflammation and Metabolism and the Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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30
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Albuquerque RBD, Geraldes AAR, Rangoussis B, Fonseca FDS, Nascimento Neto DDC, Oliveira ACCD. SWIMMING AND BONE MINERAL DENSITY: A SPORT WITHOUT OSTEOGENIC STIMULATION? REV BRAS MED ESPORTE 2020. [DOI: 10.1590/1517-869220202602216728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Introduction: The osteogenic effects generated by different sports are the subject of a growing number of research projects. Regular physical activity is one of the main recommendations for the stimulation of bone mineral density (BMD). However, evidence has shown that not all physical activities promote similar effects. In this context, the osteogenic effects of swimming need to be clarified. Objective: To verify and compare total and regional BMD levels between male and female swimming athletes and university non-athletes. Methods: The sample, composed of 60 participants of both sexes, was divided into two groups: 30 swimming athletes (GA): 15 men (22.2 ± 3.92 years; 73.61 ± 16.55 kg; 1.76 ± 0.08 m) and 15 women (21.91 ± 2.21 years; 53.15 ± 8.36 kg; 1.64 ± 0.06 m) and a control group (CG): 30 university non-athletes: 15 men (20.73 ± 1.27 years; 74.4 ± 5.54 kg, 1.74 ± 0.04 m) and 15 women (19.93 ± 2.05 years; 59.72 ± 1.33 kg; 1.63 ± 0.004 m). BMD (total, arms, legs, pelvis and spine) was measured using dual energy X-ray absorptiometry (DXA). The results were compared with one-way ANOVA using Scheffé's post hoc test, when necessary. Results: When compared with the women, the men of both groups presented superior results for all BMD values analyzed. In addition, GA had higher BMD of arms and spine when compared to the CG, both for males (p = 0.016 and p = 0.001, respectively) and females (p = 0.0001 and p = 0.011, respectively). Conclusions: The results of this study demonstrate that young male adults, athletes and non-athletes, present higher levels of BMD than their peers of the opposite sex. In addition, the results suggest that when undertaken for competitive purposes and with a weekly training volume of 12 hours or more, swimming may be beneficial for the bone development of young athletes when compared to non-athlete controls. Level of evidence III; Retrospective comparative study.
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Affiliation(s)
- Rodrigo Barbosa de Albuquerque
- Universidade Federal de Sergipe, Brazil; Universidade Federal de Alagoas, Brazil; Universidade Federal de Alagoas, Brazil; Universidade Federal de Alagoas, Brazil
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Stenqvist TB, Torstveit MK, Faber J, Melin AK. Impact of a 4-Week Intensified Endurance Training Intervention on Markers of Relative Energy Deficiency in Sport (RED-S) and Performance Among Well-Trained Male Cyclists. Front Endocrinol (Lausanne) 2020; 11:512365. [PMID: 33101190 PMCID: PMC7545350 DOI: 10.3389/fendo.2020.512365] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 08/25/2020] [Indexed: 11/23/2022] Open
Abstract
Cyclists often apply block periodization to high training volumes in meso- and macrocycles to optimize training adaptation and to prepare for competition. Body mass influences performance in many sports, including endurance disciplines, and conditions related to the syndrome Relative Energy Deficiency in Sports (RED-S) such as metabolic adaptations and premature osteoporosis have also been reported in male cyclists. This study aimed to determine how a 4-week mesocycle of intensified endurance training designed to increase performance, would affect markers of RED-S in well-trained male cyclists. Twenty-two participants (age: 33.5 ± 6.6 years, height: 181.4 ± 5.2 cm, weight: 76.5 ± 7.4 kg, peak oxygen uptake (VO2peak): 63.5 ± 6.6 mL·kg-1·min-1) were recruited and instructed to maintain their background training load and to follow a supervised training protocol consisting of three high-intensity interval training sessions per week with a work duration of 32 min per session. Protocols included pre- and postintervention assessment of resting metabolic rate (RMR) using a ventilated hood, body composition and bone health by dual-energy X-ray absorptiometry (DXA), blood samples, energy intake, and aerobic performance. The interval training increased participants' aerobic performance-peak power output [4.8%, p < 0.001], VO2peak [2.4%, p = 0.005], and functional threshold power [6.5%, p < 0.001] as well as total testosterone levels [8.1%, p = 0.011]-while no changes were observed in free testosterone [4.1%, p = 0.326]. Bodyweight, body composition, and energy intake were unchanged from pre- to post-test. Triiodothyronine (T3) [4.8%, p = 0.008], absolute RMR [3.0%, p = 0.010], relative RMR [2.6%, p = 0.013], and RMRratio [3.3%, p = 0.011] decreased, and cortisol levels increased [12.9%, p = 0.021], while no change were observed in the total testosterone:cortisol ratio [1.6%, p = 0.789] or the free testosterone:cortisol (fT:cor) ratio [3.2%, p = 0.556]. A subgroup analysis of the five participants with the largest increase in fT:cor ratio, revealed a greater improvement in functional threshold power (9.5 vs. 2.5%, p = 0.037), and higher relative RMR (0.6 vs. -4.2% p = 0.039, respectively). In conclusion, 4 weeks of intensified endurance interval training increased the athletes' aerobic performance and testosterone levels. However, negative changes in markers related to RED-S, such as a reduction in RMR and T3, and an increase in cortisol were observed. These results indicate the complexity involved, and that male athletes are at risk of developing clinical indications of RED-S even during a short 4-week endurance training mesocycle.
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Affiliation(s)
- Thomas Birkedal Stenqvist
- Department of Sport Science and Physical Education, Faculty of Health and Sport Science, University of Agder, Kristiansand, Norway
| | - Monica Klungland Torstveit
- Department of Sport Science and Physical Education, Faculty of Health and Sport Science, University of Agder, Kristiansand, Norway
| | - Jens Faber
- Department of Medicine, Endocrinology, Herlev University Hospital, Copenhagen, Denmark
| | - Anna Katarina Melin
- Department of Sport Science, Faculty of Social Sciences, Linnaeus University, Växjö/Kalmar, Sweden
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Mikkilä S, Calogiuri G, Emaus N, Morseth B. A cross-sectional and 6-year follow-up study of associations between leisure time physical activity and vertebral fracture in adults. BMC Musculoskelet Disord 2019; 20:435. [PMID: 31526375 PMCID: PMC6747745 DOI: 10.1186/s12891-019-2821-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 09/10/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction Vertebral fractures are common osteoporotic fractures, affecting 2–46% of the population, causing morbidity and increased risk of mortality. Physical activity has beneficial effects for bone health, including increased bone mineral density and reduced hip fractures. However, evidence concerning prevention of vertebral fractures is scarce. Therefore, the aim of this study was to investigate the association between leisure time physical activity and vertebral fracture risk. Methods The data were retrieved from the 2001 and 2007–2008 surveys of the Tromsø Study, a longitudinal population study in Norway. A total of 1904 participants (1030 women and 874 men, age 38–87 yr and 40–87 yr respectively) were included in the cross-sectional analysis (2007–2008). Prospective follow-up data (2001 to 2007) on physical activity were available for 1131 participants (636 women and 495 men, age 32–69 yr and 33–69 yr respectively). Physical activity was assessed by a questionnaire and vertebral fracture by lateral vertebral fracture assessment from dual-energy x-ray absorptiometry scans. Logistic regression was used to examine associations between physical activity and vertebral fracture. Results After controlling for confounders (age, height, weight, smoking, osteoporosis, osteoporosis medication, left hip total bone mineral density, and use of hormones in women only), no cross-sectional associations between physical activity levels and vertebral fracture were observed, OR 1.13 (95% CI: 0.59–2.13), for moderately active women and 1.44 (0.61–3.42) for highly active women, compared with sedentary women. In men, the respective ORs were 1.74 (95% CI: 0.91–3.35) and 1.64 (0.78–3.41). In the prospective analyses, OR for vertebral fracture in women with reduced physical activity was 0.81 (95% CI: 0.18–3.62), 1.24 (95% CI: 0.29–5.26) for increased physical activity and 1.54 (95% CI: 0.43–5.50) for active unchanged physical activity pattern, compared with sedentary unchanged physical activity. In men, the respective ORs were 2.05 (95% CI: 0.57–7.42), 2.23 (95% CI: 0.63–7.87), and 1.81 (95% CI: 0.54–6.02). Subanalyses of women and men ≥50 yr showed similar results. Conclusions Our findings suggest that physical activity does not play a major role in preventing vertebral fractures in Norwegian adults. Future studies may benefit from data on incident vertebral fracture, and objectively measured physical activity.
