Validity of a Dietary Calcium Questionnaire Modified to Include Supplement Use in Athletes

When conducting research in the area of bone health, accurate measurement of calcium intake is crucial. The rapid assessment method (RAM) is one technique that has frequently been used for its measurement of calcium intake. However, the RAM and other currently established questionnaires lack the assessment of dietary supplement use, which is common for athletes. Our objective was to evaluate the validity of a RAM questionnaire designed to assess daily calcium consumption which was further modified to meet the needs of athletes who frequently consume dietary supplements. Usefulness of the modified RAM for athletes and non-athletes was evaluated as well as utility among those who do and do not use supplements. The 47 volunteers (n = 31 women, 16 men) were between the ages of 18 and 25 including, 33 athletes and 14 controls. The population also contained 23 supplement users and 24 non-supplement users. Participants completed the modified RAM and were instructed to complete a three-day diet record (3DR), logging food intake for 2 weekdays and 1 weekend day. The data collected via the modified RAM was compared with the 3DR. Mean calcium intake was 935mg ± 420mg and 1085mg ± 573mg, for the modified RAM and 3DR respectively. A strong positive correlation (r) was found between calcium intake measured with the modified RAM and 3DRs (r(45) = 0.854, p \u3c 0.01). Intraclass correlation coefficients (ICC) revealed that agreement between the two instruments was good (ICC = 0.76, df = 45, p \u3c 0.01) and much improved when compared to agreements without consideration of supplements (ICC = 0.05, df = 21, p \u3e 0.05). We have found the modified RAM to be a valid tool which can be used to estimate calcium intake in the athletes and controls we strive to study. The accuracy of this instrument improved by including assessment of dietary supplement sources of calcium

Bone Mineral Density in Weight-Bearing and Aquatic Athletes

Bone mineral density (BMD) is a measure of mineral deposit within the bone that can be used as an early-adulthood predictor for onset of osteoporosis. Type of exercise induces a stress-response which builds BMD. PURPOSE: Non-weight-bearing-athletes were compared to weight-bearing-athletes and controls to identify differences in bone health among groups. The participants were compared longitudinally to measure change in BMD overtime. This study was modeled after work by Taaffe et al. (1995) which concluded that female athletes who do not engage in weight-bearing-activities had lower BMD. METHODS: Height, weight, and calcium intake was collected for female students (20.0±1.3 years); 23 runners (R), 9 swimmers (S), 15 water polo players (WP), and 24 controls (C). BMD (g/cm2) and lean body mass (kg) were measured on a dual-energy x-ray absorptiometer (DXA). The measures were taken at the anterior-posterior (AP) spine, lateral spine, femoral neck (FN), trochanter, total hip, and whole body (WB) at baseline and again about 5-months later. Eighteen R, 11 WP, 8 S, and 24 C returned for follow-up. RESULTS: SPSS analysis at the spine reported no statistical difference between groups (p\u3e0.05). At the total hip (1.023±0.015 vs. 0.904±0.032 g/cm2, p=0.01) and trochanter (0.795±0.014 vs. 0.692±0.029 g/cm2, p=0.01), R\u3eS. In the whole-body scan, R\u3eC (1.102±0.012 vs. 1.048±0.016 g/cm2, p=0.031) and R\u3eS (1.102±0.012 vs. 1.004±0.025 g/cm2, p=0.005). C, WP, and R had higher BMD at the FN than S (0.767±0.031(S) vs. 0.888±0.021(C), 0.906±0.029(WP), 0.899±0.015(R) g/cm2, p=0.019, p=0.002, p=0.004). Repeated-measures tests reported that S increased in BMD over time at the AP spine (1.8%), lateral spine (3.7%), FN (4.2%), and trochanter (2.1%) (p\u3c0.05) and that C significantly increased at WB (1.1%) (p\u3c0.05). CONCLUSION: Bone health has improved in non-weight-bearing-athletes since original analyses by Taaffe. However, S still show BMD 14.7% lower than R, 15.3% lower than WP, and 13.6% lower than C at the FN. Longitudinally, S increased from baseline measures, yet the final BMD does not exceed the value of any other group. While there is progress in BMD being made between different types of athletes with modern training methods, weight-bearing-athletes still have greater bone health at the FN

