Minimal Effect on Bones From Triathlon Training

Abstract

Competitive season of triathlon does not alter bone metabolism and bone mineral status in male triathletes.

This longitudinal study evaluated the effects of a triathlon season on bone metabolism and hormonal status. Seven male competitive triathletes (mean age 19.3 years, range 18 – 20) with 5.0 +/- 0.3 years of competition experience were tested twice during the season: at the beginning of training and 32 weeks later. Total and regional bone mineral density (BMD) was determined by dual-energy X-ray absorptiometry, while bone turnover was evaluated by specific biochemical markers: bone-specific alkaline phosphatase (B-ALP), osteocalcin, and urinary type I collagen C-telopeptide. In addition, sexual, calciotropic and somatotropic hormones were also analyzed. After 32 weeks, a BMD increase was found at the lumbar spine (1.9 %; p = 0.031) and skull (3.1 %; p = 0.048), while no variation was observed for total body or at the proximal femur. The B-ALP level decreased (-23.2 %; p = 0.031), but no variation was found for the other bone markers. 1.25 (OH) (2)D3, IGF-1 and the bioavailability IGF-1 index (IGF-1/IGFBP-3) increased by 18.3 % (p = 0.047), 29 % (p = 0.048), 33 % (p = 0.011), respectively, while PTH, testosterone, IGFBP-3 and cortisol concentrations were unchanged. In conclusion, the triathlon season had a moderately favourable effect on BMD, although a slowing down of bone formation activity was observed. No variation in hormonal levels was observed that could have limited the effects of exercise on bone tissue.

Maïmoun L, Galy O, Manetta J, Coste O…
Int J Sports Med Apr 2004
PMID: 15088249

Review: Exercise & Bones

Abstract

The effect of physical activity and its interaction with nutrition on bone health.

Physical activity (PA) is a popular therapy for the prevention and treatment of bone loss and osteoporosis because it has no adverse side effects, it is low cost, and it confers additional benefits such as postural stability and fall prevention. Bone mass is regulated by mechanical loading, and is limited but not controlled by diet. The mechanism by which strain thresholds turn bone remodelling ‘on’ and ‘off’ is known as the mechanostat theory. Research in animals has shown that optimal strains are dynamic, with a high change rate, an unusual distribution and a high magnitude of strain, but the results of randomized controlled trials in human subjects have been somewhat equivocal. In the absence of weight-bearing activity nutritional or endocrine interventions cannot maintain bone mass. Biochemical markers of bone turnover predict bone mass changes, and findings from our research group and others have shown that both acute and chronic exercise can reduce bone resorption. Similarly, Ca intervention studies have shown that supplementation can reduce bone resorption. Several recent meta-analytical reviews concur that changes in bone mass with exercise are typically 2-3%. Some of these studies suggest that Ca intake may influence the impact of PA on bone, with greater effects in Ca-replete subjects. Comparative studies between Asian (high PA, low Ca intake) and US populations (low PA, high Ca intake) suggest that PA may permit an adaptation to low Ca intakes. Whether Ca and PA interact synergistically is one of the most important questions unanswered in the area of lifestyle-related bone health research.

Murphy NM, Carroll P
Proc Nutr Soc Nov 2003
PMID: 15018482

Volleyball and Basketball > Soccer and Track > Swimming

Abstract

Weight-bearing exercise and markers of bone turnover in female athletes.

Weight-bearing activity provides an osteogenic stimulus, while effects of swimming on bone are unclear. We evaluated bone mineral density (BMD) and markers of bone turnover in female athletes (n = 41, age 20.7 yr) comparing three impact groups, high impact (High, basketball and volleyball, n = 14), medium impact (Med, soccer and track, n = 13), and nonimpact (Non, swimming, n = 7), with sedentary age-matched controls (Con, n = 7). BMD was assessed by dual-energy X-ray absorptiometry at the lumbar spine, femoral neck (FN), Ward’s triangle, and trochanter (TR); bone resorption estimated from urinary cross-linked N-telopeptides (NTx); and bone formation determined from serum osteocalcin. Adjusted BMD (g/cm; covariates: body mass index, weight, and calcium and calorie intake) was greater at the FN and TR in the High group (1.27 +/- 0.03 and 1.05 +/- 0.03) than in the
Non (1.05 +/- 0.04 and 0.86 +/- 0.04) and
Con (1.03 +/- 0.05 and 0.85 +/- 0.05) groups and greater at the TR in the
Med group (1.01 +/- 0.03) than in the
Non (0.86 +/- 0.04) and
Con (0.85 +/- 0.05) groups. Total body BMD was higher in the
High group (4.9 +/- 0.12) than in the
Med (4.5 +/- 0.12),
Non (4.2 +/- 0.14), and
Con (4.1 +/- 0.17) groups and greater in the Med group than in the Non and Con groups. Bone formation was lower in the
Non group (19.8 +/- 2.6) than in the
High (30.6 +/- 3.0) and
Med (32.9 +/- 1.9, P < or = 0.05) groups. No differences in a marker of bone resorption (NTx) were noted. This indicates that women who participate in impact sports such as volleyball and basketball had higher BMDs and bone formation values than female swimmers.