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Affiliation(s)
- Saija Mikkilä
- School of sport sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway. .,Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Giovanna Calogiuri
- Department of Dental Care and Public Health, Inland Norway University of Applied Sciences (INN), Elverum, Norway
| | - Nina Emaus
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bente Morseth
- School of sport sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Hammond KM, Sale C, Fraser W, Tang J, Shepherd SO, Strauss JA, Close GL, Cocks M, Louis J, Pugh J, Stewart C, Sharples AP, Morton JP. Post-exercise carbohydrate and energy availability induce independent effects on skeletal muscle cell signalling and bone turnover: implications for training adaptation. J Physiol 2019; 597:4779-4796. [PMID: 31364768 DOI: 10.1113/jp278209] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 07/30/2019] [Indexed: 12/20/2022] Open
Abstract
KEY POINTS Reduced carbohydrate (CHO) availability before and after exercise may augment endurance training-induced adaptations of human skeletal muscle, as mediated via modulation of cell signalling pathways. However, it is not known whether such responses are mediated by CHO restriction, energy restriction or a combination of both. In recovery from a twice per day training protocol where muscle glycogen concentration is maintained within 200-350 mmol kg-1 dry weight (dw), we demonstrate that acute post-exercise CHO and energy restriction (i.e. < 24 h) does not potentiate potent cell signalling pathways that regulate hallmark adaptations associated with endurance training. In contrast, consuming CHO before, during and after an acute training session attenuated markers of bone resorption, effects that are independent of energy availability. Whilst the enhanced muscle adaptations associated with CHO restriction may be regulated by absolute muscle glycogen concentration, the acute within-day fluctuations in CHO availability inherent to twice per day training may have chronic implications for bone turnover. ABSTRACT We examined the effects of post-exercise carbohydrate (CHO) and energy availability (EA) on potent skeletal muscle cell signalling pathways (regulating mitochondrial biogenesis and lipid metabolism) and indicators of bone metabolism. In a repeated measures design, nine males completed a morning (AM) and afternoon (PM) high-intensity interval (HIT) (8 × 5 min at 85% V ̇ O 2 peak ) running protocol (interspersed by 3.5 h) under dietary conditions of (1) high CHO availability (HCHO: CHO ∼12 g kg-1 , EA∼ 60 kcal kg-1 fat free mass (FFM)), (2) reduced CHO but high fat availability (LCHF: CHO ∼3 (-1 , EA∼ 60 kcal kg-1 FFM) or (3), reduced CHO and reduced energy availability (LCAL: CHO ∼3 g kg-1 , EA∼ 20 kcal kg-1 FFM). Muscle glycogen was reduced to ∼200 mmol kg-1 dw in all trials immediately post PM HIT (P < 0.01) and remained lower at 17 h (171, 194 and 316 mmol kg-1 dw) post PM HIT in LCHF and LCAL (P < 0.001) compared to HCHO. Exercise induced comparable p38MAPK phosphorylation (P < 0.05) immediately post PM HIT and similar mRNA expression (all P < 0.05) of PGC-1α, p53 and CPT1 mRNA in HCHO, LCHF and LCAL. Post-exercise circulating βCTX was lower in HCHO (P < 0.05) compared to LCHF and LCAL whereas exercise-induced increases in IL-6 were larger in LCAL (P < 0.05) compared to LCHF and HCHO. In conditions where glycogen concentration is maintained within 200-350 mmol kg-1 dw, we conclude post-exercise CHO and energy restriction (i.e. < 24 h) does not potentiate cell signalling pathways that regulate hallmark adaptations associated with endurance training. In contrast, consuming CHO before, during and after HIT running attenuates bone resorption, effects that are independent of energy availability and circulating IL-6.
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Affiliation(s)
- Kelly M Hammond
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom St Campus, Liverpool, L3 3AF, UK
| | - Craig Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, UK
| | - William Fraser
- Norwich Medical School, University of East Anglia, Norfolk and Norwich University Hospital, Norfolk, NR4 7UY, UK
| | - Jonathan Tang
- Norwich Medical School, University of East Anglia, Norfolk and Norwich University Hospital, Norfolk, NR4 7UY, UK
| | - Sam O Shepherd
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom St Campus, Liverpool, L3 3AF, UK
| | - Juliette A Strauss
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom St Campus, Liverpool, L3 3AF, UK
| | - Graeme L Close
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom St Campus, Liverpool, L3 3AF, UK
| | - Matt Cocks
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom St Campus, Liverpool, L3 3AF, UK
| | - Julien Louis
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom St Campus, Liverpool, L3 3AF, UK
| | - Jamie Pugh
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom St Campus, Liverpool, L3 3AF, UK
| | - Claire Stewart
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom St Campus, Liverpool, L3 3AF, UK
| | - Adam P Sharples
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom St Campus, Liverpool, L3 3AF, UK
| | - James P Morton
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom St Campus, Liverpool, L3 3AF, UK
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Vlachopoulos D, Barker AR, Ubago-Guisado E, Williams CA, Gracia-Marco L. A 9-Month Jumping Intervention to Improve Bone Geometry in Adolescent Male Athletes. Med Sci Sports Exerc 2019; 50:2544-2554. [PMID: 30067592 DOI: 10.1249/mss.0000000000001719] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Sports have different effects on bone development and effective interventions to improve bone health of adolescent athletes are needed. The purpose of the study was to investigate the effect of a 9-month jumping intervention on bone geometry and metabolism in adolescent male athletes. METHODS Ninety-three adolescent (14.1 yr old) male swimmers (SWI), footballers (FOO), and cyclists (CYC) were randomized to intervention and sport (INT-SWI = 19, INT-FOO = 15, and INT-CYC = 14) or sport only (CON-SWI = 18, CON-FOO = 15, and CON-CYC = 12) groups. Cross-sectional area, cross-sectional moment of inertia (CSMI), and section modulus (Z) at the femoral neck were assessed using hip structural analysis and trabecular texture of the lumbar spine using trabecular bone score. Bone mineral content (BMC) at femoral neck and lumbar spine was assessed using dual-energy x-ray absorptiometry. Serum N-terminal propeptide of procollagen type I, isomer of the carboxy-terminal telopeptide of type 1 collagen, total serum calcium, and 25-hydroxyvitamin D were analyzed. RESULTS INT-CYC acquired significantly higher lumbar spine BMC (4.6%) and femoral neck BMC (9.8%) than CON-CYC. INT-CYC acquired significantly higher cross-sectional area (11.0%), CSMI (10.1%), and trabecular bone score (4.4%) than CON-CYC. INT-SWI acquired significantly higher femoral neck BMC (6.0%) and CSMI (10.9%) than CON-SWI. There were no significant differences between INT-FOO and CON-FOO in any bone outcomes. N-terminal propeptide of procollagen type I significantly decreased in CON-SWI, INT-FOO, CON-FOO, and CON-CYC. Carboxy-terminal telopeptide of type 1 collagen significantly decreased in CON-SWI and CON-CYC. The 25-hydroxyvitamin D significantly increased in INT-CYC, CON-CYC, INT-FOO, and CON-FOO. CONCLUSIONS A 9-month jumping intervention improved bone outcomes in adolescent swimmers and cyclists, but not in footballers. This intervention might be used by sports clubs to improve bone health of adolescent athletes.
