Exploring normative sport specific bone mineral density in athletes
Research type
Research Study
Full title
Exploring and establishing normative sport specific full body bone mineral density Z-scores in athletes.
IRAS ID
333411
Contact name
Tom Gurney
Contact email
Sponsor organisation
University College London
Clinicaltrials.gov Identifier
Z6364106/2023/12/90 health research, Data Protection
Duration of Study in the UK
10 years, 0 months, 1 days
Research summary
Bone mineral density (BMD) is directly linked to bone strength, and having low BMD increases the risk of experiencing fractures and osteoporosis. In athletes, particularly those who compete in low-impact sports, the most common factor for causing low BMD is negative energy balance (otherwise known as relative energy deficiency in sport (RED-S)) which has also been associated with secondary risk factors such menstrual dysfunction, reduced resting metabolic rate, low body fat percentage, and/or disorder eating. However, the current reference scale for BMD evaluation is based on a ‘general’ population. It is therefore plausible to speculate that athletes and practitioners are interpreting BMD, particularly in female athletes, on wrong assumptions. Insufficient BMD in athletes heightens vulnerability to stress fractures and traumatic injuries, exacerbated by extreme weight control and eating disorders. For instance, low energy availability increases bone injury risk by 4.5 times in elite distance athletes. Conversely, multi-directional loading and consistent menstruation may decrease bone stress injury risk. Engaging in high-impact activities, such as tennis, running, basketball, and weightlifting, increases BMD during adolescence and adulthood, particularly in males. Low-impact sports, lacking bone-loading movements, yield BMD levels akin to non-athletes. RED-S, arising from energy deficits, disrupts bone-regulating hormones, jeopardizing bone health.
REC name
London - Surrey Borders Research Ethics Committee
REC reference
24/LO/0232
Date of REC Opinion
14 Jun 2024
REC opinion
Further Information Favourable Opinion