A review of the effect of swim training and nutrition on bone mineral density in female athletes

A Novel Computational Biomechanics Framework to Model Vascular Mechanopropagation in Deep Bone Marrow

The mechanical stimuli generated by body exercise can be transmitted from cortical bone into the deep bone marrow (mechanopropagation). Excitingly, a mechanosensitive perivascular stem cell niche is recently identified within the bone marrow for osteogenesis and lymphopoiesis. Although it is long known that they are maintained by exercise-induced mechanical stimulation, the mechanopropagation from compact bone to deep bone marrow vasculature remains elusive of this fundamental mechanobiology field. No experimental system is available yet to directly understand such exercise-induced mechanopropagation at the bone-vessel interface. To this end, taking advantage of the revolutionary in vivo 3D deep bone imaging, an integrated computational biomechanics framework to quantitatively evaluate the mechanopropagation capabilities for bone marrow arterioles, arteries, and sinusoids is devised. As a highlight, the 3D geometries of blood vessels are smoothly reconstructed in the presence of vessel wall thickness and intravascular pulse pressure. By implementing the 5-parameter Mooney-Rivlin model that simulates the hyperelastic vessel properties, finite element analysis to thoroughly investigate the mechanical effects of exercise-induced intravascular vibratory stretching on bone marrow vasculature is performed. In addition, the blood pressure and cortical bone bending effects on vascular mechanoproperties are examined. For the first time, movement-induced mechanopropagation from the hard cortical bone to the soft vasculature in the bone marrow is numerically simulated. It is concluded that arterioles and arteries are much more efficient in propagating mechanical force than sinusoids due to their stiffness. In the future, this in-silico approach can be combined with other clinical imaging modalities for subject/patient-specific vascular reconstruction and biomechanical analysis, providing large-scale phenotypic data for personalized mechanobiology discovery.

The Effect of Professional Sports Participation on Bone Content and Density in Elite Female Athletes

Background: The role of exercise in osteoporosis prevention has been proven. Nevertheless, there is no consensus about the types of sports, especially at professional levels. Non-impact sports such as swimming may have a negative effect or no effect. Objectives: Thus, the present study aimed to compare the effect of different sports on bone mineral content (BMC) and bone mineral density (BMD) of elite female athletes. Methods: This was a cross-sectional study consisting of 48 athletes in five groups of long-distance running, volleyball, basketball, swimming (n = 12 for each), and ten control subjects. For measuring the lumbar spine (L2 - L4) and proximal femur (femoral neck, trochanter, and Ward’s triangle), the dual-energy X-ray absorptiometry (DEXA) method was applied. Results: Indicated that the running, basketball, and volleyball groups had a significantly higher lumbar spine and proximal femur BMD than the swimming and control groups (P < 0.05). Running resulted in significantly higher lumbar spine BMC compared to volleyball, basketball, swimming, and control groups, respectively (P < 0.01), while basketball had higher proximal femur BMC than running and controls (P < 0.01). The Z-score of the lumbar spine in the running was significantly higher than in basketball, swimming, and controls (P < 0.05), while basketball had a significantly higher femur neck Z-score than volleyball, running, and controls (P < 0.001). Finally, the swimmers had significantly higher Z-scores in the lumbar and the proximal femur than non-athletes (P < 0.001). Conclusions: Although all sports are effective for improving the bone health, the swimmers had much better bone status than non-athletes, while the sports of long-distance running and basketball were more efficient than others; therefore, a combination of endurance and jumping exercises seems to be the best way to prevent osteoporosis.

Contemporary Variables that Impact Sleep and Development in Female Adolescent Swimmers and Gymnasts

The effects of sleep on elite athletes in late adolescence and early adulthood have been well documented in a myriad of sports. However, there is underrepresentation of pre-pubertal and young female adolescent athlete research between the ages of 11-17, and specifically female gymnast and swimmers. Neglecting to understand how high energy demand at a young age relates to sleep and restoration may lead to developmental ramifications for this group, as they display physiological dysfunctions like delayed puberty, amenorrhea and are at risk for the female athlete triad or components of the triad. This review aims to summarize the contemporary variables of blue light emitting screens, social media, and caffeine on quality and quantity of sleep in young athletes while identifying gaps in the literature on how these factors impact the target group of young female swimmers and gymnasts.  The implications of this work include sleep hygiene recommendations for increasing duration and quality of sleep, as well as future research with respect to electronic device usage, social media participation, caffeine consumption, and sport engagement in female early adolescent athletes.