Whole Body Vibration Training is Osteogenic at the Spine in College-Age Men and Women

Osteoporosis is a chronic skeletal disease characterized by low bone mass which is currently challenging the American health care system. Maximizing peak bone mass early in life is a cost-effective method for preventing osteoporosis. Whole body vibration (WBV) is a novel exercise method with the potential to increase bone mass, therefore optimizing peak bone and decreasing the risk for osteoporotic fracture. The aim of this investigation was to evaluate changes in bone mineral density at the hip, spine, and whole body in college-age men and women who underwent a WBV training protocol. Active men (n=6) and women (n=4), ages 18-22 participated in the WBV training; while an additional 14 volunteers (1 male, 13 female) served as controls. All participants completed baseline and follow-up questionnaires to assess health history, physical activity, dietary intake, and menstrual history. The WBV training program, using a Vibraflex 550, incorporated squats, stiff-leg dead lifts, stationary lunges, push-up holds, bent-over rows, and jumps performed on the platform, and occurred 3 times a week, for 12 weeks. Dual energy x-ray absorptiometry (Hologic Explorer, Waltham, MA, USA) was used to assess bone mineral density (BMD, g/cm2). A two-tailed, t-test identified significantly different changes in BMD between the WBV and control groups at the lateral spine (average change of 0.022 vs. -0.015 g/cm2). The WBV group experienced a 2.7% and 1.0% increase in BMD in the lateral spine and posterior-anterior spine while the control group decreased 1.9% and 0.9%, respectively. Results indicate that 12 weeks of WBV training was osteogenic at the spine in college-age men and women

A Two-Year Longitudinal Study of Bone Mineral Density in Collegiate Distance Runners

Research has shown that weight-bearing physical activity such as running results in osteogenesis; distance runners, however, may experience deficiencies at specific sites. The purpose of this investigation was to examine changes in bone mineral density (BMD) of male and female collegiate cross-country runners over two years. Methods: BMD of 29 collegiate distance runners (16 men and 13 women) were measured five times over 24 months using dual-energy x- ray absorptiometry (DXA) at the anterior-posterior (AP) and lateral (LAT) spine, femoral neck (FN), total hip (TH), whole body (WB), and ultra-distal (UD) forearm. A repeated measures multivariate analysis of covariance, with bone free lean mass (BFLM) as covariate, was used to compare mean BMD values. Results: Adjusted for BFLM, there were no significant differences (p\u3e0.05) in BMD at any site between sexes. There were no significant differences at the AP or LAT spine, or FN across visits for either sex. There was a significant increase in BMD (p=0.044) at the UD forearm over two years in males. However, 56% of the men (n=9) had a z-score \u3c-1 at the UD forearm. Seven of 11 women had z-scores \u3c-1.0 at the LAT spine and four of 13 had z-scores \u3c-1.0 at the AP spine. Conclusion: There were no significant changes in BMD at any site over the two-year time frame, except the men had a significant increase in BMD at the non-dominant forearm. The spine appears to be an area of concern for the women in this study when examining z-score results

Heavy episodic drinking is associated with poorer bone health in adolescent and young adult women