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Affiliation(s)
- Dimitris Vlachopoulos
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UNITED KINGDOM
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UNITED KINGDOM
| | - Esther Ubago-Guisado
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UNITED KINGDOM.,IGOID Research Group, University of Castilla-La Mancha, Toledo, SPAIN
| | - Craig A Williams
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UNITED KINGDOM
| | - Luis Gracia-Marco
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UNITED KINGDOM.,Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, Zaragoza, SPAIN.,PROFITH Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, SPAIN
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Poffé C, Ramaekers M, Van Thienen R, Hespel P. Ketone ester supplementation blunts overreaching symptoms during endurance training overload. J Physiol 2019; 597:3009-3027. [PMID: 31039280 PMCID: PMC6851819 DOI: 10.1113/jp277831] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 04/25/2019] [Indexed: 12/19/2022] Open
Abstract
KEY POINTS Overload training is required for sustained performance gain in athletes (functional overreaching). However, excess overload may result in a catabolic state which causes performance decrements for weeks (non-functional overreaching) up to months (overtraining). Blood ketone bodies can attenuate training- or fasting-induced catabolic events. Therefore, we investigated whether increasing blood ketone levels by oral ketone ester (KE) intake can protect against endurance training-induced overreaching. We show for the first time that KE intake following exercise markedly blunts the development of physiological symptoms indicating overreaching, and at the same time significantly enhances endurance exercise performance. We provide preliminary data to indicate that growth differentiation factor 15 (GDF15) may be a relevant hormonal marker to diagnose the development of overtraining. Collectively, our data indicate that ketone ester intake is a potent nutritional strategy to prevent the development of non-functional overreaching and to stimulate endurance exercise performance. ABSTRACT It is well known that elevated blood ketones attenuate net muscle protein breakdown, as well as negate catabolic events, during energy deficit. Therefore, we hypothesized that oral ketones can blunt endurance training-induced overreaching. Fit male subjects participated in two daily training sessions (3 weeks, 6 days/week) while receiving either a ketone ester (KE, n = 9) or a control drink (CON, n = 9) following each session. Sustainable training load in week 3 as well as power output in the final 30 min of a 2-h standardized endurance session were 15% higher in KE than in CON (both P < 0.05). KE inhibited the training-induced increase in nocturnal adrenaline (P < 0.01) and noradrenaline (P < 0.01) excretion, as well as blunted the decrease in resting (CON: -6 ± 2 bpm; KE: +2 ± 3 bpm, P < 0.05), submaximal (CON: -15 ± 3 bpm; KE: -7 ± 2 bpm, P < 0.05) and maximal (CON: -17 ± 2 bpm; KE: -10 ± 2 bpm, P < 0.01) heart rate. Energy balance during the training period spontaneously turned negative in CON (-2135 kJ/day), but not in KE (+198 kJ/day). The training consistently increased growth differentiation factor 15 (GDF15), but ∼2-fold more in CON than in KE (P < 0.05). In addition, delta GDF15 correlated with the training-induced drop in maximal heart rate (r = 0.60, P < 0.001) and decrease in osteocalcin (r = 0.61, P < 0.01). Other measurements such as blood ACTH, cortisol, IL-6, leptin, ghrelin and lymphocyte count, and muscle glycogen content did not differentiate KE from CON. In conclusion, KE during strenuous endurance training attenuates the development of overreaching. We also identify GDF15 as a possible marker of overtraining.
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Affiliation(s)
- Chiel Poffé
- Exercise Physiology Research GroupDepartment of Movement SciencesKU LeuvenLeuvenBelgium
| | - Monique Ramaekers
- Exercise Physiology Research GroupDepartment of Movement SciencesKU LeuvenLeuvenBelgium
| | - Ruud Van Thienen
- Exercise Physiology Research GroupDepartment of Movement SciencesKU LeuvenLeuvenBelgium
| | - Peter Hespel
- Exercise Physiology Research GroupDepartment of Movement SciencesKU LeuvenLeuvenBelgium
- Bakala Academy‐Athletic Performance CenterKU LeuvenLeuvenBelgium
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Rapún-López M, Olmedillas H, Gonzalez-Agüero A, Gomez-Cabello A, Pradas de la Fuente F, Moreno LA, Casajús JA, Vicente-Rodríguez G. May Young Elite Cyclists Have Less Efficient Bone Metabolism? Nutrients 2019; 11:nu11051178. [PMID: 31130694 PMCID: PMC6567682 DOI: 10.3390/nu11051178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 05/16/2019] [Accepted: 05/21/2019] [Indexed: 11/16/2022] Open
Abstract
The purpose of this work was to describe changes in metabolic activity in the bones of young male competitive cyclists (CYC) as compared with age-matched controls (CON) over a one-year period of study. Eight adolescent male cyclists aged between fourteen and twenty, and eight age-matched controls participated in this longitudinal study. Serum osteocalcin (OC), amino-terminal propeptide of type I procollagen (PINP), beta-isomerized C-telopeptides (β-CTx) and plasma 25 hydroxyvitamin D [25(OH)D], were investigated by an electrogenerated chemiluminescence immunoassay. Analysis of variance revealed no significant differences in formation and resorption markers between cyclists and controls. Within the groups, both CYC and CON showed decreased OC at -30% and -24%, respectively, and PINP where the figures were -28% and -30% respectively (all p < 0.05). However, only the CYC group showed a decrease in [25(OH)D], lower by 11% (p < 0.05). The similarity in the concentrations of markers in cyclists and controls seems to indicate that cycling does not modify the process of bone remodeling. The decrease in vitamin D in cyclists might be detrimental to their future bone health.
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Affiliation(s)
- Marta Rapún-López
- Departamento de Expresión Musical, Plástica y Corporal, Facultad de Ciencias de la Salud y del Deporte, Universidad de Zaragoza, Huesca, C/Ronda Misericordia, 5, 22001 Huesca, Spain.
| | - Hugo Olmedillas
- Department of Functional Biology, Universidad de Oviedo, Campus del Cristo B. Julián Clavería s/n, 33006 Asturias, Spain.
| | - Alejandro Gonzalez-Agüero
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain.