Screening for Bone Mineral Density and Assessment Knowledge Level of Low Peak Bone Risk Factors and Preventive Practices Among Kuwaiti Future Mothers

Background

Attaining greater peak bone mass (PBM) prior to the onset of bone loss is getting increasing public health attention as healthy strong bones are essential to maintain our life. Females are more susceptible to bone loss. Knowledge and awareness about low peak bone mass and its related risk factors are important contributors to its preventive behavior.

Objective

To screen apparently healthy young Kuwaiti future mothers for low bone mineral density (BMD) and to assess their knowledge level about determinants of PBM and preventive practices.

Methods

A cross-sectional comparative study on 445 eligible women aged 18–35 years (either students or employees from Kuwait University) was performed. Data on socio-demographic and lifestyle variables were obtained by a semi-structured questionnaire. Their knowledge was assessed using the modified Osteoporosis Knowledge Assessment Tool (OKAT). Bone mineral Density (BMD) was measured using Quantitative Ultrasonography (QUS).

Results

More than half (59.3%) of females had poor knowledge. A statistically significant relation was noted between the overall knowledge score and age, college, occupation, and socioeconomic class (P<0.05 for each). Only 13.9% have low Z-score by QUS. By logistic regression, less carbonated beverages and coffee consumption positively affect BMD, while inadequate exercises level, indoor exposure to sunlight, and less frequency of brisk walking negatively affect BMD.

Conclusion

Unacceptable knowledge score significantly associated with BMD Z-score status. More attention should be devoted to education programs targeting adolescents and young females to promote knowledge about PBM and practice towards accrual and maintenance of bone health.

Dominant vs. non-dominant hip comparison in bone mineral density in young sporting athletes

To explore differences in bone mineral density (BMD) between dominant and non-dominant hip within levels of sport impact. BMD was higher in the non-dominant hip in high-impact sports, whereas the dominant hip had increased BMD for low-impact sports. The side-to-side differences were relatively small and not clinically relevant.

PURPOSE

It is unknown whether there is difference in BMD at the hip between dominant and non-dominant sides in young athletes. The aims of this study were to explore the dominant-non-dominant differences in hip BMD in young athletes participating in low- and high-impact sports and to assess the effect of ground force impact on BMD.

METHODS

Data was collected on University of Oxford athletes and controls (CG) between 2016 and 2018. Athletes were classified into two groups: high-impact sports (HIG) and low-impact sports (LIG). Total and regional measurements of both hips' BMD were recorded using a dual-energy X-ray absorptiometry (DXA). Linear regression method was used to assess differences in BMD between and within groups.

RESULTS

One hundred ninety-four athletes (HIG: n = 89, LIG: n = 105) and 48 controls were included in this study. Total hip and femoral neck BMD was higher in athletes compared to the CG (p < 0.01), with HIG recording highest levels of BMD. The BMD difference between the dominant and non-dominant sides was significant in the LIG, with BMD being higher in the dominant side. Conversly, BMD was higher in the non-dominant hip within the HIG. However, the hip asymmetries were not clinically relevant (%BMD difference < 3%). A significant interaction between side and sport group on BMD was observed.

CONCLUSIONS

High-impact sports had significantly higher BMD compared with low-impact sports and CG. BMD in the dominant hip was significantly higher for the LIG and lower in the HIG; however, differences were not clinically relevant.

Nutritional Aspects of the Female Athlete

Athletes have specific needs based on sex, size, sport, exercise intensity, duration of activity, phase of training, and the season in which the sport is played. Nutritionally, the female athlete is unique, with needs that may vary based on hormonal fluctuations related to the menstrual cycle. This article provides an overview of the distinct nutritional needs and concerns of the physically active female, including energy availability, macronutrient needs, micronutrient needs, hydration, supplements, and other nutritional issues. Although there is some research focusing specifically on the female athlete and her exceptional nutritional concerns, further gender-specific exploration is needed in all areas.