Sports participation in high school and college leads to high bone density and greater rates of bone loss in young men: results from a population-based study.
Minett MM, Weidauer L, Wey HE, Blinkley TL, Beare TM, and Specker BL. Calcif Tissue Int. 2018. [Epub Ahead of Print].
Take Home Message: Sport participation in high school and college positively contributes to maintaining bone mineral density and bone mineral content. As athletes age however, these losses are less significant.
While public education about osteoporosis often focuses on women, there are significant long-term impacts on men as well. Therefore, we need to learn about how factors, like sport participation, influence bone remodeling to understand the onset and progression of osteoporosis in men. Therefore, Minett and colleagues completed a study to determine whether sports participation in high school and college was associated with bone mass or bone loss. Researchers identified 253 male participants (20 to 66 years of age) using the South Dakota Rural Bone Health Study. During 7.5 years, the researchers collected data every 18 months on anthropometrics, bone, body composition, grip strength, diet, physical activity, height, weight, and arm length. Bone measurements were collected with dual-energy x-ray absorptiometry (DEXA) and peripheral quantitative computed tomography (left wrist only). Overall, participants who reported more than 7 sports seasons had greater bone mineral content and bone mineral density than those who reported 6 or less sports seasons. When looking specifically at bone mineral content or density at the hip and spine the authors found that the differences between sport participants was most pronounced among younger members of the study. However, younger participants with greater than 7 seasons of sports participation showed a more rapid loss of bone mineral content and bone mineral density.
Overall, the results of the study support participation in sports as a strategy for establishing greater bone mineral content and bone mineral density early in life. The data also suggests that as participants age, the differences between those who participated in sports and those who did not, is less significant. This may be explained by the faster rate of bone loss that occurs in the young participants who played in 7 or more seasons. Ultimately while differences in bone mineral content and bone mineral density are less significant as participants age, physical activity plays an important part in maintaining bone strength. This is not surprising, as physical activity is a common strategy for mitigating bone density loss especially in older patients. When the authors adjusted for a person’s current physical activity it didn’t change the results much, but it may be more important to know how much loading was involved in the activities these participants performed. This would help clarify if continuing to weightlift or play their sports recreationally may be beneficial in preventing the more accelerated loss of bone. Future research on this topic, could also benefit from identifying specific sports rather than generic seasons of sport participation. This data would help clinicians better understand how participation in different sports influences bone strength both immediately and over the course of life. Until this research is completed, clinicians could find it helpful to inquire about a patient’s past sport participation. Furthermore, clinicians working with younger athletes should encourage athletes to continue a healthy lifestyle after their competitive athletic career.
Questions for Discussion: Do you inquire about patient’s past sport participation during the injury evaluation process? If not, do you think this study presents enough data to consider making this a part of your injury evaluation process?