- Department of Physiatry and Nursing, Faculty of Health and Sport Sciences (FCSD), University of Zaragoza, Ronda Misericordia 5, 22001 Huesca, Spain.
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), 28029 Madrid, Spain.
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain.
| | - Alba Gomez-Cabello
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain.
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), 28029 Madrid, Spain.
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain.
- Centro Universitario de la Defensa, 50090 Zaragoza, Spain.
| | - Francisco Pradas de la Fuente
- Departamento de Expresión Musical, Plástica y Corporal, Facultad de Ciencias de la Salud y del Deporte, Universidad de Zaragoza, Huesca, C/Ronda Misericordia, 5, 22001 Huesca, Spain.
| | - Luis A Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain.
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), 28029 Madrid, Spain.
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain.
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral, s/n, 50009 Zaragoza, Spain.
| | - José A Casajús
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain.
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), 28029 Madrid, Spain.
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain.
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Calle Domingo Miral, s/n, 50009 Zaragoza, Spain.
| | - Germán Vicente-Rodríguez
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain.
- Department of Physiatry and Nursing, Faculty of Health and Sport Sciences (FCSD), University of Zaragoza, Ronda Misericordia 5, 22001 Huesca, Spain.
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), 28029 Madrid, Spain.
- Instituto Agroalimentario de Aragón (IA2), 50013 Zaragoza, Spain.
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Gomez-Bruton A, Gonzalez-Aguero A, Matute-Llorente A, Lozano-Berges G, Gomez-Cabello A, Moreno LA, Casajus JA, Vicente-Rodríguez G. The muscle-bone unit in adolescent swimmers. Osteoporos Int 2019; 30:1079-1088. [PMID: 30729250 DOI: 10.1007/s00198-019-04857-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 01/14/2019] [Indexed: 12/13/2022]
Abstract
UNLABELLED Most researchers adjust bone by lean mass when comparing swimmers with controls. This adjustment is done under the assumption that lean affects bone similarly in both groups. Nonetheless, we found that the muscle-bone association is uncoupled in swimmers, and consequently, researchers should avoid this adjustment when evaluating swimmers' bone. INTRODUCTION To examine the functional and structural muscle-bone unit in adolescent swimmers. METHODS Sixty-five swimmers (34 girls/31 boys) and 119 controls (51 girls/68 boys) participated in the study. Muscle cross-sectional area (MCSA), bone mineral content (BMC), and polar strength-strain index (SSIPOL) were measured in the non-dominant radius by peripheral quantitative computed tomography (pQCT). Subtotal BMC and lean mass were evaluated with dual-energy X-ray absorptiometry (DXA). Handgrip and isometric knee extension (IKE) tests were performed to determine muscle force. The effect of MCSA, lean and force on SSIPOL, and BMC were tested, and the functional and structural muscle-bone ratios of swimmers and controls were compared. RESULTS Both muscle size (MCSA and lean) and muscle force (handgrip and IKE) influenced BMC and SSIPOL in swimmers and controls similarly. Swimmers presented normal MCSA and lean values for their height, but when compared with controls, swimmers presented a higher amount of lean and MCSA for the same BMC or SSIPOL (structural muscle-bone unit). For the functional muscle-bone unit, different results were found for the lower and upper limbs, as no differences were found for the upper limbs, while for the lower limbs, swimmers presented higher muscle force for the same amount of BMC. CONCLUSIONS The contradictory results regarding BMC in swimmers found in previous studies could partly be explained with the findings of the present study that reinforce the idea that swimming is not an effective sport to practice regarding bone mass and that the muscle-bone unit is different in swimmers than in controls.
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Affiliation(s)
- A Gomez-Bruton
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
- EXERNET red de investigación en ejercicio físico y salud para poblaciones especiales, Madrid, Spain
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain
| | - A Gonzalez-Aguero
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
- EXERNET red de investigación en ejercicio físico y salud para poblaciones especiales, Madrid, Spain
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
| | - A Matute-Llorente
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
- EXERNET red de investigación en ejercicio físico y salud para poblaciones especiales, Madrid, Spain
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain
| | - G Lozano-Berges
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
- EXERNET red de investigación en ejercicio físico y salud para poblaciones especiales, Madrid, Spain
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
| | - A Gomez-Cabello
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
- EXERNET red de investigación en ejercicio físico y salud para poblaciones especiales, Madrid, Spain
- Centro Universitario de la Defensa, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
| | - L A Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
- Faculty of Health Science (FCS), Universidad de Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
| | - J A Casajus
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain
- EXERNET red de investigación en ejercicio físico y salud para poblaciones especiales, Madrid, Spain
- Faculty of Health Science (FCS), Universidad de Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
| | - G Vicente-Rodríguez
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Zaragoza, Spain.
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Madrid, Spain.
- EXERNET red de investigación en ejercicio físico y salud para poblaciones especiales, Madrid, Spain.
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain.
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.
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Lozano-Berges G, Matute-Llorente Á, Gómez-Bruton A, Alfaro-Santafé V, González-Agüero A, Vicente-Rodríguez G, Casajús JA. Plantar pressures in male adolescent soccer players and its associations with bone geometry and strength. J Sports Med Phys Fitness 2019; 59:1716-1723. [PMID: 30758166 DOI: 10.23736/s0022-4707.19.09267-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Mechanical loads exerted by soccer-specific actions increase bone remodeling activity. Nevertheless, little is known about the relationship between plantar pressure and bone structure. Therefore, the aim of this study was to compare bone geometry and strength between soccer players who exhibited different maximum values of the average pressures (MP) when performing a combination of soccer-specific tasks. METHODS Forty male adolescent soccer players (mean age 13.2±0.5 years) and 13 controls (mean age 13.1±0.9 years) participated in this study. Biofoot® system was used to measure MP at the non-dominant foot during a circuit of soccer-specific tasks. Cluster analysis was performed to classify players into groups of similar MP profiles resulting two different groups as follows: 15 players with high MP (SOC-HP; mean MP: 392.7±68.2 kPa) and 25 with low MP (SOC-LP; mean MP: 261.0±49.6 kPa). Total and cortical volumetric bone mineral content (Tt.BMC/Ct.BMC), cross-sectional area (Tt.Ar/Ct.Ar), cortical thickness (Ct.Th), fracture load in X-axis, and polar strength index (SSIp) were measured at 38% of the non-dominant tibia by peripheral quantitative computed tomography. Bone geometry and strength comparisons between SOC-HP and SOC-LP were performed using analyses of covariance controlling by weight and tibia length. RESULTS Greater Tt.BMC, Ct.BMC and Tt.Ar. were found in SOC-HP compared to CG (Tt.BMC: 3.22vs2.95 g, Ct.BMC: 2.95vs2.68 g, Ct.Ar: 280vs253 mm2; P<0.05). Nevertheless, no significant bone geometry and strength differences were found between soccer groups and between SOC-LP and CG (P>0.05). CONCLUSIONS Developing high MP when training and playing soccer might be favorable to bone development.