Creighton DL, Morgan AL, Boardley D, Brolinson PG
J. Appl. Physiol. Feb 2001
PMID: 11160054 | Free Full Text

Unclear How Strength Training Increases Bone Density

Abstract

Effects of strength training on bone mineral density: hormonal and bone turnover relationships.

The effects of a 16-wk strength-training program on bone mineral density (BMD) was assessed by dual-energy X-ray absorptiometry in 21 men [age 61 +/- 1 (SE) yr]. Sixteen men (age 59 +/- 2 yr) served as control subjects. To investigate the possible hormonal relationships underlying the effects on BMD, serum concentrations of growth hormone, insulin-like growth factor I, and testosterone were determined before and after training. In addition, osteocalcin and skeletal alkaline phosphatase (markers of bone formation) and tartrate-resistant acid phosphatase (a marker of bone resorption) were measured before and after training to assess bone turnover. The training program resulted in a 2.8 +/- 0.6% increase in femoral neck BMD (1.004 +/- 0.037 vs. 1.031 +/- 0.037 g/cm2; P < 0.001). However, there were no significant changes in total body, anterioposterior spine, lateral spine, Ward’s triangle, or greater trochanter BMD. Moreover, there were no significant changes in growth hormone, insulin-like growth factor I, testosterone, osteocalcin, or skeletal alkaline phosphatase. There were no changes in the control group. Thus, strength training can increase femoral neck BMD, and this effect does not appear to be accompanied by changes in anabolic hormones or markers of bone formation and resorption.

Ryan AS, Treuth MS, Rubin MA, Miller JP…
J. Appl. Physiol. Oct 1994
PMID: 7836186

Running Improves Calcium Balance in Rats

Abstract

Hypokinesia-induced negative net calcium balance reversed by weight-bearing exercise.

Negative calcium balance and bone loss occurring with immobilization and hypokinesia have been attributed to a lack of weight bearing on bones. The effects of weight-bearing exercise for promotion of calcium balance after hypokinesia were examined. Rats were randomly assigned to either hypokinetic suspension for 28 d or to a control sedentary group, free to move about their cages at will. After 28 d, the rats in each group were randomly subdivided to either post-hypokinetic forced running (HR), post-hypokinetic sedentary (HS), control forced running (CR), or control sedentary (CS) groups. Net calcium balance was then determined for 25 consecutive days. Net calcium balance of HR was negative for the first 5-d period of recovery and then became positive; that of HS was negative for 25 d; that of CR and CS remained essentially positive. Net calcium absorption paralleled net calcium balance. Forced running was effective in reestablishment of positive net calcium balance after 28 d of decreased weight bearing.

Lutz J, Chen F, Kasper CE
Aviat Space Environ Med Apr 1987
PMID: 3579816

Exercise + HRT = Bone Synergy

Abstract

Additive effects of weight-bearing exercise and estrogen on bone mineral density in older women.

The separate and combined effects of weight-bearing exercise and hormone replacement therapy (HRT) on bone mineral density (BMD) were studied in 32 women, 60 to 72 years of age. HRT consisted of continuous conjugated estrogens 0.625 mg/day and trimonthly medroxyprogesterone acetate 5 mg/day for 13 days. Exercise consisted of 2 months of low-intensity exercise followed by 9 months of more vigorous weight-bearing exercise approximately 45 minutes/day, > or = 3 days/week, at 65-85% of maximal heart rate. Lumbar spine and proximal femur BMD were significantly increased in response to exercise and to HRT, and total body BMD was significantly increased in response to HRT; neither exercise nor HRT had an effect on wrist BMD. The combination of exercise + HRT resulted in increased BMD at all sites except the wrist, with effects being additive for the lumbar spine and Ward’s triangle and synergistic for the total body. Based on reductions in serum osteocalcin levels, it appears that increases in BMD in response to HRT and exercise + HRT were due to decreased bone turnover. The lack of change in serum osteocalcin and IGF-I in response to exercise alone suggests that increases in BMD were due to decreased bone resorption and not increased formation. Results indicate that weight-bearing exercise + HRT may be effective in preventing and/or treating osteoporosis. It is likely that the additive effects of weight-bearing exercise and HRT on bone mineral accretion, coupled with other adaptations to the exercise (i.e., increased strength and functional capacity), could effectively reduce the incidence of falls and osteoporotic fractures.