Objective: Osteoporosis is a costly bone disease characterized by low bone mineral density (BMD) that primarily affects postmenopausal women. One factor that may lead to osteoporosis is a failure to reach peak bone mass (PBM) in early adulthood. In older adults and animal models, heavy episodic drinking (HED) has been found to predict failure to reach PBM. However, this relationship has yet to be investigated in adolescent human females. Method: Female college students (N = 87; 60% White) reported age at menarche, hormonal contraceptive use, physical activity, smoking habits, and HED history via an online survey and then received a dual energy x-ray absorptiometry bone scan to assess both lean body mass and BMD at the lumbar spine. Results: Frequent HED (having four or more drinks within 2 hours on 115 or more occasions since the start of high school, which is approxi mately equal to 1.6 episodes per month over this period) was associated with decreased vertebral BMD even when variables most commonly associated with bone health (lean body mass, physical activity, age at menarche, smoking, and oral contraception use) were controlled for. However, early HED initiation (beginning HED at age 15 years or younger) was not significantly related to BMD. Conclusions: This is the first study to assess the impacts of early HED initiation and frequent HED during adolescence on the bone health of young women. Results suggest frequency of HED before reaching PBM, but not age at initiation, may be negatively related to skeletal health during young adulthood. These findings encourage research into the association between HED and BMD in late adolescence

Physical Activity in Childhood May Be the Key to Optimizing Lifespan Skeletal Health

Physical activities undertaken in childhood, particularly activities which apply large forces quickly convey optimal benefits to bone mass, size, and structure. Evidence is accumulating that benefits persist well beyond activity cessation. This review examines the potential for early childhood activity to improve bone mineralization and structure and explores childhood activity as prevention for osteoporosis in later life

Velocity at maximal oxygen uptake best predicts 3 km race time in collegiate distance runners

Purpose: There is a lack of scientific investigation into the predictors of 3 km race performance in collegiate distance runners. The purpose of this investigation was to determine what physiological variables best predict 3 km race time in a group of collegiate distance runners. Methods: Twenty-one endurance trained runners (11 men, 10 women) volunteered for this investigation. Running economy (RE) and maximal oxygen uptake (VO2max) testing were conducted within 9 ± 6 days of the race in a single session. All participants ran in a 3 km race at an NCAA sanctioned track meet. Pearson’s product moment correlations were performed between 3 km race time and velocity at VO2max (vVO2max), relative VO2max, RE at 9.7, 11.3, 12.9, and 14.5 km•hr-1 and percent of VO2max. A stepwise multiple regression was performed with 3 km race time as the dependent variable and independent variables of vVO2max, VO2max, RE9.7, RE11.3, RE12.9, RE14.5. Results: The results revealed that vVO2max was the best predictor of 3 km race performance in a heterogeneous group of collegiate distance runners (R2=0.90). For the men, vVO2max remained the best predictor of 3 km race performance (R2=0.49). For the women, the best predictors of 3 km performance were vVO2max and VO2max (R2=0.97). Conclusions: Distance coaches should consider emphasizing vVO2max as a primary factor in training to improve 3 km race performance and conversely, the pace achieved in a 3-km race is a good predictor of vVO2max

Whole Body Vibration Training is Osteogenic at the Spine in College-Age Men and Women

Osteoporosis is a chronic skeletal disease characterized by low bone mass which is currently challenging the American health care system. Maximizing peak bone mass early in life is a cost-effective method for preventing osteoporosis. Whole body vibration (WBV) is a novel exercise method with the potential to increase bone mass, therefore optimizing peak bone and decreasing the risk for osteoporotic fracture. The aim of this investigation was to evaluate changes in bone mineral density at the hip, spine, and whole body in college-age men and women who underwent a WBV training protocol. Active men (n=6) and women (n=4), ages 18–22 participated in the WBV training; while an additional 14 volunteers (1 male, 13 female) served as controls. All participants completed baseline and follow-up questionnaires to assess health history, physical activity, dietary intake, and menstrual history. The WBV training program, using a Vibraflex 550, incorporated squats, stiff-leg dead lifts, stationary lunges, push-up holds, bent-over rows, and jumps performed on the platform, and occurred 3 times a week, for 12 weeks. Dual energy x-ray absorptiometry (Hologic Explorer, Waltham, MA, USA) was used to assess bone mineral density (BMD, g/cm(2)). A two-tailed, t-test identified significantly different changes in BMD between the WBV and control groups at the lateral spine (average change of 0.022 vs. −0.015 g/cm(2)). The WBV group experienced a 2.7% and 1.0% increase in BMD in the lateral spine and posterior-anterior spine while the control group decreased 1.9% and 0.9%, respectively. Results indicate that 12 weeks of WBV training was osteogenic at the spine in college-age men and women