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Affiliation(s)
- Gabriel Lozano-Berges
- Growth, Exercise, Nutrition and Development Research Group (GENUD), University of Zaragoza, Zaragoza, Spain.,Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Huesca, Spain.,Agri-food Institute of Aragón IA2, University of Zaragoza, Zaragoza, Spain
| | - Ángel Matute-Llorente
- Growth, Exercise, Nutrition and Development Research Group (GENUD), University of Zaragoza, Zaragoza, Spain.,Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Huesca, Spain.,Agri-food Institute of Aragón IA2, University of Zaragoza, Zaragoza, Spain.,Physiopathology of Obesity and Nutrition Networking Biomedical Research Center (CIBERObn), Madrid, Spain
| | - Alejandro Gómez-Bruton
- Growth, Exercise, Nutrition and Development Research Group (GENUD), University of Zaragoza, Zaragoza, Spain.,Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Huesca, Spain.,Agri-food Institute of Aragón IA2, University of Zaragoza, Zaragoza, Spain.,Physiopathology of Obesity and Nutrition Networking Biomedical Research Center (CIBERObn), Madrid, Spain
| | | | - Alex González-Agüero
- Growth, Exercise, Nutrition and Development Research Group (GENUD), University of Zaragoza, Zaragoza, Spain.,Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Huesca, Spain.,Agri-food Institute of Aragón IA2, University of Zaragoza, Zaragoza, Spain.,Physiopathology of Obesity and Nutrition Networking Biomedical Research Center (CIBERObn), Madrid, Spain
| | - Germán Vicente-Rodríguez
- Growth, Exercise, Nutrition and Development Research Group (GENUD), University of Zaragoza, Zaragoza, Spain.,Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Huesca, Spain.,Agri-food Institute of Aragón IA2, University of Zaragoza, Zaragoza, Spain.,Physiopathology of Obesity and Nutrition Networking Biomedical Research Center (CIBERObn), Madrid, Spain
| | - José A Casajús
- Growth, Exercise, Nutrition and Development Research Group (GENUD), University of Zaragoza, Zaragoza, Spain - .,Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Huesca, Spain.,Agri-food Institute of Aragón IA2, University of Zaragoza, Zaragoza, Spain.,Physiopathology of Obesity and Nutrition Networking Biomedical Research Center (CIBERObn), Madrid, Spain
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39
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Relative Energy Deficiency in Sport in Male Athletes: A Commentary on Its Presentation Among Selected Groups of Male Athletes. Int J Sport Nutr Exerc Metab 2018; 28:364-374. [PMID: 30040508 DOI: 10.1123/ijsnem.2018-0182] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Low energy availability (LEA) is a key element of the Female Athlete Triad. Causes of LEA include failure to match high exercise energy expenditure (unintentional) or pathological behaviors of disordered eating (compulsive) and overzealous weight control programs (misguided but intentional). Recognition of such scenarios in male athletes contributed to the pronouncement of the more inclusive Relative Energy Deficiency in Sport (RED-S) syndrome. This commentary describes the insights and experience of the current group of authors around the apparently heightened risk of LEA in some populations of male athletes: road cyclists, rowers (lightweight and open weight), athletes in combat sports, distance runners, and jockeys. The frequency, duration, and magnitude of the LEA state appear to vary between populations. Common risk factors include cyclical management of challenging body mass and composition targets (including "making weight") and the high energy cost of some training programs or events that is not easily matched by energy intake. However, additional factors such as food insecurity and lack of finances may also contribute to impaired nutrition in some populations. Collectively, these insights substantiate the concept of RED-S in male athletes and suggest that a specific understanding of a sport, subpopulation, or culture may identify a complex series of factors that can contribute to LEA and the type and severity of its outcomes. This commentary provides a perspective on the range of risk factors that should be addressed in future surveys of RED-S in athletic populations and targeted for specific investigation and modification.
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Male Flat Jockeys Do Not Display Deteriorations in Bone Density or Resting Metabolic Rate in Accordance With Race Riding Experience: Implications for RED-S. Int J Sport Nutr Exerc Metab 2018; 28:434-439. [DOI: 10.1123/ijsnem.2017-0371] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Despite consistent reports of poor bone health in male jockeys, it is not yet known if this is a consequence of low energy availability or lack of an osteogenic stimulus. Given the rationale that low energy availability is a contributing factor in low bone health, we tested the hypothesis that both hip and lumbar bone mineral density (BMD) should progressively worsen in accordance with the years of riding. In a cross-sectional design, male apprentice (n = 17) and senior (n = 14) jockeys (matched for body mass and fat-free mass) were assessed for hip and lumbar spine BMD, as well as both measured and predicted resting metabolic rate (RMR). Despite differences (p < .05) in years of race riding (3.4 ± 2 vs. 16.3 ± 6.8), no differences were apparent (p > .05) in hip (−0.9 ± 1.1 vs. −0.8 ± 0.7) and lumbar Z-scores (−1.3 ± 1.4 vs. −1.5 ± 1) or measured RMR (1,459 ± 160 vs. 1,500 ± 165 kcal/day) between apprentices and senior jockeys, respectively. Additionally, years of race riding did not demonstrate any significant correlations (p > .05) with either hip or lumbar spine BMD. Measured RMR was also not different (p > .05) from predicted RMR in either apprentice (1,520 ± 44 kcal/day) or senior jockeys (1,505 ± 70 kcal/day). When considered with previously published data examining underreporting of energy intake and direct assessments of energy expenditure, we suggest that low BMD in jockeys is not due to low energy availability per se but rather the lack of an osteogenic stimulus associated with riding.
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Jürimäe J, Gruodyte-Raciene R, Baxter-Jones ADG. Effects of Gymnastics Activities on Bone Accrual during Growth: A Systematic Review. J Sports Sci Med 2018; 17:245-258. [PMID: 29769826 PMCID: PMC5950742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 03/28/2018] [Indexed: 06/08/2023]
Abstract
The amount of bone gained during childhood and adolescence impacts greatly on lifetime skeletal health. The purpose of this review is to summarize current evidence of the effects of gymnastics activities on bone mineral accrual during growth and to describe possible factors that influence bone mineral gains. The PubMed and SportDiscus databases were searched, and a total of 24 articles met the selection criteria and were included in this review. Artistic and rhythmic gymnasts presented higher bone mineral density and content values compared to untrained controls, despite possible negative effects associated with hormonal levels, dietary restrictions and body fat. The results suggest that gymnasts had similar bone turnover values compared to untrained controls. High-intensity mechanical loading of gymnastics activity appears to increase bone development and counterbalance negative effects, such as later pubertal development, lower body fat mass and lower hormone levels. In conclusion, gymnasts present higher bone mineral values in comparison with untrained controls. The osteogenic effect of gymnastics athletic activity has a positive influence on bone mineral accrual and overcomes the possible negative influence of high athletic activity that may cause negative energy balance and low body fat mass which are associated with lower bone accrual.
