Bone formation is suppressed with multi-stressor military training

Hughes, Julie M.; Smith, M. A.; Henning, Paul C.; Scofield, Dennis E.; Spiering, Barry A.; Staab, Jeffery S.; Hydren, Jay R.; Nindl, Bradley C.; Matheny, Ronald W.

doi:10.1007/s00421-014-2950-6

Cited by 38 publications

(40 citation statements)

References 36 publications

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“…In another controlled laboratory study of ten male soldiers exposed to 72 h of sleep restriction (2 h of sleep opportunity per night for three nights), bone formation marker levels declined after 24 h and bone resorption markers increased after 48-72 h [7]. Similar changes in bone turnover markers (BTMs) were observed in men before and after an 8-week US Army Ranger Training Program that included sleep restriction [8]. Over time, these BTM changes (lower levels of bone formation markers and unchanged or higher levels of bone resorption) could lead to bone loss, osteoporosis, and fracture.…”

Section: Introductionmentioning

confidence: 72%

Sleep duration and bone health measures in older men

et al. 2020

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The associations between objective measures of sleep duration and bone outcomes in older men are unknown. No consistent, significant association was identified between sleep duration and bone mineral density (BMD) in the current analysis. However, future research should determine if vitamin D status modifies this relationship. Introduction Prior studies, predominantly in women, reported that long and short self-reported sleep duration are associated with lower BMD. Associations between actigraphy-determined sleep duration and BMD or bone turnover markers (BTMs) in older men are unknown. Methods Men in The Osteoporotic Fractures in Men (MrOS) Study with wrist actigraphy and concurrent BMD assessment but without comorbidities affecting bone health were included. Sleep duration was considered as a continuous (N = 1926) and dichotomized variable where men were classified as getting the recommended (7-8 h/night; N = 478) or short (< 6 h/night; N = 577) sleep. The cross-sectional association between BMD, BTMs, and sleep duration was examined using a t test or linear regression, where appropriate, in unadjusted and adjusted models. Results There were no clinically or statistically significant differences in BMD at the L-spine, total hip, or femoral neck between men getting the recommended vs. short sleep duration, using actigraphy or self-reported sleep duration (all p ≥ 0.07). When sleep duration was considered as a continuous variable, femoral neck BMD was higher in men with longer self-reported sleep duration (β = 0.006 ±0.003, p = 0.02), but this was not significant after further adjustment. In men with low 25OHD (< 20 ng/mL), longer actigraphy-determined sleep duration was associated with higher total hip BMD (β = 0.016 ± 0.008; p = 0.04). Sleep duration and BTMs were not associated.

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Section: Introductionmentioning

confidence: 72%

Sleep duration and bone health measures in older men

et al. 2020

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“…Male US Army Rangers had decreased markers of bone formation (bone-specific alkaline phosphatase) and increased markers of bone resorption (tartrate-resistant acid phosphatase) after 8 weeks of training with energy deficits of ∼1,000 kcal•d −1 (114). Bone-specific alkaline phosphatase is indicative of bone mineralisation and tartrate-resistant acid phosphatase reflects osteoclast number (115), whereas C-telopeptide cross-links of type 1 collagen, a marker of type I collagen breakdown, was unchanged.…”

Section: Bonementioning

confidence: 99%

Energy Deficiency in Soldiers: The Risk of the Athlete Triad and Relative Energy Deficiency in Sport Syndromes in the Military

2020

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Military personnel experience energy deficit (total energy expenditure higher than energy intake), particularly during combat training and field exercises where exercising energy expenditures are high and energy intake is reduced. Low energy availability (energy intake minus exercising energy expenditure expressed relative to fat free mass) impairs endocrine function and bone health, as recognized in female athletes as the Female Athlete Triad syndrome. More recently, the Relative Energy Deficiency in Sport (RED-S) syndrome encompasses broader health outcomes, physical and cognitive performance, non-athletes, and men. This review summarizes the evidence for the effect of low energy availability and energy deficiency in military training and operations on health and performance outcomes. Energy availability is difficult to measure in free-living individuals but doubly labeled water studies demonstrate high total energy expenditures during military training; studies that have concurrently measured energy intake, or measured body composition changes with DXA, suggest severe and/or prolonged energy deficits. Military training in energy deficit disturbs endocrine and metabolic function, menstrual function, bone health, immune function, gastrointestinal health, iron status, mood, and physical and cognitive performance. There are more data for men than women, and little evidence on the chronic effects of repeated exposures to energy deficit. Military training impairs indices of health and performance, indicative of the Triad and REDS , but the multi-stressor environment makes it difficult to isolate the independent effects of energy deficiency. Studies supplementing with energy to attenuate the energy deficit suggest an independent effect of energy deficiency in the disturbances to metabolic, endocrine and immune function, and physical performance, but randomized controlled trials are lacking.

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“…For instance, sleep loss is common in perimenopausal and postmenopausal women and may accelerate the rapid estrogen‐deficient bone loss that occurs during this time. Military training and space flight also represent overlapping periods of sleep disturbance and alterations in bone turnover with accelerated bone loss. There may be additional skeletal implications for these groups.…”

Section: Direct and Indirect Mechanisms By Which Osa May Affect Bonementioning

confidence: 99%

Obstructive Sleep Apnea and Metabolic Bone Disease: Insights Into the Relationship Between Bone and Sleep

Swanson

Shea

Stone

et al. 2015

Journal of Bone and Mineral Research

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Obstructive sleep apnea (OSA) and low bone mass are two prevalent conditions, particularly among older adults, a section of the U.S. population that is expected to grow dramatically over the coming years. OSA, the most common form of sleep disordered breathing, has been linked to multiple cardiovascular, metabolic, hormonal and inflammatory derangements and may have adverse effects on bone. However, little is known about how OSA (including the associated hypoxia and sleep loss) affects bone metabolism. In order to gain insight into the relationship between sleep and bone, we review the growing information on OSA and metabolic bone disease and discuss the pathophysiological mechanisms by which OSA may affect bone metabolism/architecture.

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Bone formation is suppressed with multi-stressor military training

Abstract: These data indicate that multi-stressor military training results in increased bone resorption and suppressed bone formation, with recovery of bone metabolism 2-6 weeks after completion of training.

Cited by 38 publications

References 36 publications

Sleep duration and bone health measures in older men

Sleep duration and bone health measures in older men

Energy Deficiency in Soldiers: The Risk of the Athlete Triad and Relative Energy Deficiency in Sport Syndromes in the Military

Obstructive Sleep Apnea and Metabolic Bone Disease: Insights Into the Relationship Between Bone and Sleep

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