The Relationship Between Muscular Strength, Jump Power, and Bone Health in Collegiate Distance Runners

International Journal of Exercise Science 16(4): 563-575, 2023. Participation in sports, especially those involving impact loading, enhance bone mineral content (BMC) and density (BMD). Additionally, participation in impact loading sports may strengthen relationships between strength or power and bone variables. The purpose of this investigation was to examine relationships between measures of muscular performance and bone variables in Division I endurance athletes (29 males, 31 females, 19.6 ± 1.4 years). Dual-energy x-ray absorptiometry (DXA) scans were analyzed at the anterior-posterior (AP) and lateral (LAT) spine, femoral neck (FN), total hip (TH), whole body (WB), and ultra-distal forearm (UD) for BMC and BMD measures. WB scans provided information for bone-free lean mass (BFLM). Performance measures included absolute, and relative (to body weight), grip strength (GS) and absolute lower body power (LBP) derived from a vertical jump. Pearson correlation coefficients were determined between bone variables and muscular performance measures. Hierarchical multiple regression was used to quantify the variance explained in bone variables. Male runners showed strong relationships between absolute and relative GS and numerous bone variables. Female runner had significant relationships between absolute jump power and numerous bone variables. Sex, GS, and LBP explained 41-76% of BMC at the various bone sites and 12-30% of BMD. Results indicate that in collegiate men, greater strength is related to higher BMC and BMD, however this was not the case for women. In female collegiate distance runners, higher jump power was related to greater BMC and BMD

Combined aerobic and resistance training improves bone health of female cancer survivors

Introduction: Cancer pathogenesis and resulting treatment may lead to bone loss and poor skeletal health in survivorship. The purpose of this investigation was to evaluate the influence of 26 weeks of combined aerobic and resistance-training (CART) exercise on bone mineral density (BMD) in a multi-racial sample of female cancer survivors. Methods: Twenty-six female cancer survivors volunteered to undergo CART for 1 h/day, 3 days/week, for 26 weeks. The Improving Physical Activity After Cancer Treatment (IMPAACT) Program involves supervised group exercise sessions including 20 min of cardiorespiratory training, 25 min of circuit-style resistance-training, and 15 min of abdominal exercises and stretching. BMD at the spine, hip, and whole body was assessed using dual-energy X-ray absorptiometry (DXA) before and after the intervention. Serum markers of bone metabolism (procollagen-type I N-terminal propeptide, P1NP, and C-terminal telopeptides, CTX) were measured at baseline, 13 weeks, and at study completion. Results: Eighteen participants, with the average age of 63.0 ± 10.3 years, completed the program. Mean duration since completion of cancer treatment was 6.2 ± 10.6 years. Paired t-tests revealed significant improvements in BMD of the spine (0.971 ± 0.218 g/cm2 vs. 0.995 ± 0.218 g/cm2, p = 0.012), hip (0.860 ± 0.184 g/cm2 vs. 0.875 ± 0.191 g/cm2, p = 0.048), and whole body (1.002 ± 0.153 g/cm2 vs. 1.022 ± 0.159 g/cm2, p = 0.002). P1NP declined 22% at 13 weeks and 28% at 26 weeks in comparison to baseline (p < 0.01) while CTX showed a non-significant decrease of 8% and 18% respectively. Conclusions: We report significant improvements in BMD at the spine, hip, and whole body for female cancer survivors who completed 26 weeks of CART. This investigation demonstrates the possible effectiveness of CART at improving bone health and reducing risk of osteoporosis for women who have completed cancer treatment. The IMPAACT Program appears to be a safe and feasible way for women to improve health after cancer treatment. Keywords: Bone mineral density, Osteoporosis, Oncology, Cancer-induced bone loss, Bone turnover marker