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Affiliation(s)
- Jaak Jürimäe
- Institute of Sport Sciences and Physiotherapy, University of Tartu, Tartu, Estonia
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42
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Belavy DL, Quittner MJ, Ridgers ND, Shiekh A, Rantalainen T, Trudel G. Specific Modulation of Vertebral Marrow Adipose Tissue by Physical Activity. J Bone Miner Res 2018; 33:651-657. [PMID: 29336053 DOI: 10.1002/jbmr.3357] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 11/23/2017] [Accepted: 12/02/2017] [Indexed: 11/09/2022]
Abstract
Marrow adipose tissue (MAT) accumulation with normal aging impacts the bone, hemopoiesis, and metabolic pathways. We investigated whether exercise was associated with lower MAT, as measured by vertebral marrow fat fraction (VFF) on magnetic resonance imaging. A total of 101 healthy individuals (54 females) aged 25 to 35 years without spine or bone disease but with distinct exercise histories were studied. Long-distance runners (67 km/wk, n = 25) exhibited lower mean lumbar VFF (27.9% [8.6%] versus 33.5% [6.0%]; p = 0.0048) than non-sporting referents (n = 24). In habitual joggers (28 km/wk, n = 30), mean lumbar VFF was 31.3% (9.0%) (p = 0.22 versus referents) and 6.0 percentage points lower than referents at vertebrae T10 , T11 , and T12 (p ≤ 0.023). High-volume road cycling (275 km/wk, n = 22) did not impact VFF. 3D accelerations corresponding to faster walking, slow jogging, and high-impact activities correlated with lower VFF, whereas low-impact activities and sedentary time correlated with higher mean lumbar VFF (all p ≤ 0.05). Given an estimated adipose bone marrow conversion of 7% per decade of life, long distance runners, with 5.6 percentage points lower VFF, showed an estimated 8-year younger vertebral marrow adipose tissue phenotype. Regression analysis showed a 0.7 percentage point reduction in mean lumbar VFF with every 9.4 km/wk run (p = 0.002). This study presents the first evidence in humans or animals that specific volumes and types of exercise may influence the age-determined adipose marrow conversion and result in low MAT. These results identify a potentially modifiable risk factor for prevalent chronic conditions related to bone metabolism, hemopoietic production, and other metabolic functions with potential global health applications. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Daniel L Belavy
- Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Geelong, Australia
| | - Matthew J Quittner
- Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Geelong, Australia
| | - Nicola D Ridgers
- Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Geelong, Australia
| | - Adnan Shiekh
- Department of Radiology, The Ottawa Hospital, University of Ottawa, Ottawa, Canada
| | - Timo Rantalainen
- Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Geelong, Australia
| | - Guy Trudel
- Department of Medicine, Division of Physical Medicine and Rehabilitation, Bone and Joint Research Laboratory, University of Ottawa, Ottawa, Canada
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Olmedillas H, Gonzalez-Agüero A, Rapún-López M, Gracia-Marco L, Gomez-Cabello A, Pradas de la Fuente F, Moreno LA, Casajús JA, Vicente-Rodríguez G. Bone metabolism markers and vitamin D in adolescent cyclists. Arch Osteoporos 2018; 13:11. [PMID: 29397487 DOI: 10.1007/s11657-018-0415-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 11/17/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED This study aimed to describe bone metabolic activity in adolescent competitive cyclists compared to age-matched controls. The main result is that younger subjects present a higher bone turnover than the older ones. Moreover, cyclists under the age of 17 have higher scores on all markers than age-matched controls. PURPOSE The purpose of this study was to describe bone metabolic activity in adolescent competitive cyclists compared to age-matched controls. METHODS Twenty-two male adolescent cyclists between 14 and 20 years (y) and 20 age-matched controls participated in this study. Serum osteocalcin (OC), aminoterminal propeptide of type I procollagen (PINP), and β-isomerized C-telopeptides (β-CTX) were analyzed by electrochemiluminescence immunoassay (ECLIA); plasma 25 hydroxyvitamin D [25(OH)D] was analyzed by enzyme-linked immunosorbent assay (ELISA). RESULTS Analysis of variance revealed no significant differences in bone metabolism markers and vitamin D between cyclists and controls. Cyclists over 17 y had a significantly lower concentration in bone formation and resorption biochemical markers compared to cyclists under 17 y (all P < 0.05). Moreover, controls over 17 y presented lower concentration for PINP (P < 0.05) compared to their peers under 17 y. Comparisons between cyclists and controls under 17 y revealed higher concentrations of OC and PINP (P < 0.05) in cyclists. Group interaction by age was found for OC, PINP, and β-CTX (P < 0.01). Cyclists over 17 y had higher concentrations of [25(OH)D] (P < 0.05) than age-matched controls. CONCLUSIONS The present results support the idea that cycling during adolescence may be associated to a decrease in bone turnover that may affect bone health later in life.
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Affiliation(s)
- Hugo Olmedillas
- Department of Functional Biology, Universidad de Oviedo, Campus del Cristo B. Julián Clavería s/n, Asturias, Spain
| | - Alejandro Gonzalez-Agüero
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain.,Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Santiago de Compostela, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Marta Rapún-López
- Departamento de Expresión Musical, Plástica y Corporal, Facultad de Ciencias de la Salud y del Deporte, Universidad de Zaragoza, C/Ronda Misericordia, 5, 22001, Huesca, Spain
| | - Luis Gracia-Marco
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain.,PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Alba Gomez-Cabello
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Santiago de Compostela, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.,Centro Universitario de la Defensa, Zaragoza, Spain
| | - Francisco Pradas de la Fuente
- Departamento de Expresión Musical, Plástica y Corporal, Facultad de Ciencias de la Salud y del Deporte, Universidad de Zaragoza, C/Ronda Misericordia, 5, 22001, Huesca, Spain
| | - Luís A Moreno
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Santiago de Compostela, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.,Facultad de Ciencias de la Salud, 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 Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain.,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Santiago de Compostela, Spain.,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain.,Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Germán Vicente-Rodríguez
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, Zaragoza, Spain. .,Faculty of Health and Sport Sciences (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001, Huesca, Spain. .,Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Santiago de Compostela, Spain. .,Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain. .,Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain.
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Ikpeze TC, Glaun G, McCalla D, Elfar JC. Geriatric Cyclists: Assessing Risks, Safety, and Benefits. Geriatr Orthop Surg Rehabil 2018; 9:2151458517748742. [PMID: 29383267 PMCID: PMC5784561 DOI: 10.1177/2151458517748742] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 10/31/2017] [Accepted: 11/19/2017] [Indexed: 12/15/2022] Open
Abstract
Nearly 1 in every 3 Americans ride bicycles each year, but only 20% of the reported 100 million cyclists ride on a weekly basis. Bicycling is a common form of transportation and recreation and has gained popularity among the elderly patients. In recent years, the number of elderly cyclists has increased steadily and studies have cited ease of use, need for exercise, and enjoyment as important contributing factors. The benefits of physical activity on health is well-documented, and elderly individuals are encouraged to remain active to reduce the progression of age-related weakness and loss of muscle mass. Safety concerns, however, have been a prevalent public health issue. According to the Center for Disease Control and Prevention, elderly and teenage cyclists account for the highest number of head injuries and fatalities among all cyclists. Safety measures that include wearing protective gear such as helmets and choosing the appropriate bicycle have been recommended to minimize the risk of sustaining injuries while riding. Despite these concerns, bicycling has remained a popular and exciting activity for the elderly patients.
