The Influence of Intensive Physical Exercise on Bone Acquisition in Adolescent Elite Female and Male Artistic Gymnasts

Markou, Kostas B.; Mylonas, Panagiotis; Theodoropoulou, Anastasia; Kontogiannis, Apostolos; Léglise, Michel; Vagenakis, Apostolos G.; Georgopoulos, Neoklis A.

doi:10.1210/jc.2003-031865

Cited by 44 publications

(39 citation statements)

References 33 publications

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“…Associations of BMI and lean mass with bone density are consistent with findings in other studies with athletes 46 and other populations. 30 Although subjects in our study were within a normal range for BMI, athletes with amenorrhea had lower BMI z scores than athletes with eumenorrhea and lower IGF-I levels than control subjects.…”

Section: Discussionsupporting

confidence: 90%

Bone Metabolism in Adolescent Athletes With Amenorrhea, Athletes With Eumenorrhea, and Control Subjects

et al. 2008

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OBJECTIVE-We hypothesized that, despite increased activity, bone density would be low in athletes with amenorrhea, compared with athletes with eumenorrhea and control subjects, because of associated hypogonadism and would be associated with a decrease in bone formation and increases in bone-resorption markers.METHODS-In a cross-sectional study, we examined bone-density measures (spine, hip, and whole body) and body composition by using dual-energy radiograph absorptiometry and assessed fasting levels of insulin-like growth factor I and bone-turnover markers (N-terminal propeptied of type 1 procollagen and N-telopeptide) in 21 athletes with amenorrhea, 18 athletes with eumenorrhea, and 18 control subjects. Subjects were 12 to 18 years of age and of comparable chronologic and bone age.RESULTS-Athletes with amenorrhea had lower bone-density z scores at the spine and whole body, compared with athletes with eumenorrhea and control subjects, and lower hip z scores, compared with athletes with eumenorrhea. Lean mass did not differ between groups. However, athletes with amenorrhea had lower BMI z scores than did athletes with eumenorrhea and lower insulin-like growth factor I levels than did control subjects. Levels of both markers of bone turnover were lower in athletes with amenorrhea than in control subjects. BMI z scores, lean mass, insulin-like growth factor I levels, and diagnostic category were important independent predictors of bone mineral density z scores.CONCLUSIONS-Although they showed no significant differences in lean mass, compared with athletes with eumenorrhea and control subjects, athletes with amenorrhea had lower bone density at the spine and whole body. Insulin-like growth factor I levels, body-composition parameters, and menstrual status were important predictors of bone density. Follow-up studies are necessary to Copyright © 2008 by the American Academy of Pediatrics. All rights reserved.Address correspondence to Madhusmita Misra, MD, MPH, Massachusetts General Hospital, Neuroendocrine Unit, BUL 457, 55 Fruit St, Boston, MA 02114. mmisra@partners.org. The authors have indicated they have no financial relationships relevant to this article to disclose.Drs Christo and Prabhakaran contributed equally to this work. NIH Public Access Author ManuscriptPediatrics. Author manuscript; available in PMC 2011 November 4. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript determine whether amenorrhea in athletes adversely affects the rate of bone mass accrual and therefore peak bone mass. Keywordsadolescents; athletes; bone density; bone-turnover markers; insulin-like growth factor I Amenorrhea has been reported to occur in 23.5% of high school athletes, 1 although the prevalence may vary depending on the type, intensity, and duration of exercise, as well as the athlete's nutritional status. [1][2][3][4] In particular, activities such as gymnastics, running track, ballet, diving, swimming, and cheerleading are common among high school girls, require a thin physique, and are as...

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Section: Discussionsupporting

confidence: 90%

Bone Metabolism in Adolescent Athletes With Amenorrhea, Athletes With Eumenorrhea, and Control Subjects

et al. 2008

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“…There were similar findings for female artistic gymnasts, with a delay of 2 years. Bone-mineral density was positively correlated with height, weight, BMI, lean and fat mass, and the age of onset of training and was negatively correlated with exercise intensity and duration (Markou et al, 2004).…”

Section: Bone Health and Menstrual Statusmentioning

confidence: 95%

Nutrition for Synchronized Swimming: A Review

Lundy

2011

International Journal of Sport Nutrition and Exercise Metabolism

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Synchronized swimming enjoys worldwide popularity and has been part of the formal Olympic program since 1984. Despite this, relatively little research has been conducted on participant nutrition practices and requirements, and there are significant gaps in the knowledge base despite the numerous areas in which nutrition could affect performance and safety. This review aimed to summarize current findings and identify areas requiring further research. Uniform physique in team or duet events may be more important than absolute values for muscularity or body fat, but a lean and athletic appearance remains key. Synchronized swimmers appear to have an increased risk of developing eating disorders, and there is evidence of delayed menarche, menstrual dysfunction, and lower bone density relative to population norms. Dietary practices remain relatively unknown, but micronutrient status for iron and magnesium may be compromised. More research is required across all aspects of nutrition status, anthropometry, and physiology, and both sports nutrition and sports medicine support may be required to reduce risks for participants.

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“…76 Bone acquisition was proportional to the development of puberty according to Tanner stages of breast development and there was a strong negative influence of early onset of training on bone acquisition, indicating vulnerability of bone metabolism before the onset of sex steroids production. 76 Therefore, the early exposure of AG to excess mechanical load exerts its beneficial effect on bone acquisition, after sex steroid production initiation leading to a positive net-effect. The same appears to be true of Rhythmic Gymnasts.…”

Section: Effects On Bonesmentioning

confidence: 99%

Menstrual function in sports

Roupas¹,

Georgopoulos²

2011

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ObjecTIVe: To highlight the recent developments in the field of menstrual function in sports and to provide an overview of our current understanding in regard to the pathophysiology, evaluation and management strategies of exercise-related reproductive dysfunction. DeSIgn: A PUbMeD search was carried out and all articles published from 1980 to 2010 with title words related to exercise, athletes, menstrual function and primary and secondary amenorrhea were reviewed. The review structure includes a pathophysiology overview, menstrual dysfunction among different athletic disciplines, clinical manifestations, evaluation and management strategies, with particular emphasis on recent data regarding the use of oral contraceptives and hormone replacement therapy. ReSUlTS AnD cOnclUSIOn: exercise-related reproductive dysfunction appears to be multifactorial in origin and remains a diagnosis of exclusion. Recent findings underscore the endocrine role of adipose tissue in the regulation of metabolism and reproduction, providing further data on our understanding of the pathophysiology of exerciserelated reproductive dysfunction. clinical manifestations range from primary amenorrhea or delayed menarche to luteal phase deficiency, oligomenorrhea, anovulation and secondary amenorrhea. Amenorrhea constitutes the most serious clinical consequence and is associated with bone pathology. early diagnosis, thorough evaluation and individualized management (ranging from diet and exercise, or behavior adjustments to pharmacologic treatment) should be achieved in order to preserve bone mass.

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The Influence of Intensive Physical Exercise on Bone Acquisition in Adolescent Elite Female and Male Artistic Gymnasts

Cited by 44 publications

References 33 publications

Bone Metabolism in Adolescent Athletes With Amenorrhea, Athletes With Eumenorrhea, and Control Subjects

Bone Metabolism in Adolescent Athletes With Amenorrhea, Athletes With Eumenorrhea, and Control Subjects

Nutrition for Synchronized Swimming: A Review

Menstrual function in sports

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