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Affiliation(s)
- Tochukwu C Ikpeze
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | | | - Daren McCalla
- Department of Orthopaedics and Rehabilitation, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - John C Elfar
- Department of Orthopaedics and Rehabilitation, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
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Mathis SL, Caputo JL. Resistance Training Is Associated With Higher Lumbar Spine and Hip Bone Mineral Density in Competitive Male Cyclists. J Strength Cond Res 2018; 32:274-279. [DOI: 10.1519/jsc.0000000000002209] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Vlachopoulos D, Barker AR, Ubago-Guisado E, Williams CA, Gracia-Marco L. The effect of a high-impact jumping intervention on bone mass, bone stiffness and fitness parameters in adolescent athletes. Arch Osteoporos 2018; 13:128. [PMID: 30446875 PMCID: PMC6244891 DOI: 10.1007/s11657-018-0543-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 11/07/2018] [Indexed: 02/03/2023]
Abstract
UNLABELLED This study demonstrates that a 9-month jumping intervention can improve bone mass gains and physical fitness performance in adolescent males participating in non-osteogenic sports, such as swimming and cycling. PURPOSE To examine the effect of a jumping intervention on bone mass, bone stiffness and fitness parameters in adolescents involved in different sports. METHODS Ninety-three adolescent male swimmers (SWI), footballers (FOO) and cyclists (CYC) were randomised to intervention (INT) and sport (INT-SWI = 19, INT-FOO = 15, INT-CYC = 14) or sport only (CON-SWI = 18, CON-FOO = 15, CON-CYC = 12) groups. The 9-month jumping intervention consisted of 3 levels (12 weeks each) of 20 repetitions per set of counter movement jumps (CMJ) using adjustable weight vests (level 1 = 20 CMJ jumps/set, 0 kg, 3 sets/day, 3 times/week; level 2 = 20 CMJ jumps/set, 2 kg, 4 sets/day, 3 times/week; level 3 = 20 CMJ jumps/set, 5 kg, 4 sets/day, 4 times/week). Total body bone mineral content (BMC) at total body less head (TBLH) was measured using dual-energy X-ray absorptiometry and bone stiffness using quantitative ultrasound. Fitness was assessed using the 20-m shuttle run (20mSRT), CMJ and standing long jump (SLJ) tests. RESULTS INT-SWI had significantly higher increase in BMC legs and bone stiffness compared to CON-SWI (4.2-12.7%). INT-CYC had significantly higher increase in BMC at TBLH and legs and bone stiffness compared to CON-CYC (5.0-12.3%). There were no significant differences between INT-FOO and CON-FOO in any bone outcomes (0.9-3.9%). The increase in CMJ performance was significantly higher in INT-SWI (3.1 cm) and INT-CYC (3.2 cm) compared to CON-SWI and CON-CYC groups, respectively. CONCLUSIONS A 9-month jumping intervention can improve bone mass, bone stiffness and muscular fitness in adolescent males participating in non-osteogenic sports, such as swimming and cycling. CLINICAL TRIAL REGISTRATION ISRCTN17982776.
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Affiliation(s)
- Dimitris Vlachopoulos
- 0000 0004 1936 8024grid.8391.3Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Exeter, EX1 2LU UK
| | - Alan R. Barker
- 0000 0004 1936 8024grid.8391.3Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Exeter, EX1 2LU UK
| | - Esther Ubago-Guisado
- 0000 0004 1936 8024grid.8391.3Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Exeter, EX1 2LU UK ,0000 0001 2194 2329grid.8048.4IGOID Research Group, University of Castilla-La Mancha, Toledo, Spain
| | - Craig A. Williams
- 0000 0004 1936 8024grid.8391.3Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Exeter, EX1 2LU UK
| | - Luis Gracia-Marco
- 0000 0004 1936 8024grid.8391.3Children’s Health and Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke’s Campus, Exeter, EX1 2LU UK ,0000 0001 2152 8769grid.11205.37Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, Zaragoza, Spain ,0000000121678994grid.4489.1PROFITH “PROmoting FITness and Health through physical activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
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Vlachopoulos D, Barker AR, Ubago-Guisado E, Fatouros IG, Knapp KM, Williams CA, Gracia-Marco L. Longitudinal Adaptations of Bone Mass, Geometry, and Metabolism in Adolescent Male Athletes: The PRO-BONE Study. J Bone Miner Res 2017; 32:2269-2277. [PMID: 28685886 DOI: 10.1002/jbmr.3206] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 06/24/2017] [Accepted: 06/26/2017] [Indexed: 11/09/2022]
Abstract
Adolescence is a crucial period for bone development, and exercise can enhance bone acquisition during this period of life. However, it is not known how the different loading sports practiced can affect bone acquisition in adolescent male athletes. Therefore, the purpose of the present study was to determine the 1-year longitudinal bone acquisition among adolescent males involved in osteogenic (football) and non-osteogenic (swimming and cycling) sports and to compare with active controls. A total of 116 adolescent males aged 12 to 14 years at baseline were followed for 1 year: 37 swimmers, 37 footballers, 28 cyclists, and 14 active controls. Bone mineral content (BMC) was assessed using dual-energy X-ray absorptiometry (DXA); cross-sectional area (CSA), cross-sectional moment of inertia (CSMI), and section modulus (Z) at the femoral neck was assessed using hip structural analysis (HSA); and bone texture of the lumbar spine was assessed using trabecular bone score (TBS). Serum N-terminal propeptide of procollagen type I (PINP), isomer of the Carboxi-terminal telopeptide of type 1 collagen (CTX-I), total serum calcium, and 25 hydroxyvitamin D [25(OH)D] were analyzed. Footballers had significantly higher adjusted BMC at the lumbar spine (7.0%) and femoral neck (5.0%) compared with cyclists, and significantly greater BMC at the lumbar spine (6.9%) compared with swimmers. Footballers presented significantly greater TBS (4.3%) compared with swimmers, and greater CSMI (10.2%), CSA (7.1%), Z (8.9%) and TBS (4.2%) compared with cyclists. No differences were noted between cyclists and swimmers, both groups had similar bone acquisition compared with controls. PINP was significantly higher in footballers and controls compared with cyclists and swimmers (3.3% to 6.0%), and 25(OH)D was significantly higher in footballers and cyclists compared with swimmers and controls (9.9% to 13.1%). These findings suggest that bone acquisition is higher in adolescent male footballers compared with swimmers and cyclists at the femoral neck and lumbar spine sites of the skeleton. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Dimitris Vlachopoulos
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UK
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UK
| | - Esther Ubago-Guisado
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UK.,IGOID Research Group, University of Castilla-La Mancha, Toledo, Spain
| | - Ioannis G Fatouros
- Department of Kinesiology, Institute for Research and Technology, Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | | | - Craig A Williams
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UK
| | - Luis Gracia-Marco
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter, UK.,Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, Zaragoza, Spain
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Vlachopoulos D, Barker AR, Ubago-Guisado E, Ortega FB, Krustrup P, Metcalf B, Castro Pinero J, Ruiz JR, Knapp KM, Williams CA, Moreno LA, Gracia-Marco L. The effect of 12-month participation in osteogenic and non-osteogenic sports on bone development in adolescent male athletes. The PRO-BONE study. J Sci Med Sport 2017; 21:404-409. [PMID: 28886923 DOI: 10.1016/j.jsams.2017.08.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 07/24/2017] [Accepted: 08/22/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Research investigating the longitudinal effects of the most popular sports on bone development in adolescent males is scarce. The aim is to investigate the effect of 12-month participation in osteogenic and non-osteogenic sports on bone development. DESIGN A 12-month study was conducted in adolescent males involved in football, swimming and cycling and compared with an active control group. METHODS 116 adolescent males (13.1±0.1years at baseline): 37 footballers, 37 swimmers, 28 cyclists and 14 active controls were followed for 12 months. Bone mineral content (BMC) was measured by dual-energy X-ray absorptiometry, and bone stiffness was measured by quantitative ultrasound. Bone outcomes at 12 months were adjusted for baseline bone status, age, height, lean mass and moderate to vigorous physical activity. RESULTS Footballers had higher improvement in adjusted BMC at the total body, total hip, shaft, Ward's triangle, legs and bone stiffness compared to cyclists (6.3-8.0%). Footballers had significantly higher adjusted BMC at total body, shaft and legs compared to swimmers (5.4-5.6%). There was no significant difference between swimmers and cyclists for any bone outcomes. Swimming and cycling participation resulted in non-significant lower bone development at most sites of the skeleton compared to controls (-4.3 to -0.6%). CONCLUSIONS Football participation induces significantly greater improvements in BMC and bone stiffness over 12 months compared to cycling and swimming. CLINICAL TRIAL REGISTRATION ISRCTN17982776.
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Affiliation(s)
- Dimitris Vlachopoulos
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, United Kingdom
| | - Alan R Barker
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, United Kingdom
| | - Esther Ubago-Guisado
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, United Kingdom; IGOID Research Group, University of Castilla-La Mancha, Spain
| | - Francisco B Ortega
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Spain
| | - Peter Krustrup
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, United Kingdom; Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | - Brad Metcalf
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, United Kingdom
| | - Jose Castro Pinero
- GALENO Research Group, Department of Physical Education, School of Education, University of Cadiz, Spain
| | - Jonatan R Ruiz
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Spain
| | | | - Craig A Williams
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, United Kingdom
| | - Luis A Moreno
- Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, Spain
| | - Luis Gracia-Marco
- Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, United Kingdom; PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Spain; Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, Spain.
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49
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Papageorgiou M, Dolan E, Elliott-Sale KJ, Sale C. Reduced energy availability: implications for bone health in physically active populations. Eur J Nutr 2017; 57:847-859. [PMID: 28721562 PMCID: PMC5861178 DOI: 10.1007/s00394-017-1498-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 07/03/2017] [Indexed: 01/17/2023]
Abstract
Purpose The present review critically evaluates existing literature on the effects of short- and long-term low energy availability (EA) on bone metabolism and health in physically active individuals. Methods We reviewed the literature on the short-term effects of low EA on markers of bone metabolism and the long-term effects of low EA on outcomes relating to bone health (bone mass, microarchitecture and strength, bone metabolic markers and stress fracture injury risk) in physically active individuals. Results Available evidence indicates that short-term low EA may increase markers of bone resorption and decrease markers of bone formation in physically active women. Bone metabolic marker responses to low EA are less well known in physically active men. Cross-sectional studies investigating the effects of long-term low EA suggest that physically active individuals who have low EA present with lower bone mass, altered bone metabolism (favouring bone resorption), reduced bone strength and increased risk for stress fracture injuries. Conclusions Reduced EA has a negative influence on bone in both the short- and long-term, and every effort should be made to reduce its occurrence in physically active individuals. Future interventions are needed to explore the effects of long-term reduced EA on bone health outcomes, while short-term low EA studies are also required to give insight into the pathophysiology of bone alterations.
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Affiliation(s)
- Maria Papageorgiou
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS UK
| | - Eimear Dolan
- Applied Physiology and Nutrition Research Group, University of Sao Paulo, São Paulo, Brazil
| | - Kirsty J. Elliott-Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS UK
| | - Craig Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS UK
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Gomez-Bruton A, Montero-Marín J, González-Agüero A, Gómez-Cabello A, García-Campayo J, Moreno LA, Casajús JA, Vicente-Rodríguez G. Swimming and peak bone mineral density: A systematic review and meta-analysis. J Sports Sci 2017; 36:365-377. [PMID: 28394711 DOI: 10.1080/02640414.2017.1307440] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This meta-analysis aims to determine the effects of regular swimming on bone mineral density (BMD) in young adults (18-30 years). A systematic search was performed in Pubmed, SPORTDiscus and the Cochrane Library from the earliest possible year to March 2016. Swimmers were compared to non-athletic controls (CG) and to high-impact athletes (HIGH). Effect sizes with the Hedges g in random effects models were developed. Fourteen studies met the inclusion criteria and were included in the meta-analyses. Swimmers presented similar BMD values to CG in whole-body (g = -0.20; P = 0.251), femoral neck (g = -0.05; P = 0.818) and lumbar spine (g = 0.18; P = 0.492); and lower BMD in the whole-body (g = -1.21; P < 0.001), femoral neck (g = -1.51; P < 0.001) and lumbar spine (g = -0.84; P = 0.017) than the HIGH. For the whole-body differences, the higher the latitude the smaller the differences between swimmers and HIGH (B = 0.10; P = 0.001). For the femoral neck differences, age also seemed to reduce the differences between groups (B = 0.19; P = 0.020). Young adult swimmers present similar BMD values than CG and lower values than HIGH.
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Affiliation(s)
- Alejandro Gomez-Bruton
- a Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing , Universidad de Zaragoza , Huesca , Spain.,b GENUD (Growth, Exercise, Nutrition and Development) Research Group , Zaragoza , Spain.,c Centro de Investigación Biomédica en Red de Fisología de la Obesidad y Nutrición , Madrid , Spain
| | - Jesús Montero-Marín
- a Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing , Universidad de Zaragoza , Huesca , Spain.,d redIAPP Reseach Network , Zaragoza , Spain
| | - Alejandro González-Agüero
- a Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing , Universidad de Zaragoza , Huesca , Spain.,b GENUD (Growth, Exercise, Nutrition and Development) Research Group , Zaragoza , Spain.,c Centro de Investigación Biomédica en Red de Fisología de la Obesidad y Nutrición , Madrid , Spain
| | - Alba Gómez-Cabello
- b GENUD (Growth, Exercise, Nutrition and Development) Research Group , Zaragoza , Spain.,c Centro de Investigación Biomédica en Red de Fisología de la Obesidad y Nutrición , Madrid , Spain.,e Centro Universitario de la Defensa , Zaragoza , Spain
| | - Javier García-Campayo
- d redIAPP Reseach Network , Zaragoza , Spain.,f Miguel Servet University Hospital , Zaragoza , Spain
| | - Luis A Moreno
- b GENUD (Growth, Exercise, Nutrition and Development) Research Group , Zaragoza , Spain.,c Centro de Investigación Biomédica en Red de Fisología de la Obesidad y Nutrición , Madrid , Spain.,g Faculty of Health Science (FCS) , Universidad de Zaragoza , Zaragoza , Spain
| | - Jose A Casajús
- a Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing , Universidad de Zaragoza , Huesca , Spain.,b GENUD (Growth, Exercise, Nutrition and Development) Research Group , Zaragoza , Spain.,c Centro de Investigación Biomédica en Red de Fisología de la Obesidad y Nutrición , Madrid , Spain
| | - Germán Vicente-Rodríguez
- a Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing , Universidad de Zaragoza , Huesca , Spain.,b GENUD (Growth, Exercise, Nutrition and Development) Research Group , Zaragoza , Spain.,c Centro de Investigación Biomédica en Red de Fisología de la Obesidad y Nutrición , Madrid , Spain
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