Kohrt WM, Snead DB, Slatopolsky E, Birge SJ
J. Bone Miner. Res. Sep 1995
PMID: 7502701

Chocolate Bad for Bones

Abstract

Chocolate consumption and bone density in older women.

Nutrition is important for the development and maintenance of bone structure and for the prevention of osteoporosis and fracture. The relation of chocolate intake with bone has yet to be investigated.
We investigated the relation of chocolate consumption with measurements of whole-body and regional bone density and strength.
Randomly selected women aged 70-85 y (n=1460) were recruited from the general population to a randomized controlled trial of calcium supplementation and fracture risk. We present here a cross-sectional analysis of 1001 of these women. Bone density and strength were measured with the use of dual-energy X-ray absorptiometry, peripheral quantitative computed tomography, and quantitative ultrasonography. Frequency of chocolate intake was assessed with the use of a questionnaire and condensed into 3 categories: or=1 time/d.
Higher frequency of chocolate consumption was linearly related to lower bone density and strength (P<0.05). Daily (>or=1 times/d) consumption of chocolate, in comparison to Older women who consume chocolate daily had lower bone density and strength. Additional cross-sectional and longitudinal studies are needed to confirm these observations. Confirmation of these findings could have important implications for prevention of osteoporotic fracture.

Hodgson JM, Devine A, Burke V, Dick IM…
Am. J. Clin. Nutr. Jan 2008
PMID: 18175753 | Free Full Text

This is disappointing. Cocoa is normally so healthy. My first thought was that they may be seeing the effects of sugar. Reading the full study, which is available for free using the link above, the authors made these comments:

Chocolate is usually also rich in sugar and contains the methylxanthines, theobromine and caffeine (27), and oxalate (11, 12)….

Oxalate is a potent inhibitor of calcium absorption (13). Furthermore, a single 100-g dose of dark chocolate was found to increase calcium excretion by 147% (14). The basis for this is not clear, but it is likely to include an effect of sugar to increase urinary calcium excretion (14, 15), dependent in part on an increase in plasma insulin that itself stimulates calciuria (29).

I wonder what would happen if you consumed a very dark chocolate (so very low in sugar) and supplemented calcium and vitamin D? The idea being that the very dark chocolate would avoid most of the sugar, and the calcium and vitamin D would hopefully overcome the reduced calcium absorption.

Olive Oil, but Not Nuts, May Protect Bones

Abstract

A Mediterranean diet enriched with olive oil is associated with higher serum total osteocalcin levels in elderly men at high cardiovascular risk.

The intake of olive oil has been related to the prevention of osteoporosis in experimental and in in vitro models. Very few prospective studies have evaluated the effects of olive oil intake on circulating osteocalcin (OC) in humans.
The objective of the study was to examine the longitudinal effects of a low-fat control diet (n=34), a Mediterranean diet enriched with nuts (MedDiet+nuts, n=51), or a Mediterranean diet enriched with virgin olive oil (MedDiet+VOO, n=42) on circulating forms of OC and bone formation markers in elderly men at high cardiovascular risk.
Longitudinal associations between baseline and follow-up (2 yr) measurements of total OC, undercarboxylated osteocalcin, C-telopeptide of type I collagen, and procollagen I N-terminal propeptide (P1NP) concentrations were examined in 127 elderly men randomized to three healthy dietary interventions.
Baseline characteristics (age, body mass index, waist circumference, lipid profile, fasting insulin levels, and bone formation and resorption markers) were similar in all intervention groups. The total osteocalcin concentration increased robustly in the MedDiet+VOO group (P=0.007) in parallel to increased P1NP levels (P=0.01) and homeostasis model assessment-β-cell function (P=0.01) but not in subjects on the MedDiet+nuts (P=0.32) or after the control diet (P=0.74). Interestingly, the consumption of olives was associated positively with both baseline total osteocalcin (r=0.23, P=0.02) and the 2-yr osteocalcin concentrations (r=0.21, P=0.04) in the total cohort.
Consumption of a Mediterranean diet enriched with virgin olive oil for 2 years is associated with increased serum osteocalcin and P1NP concentrations, suggesting protective effects on bone.

Fernández-Real JM, Bulló M, Moreno-Navarrete JM, Ricart W…
J. Clin. Endocrinol. Metab. Oct 2012
PMID: 22855341

Interestingly, nuts did not show a benefit.

Oleuropein (from Olives) Increases Osteoblasts In Vitro

Abstract

Oleuropein enhances osteoblastogenesis and inhibits adipogenesis: the effect on differentiation in stem cells derived from bone marrow.

The effects of oleuropein on the processes of osteoblastogenesis and adipogenesis in mesenchymal stem cells (MSCs) from human bone marrow have been studied. We report that oleuropein, a polyphenol abundant in olive tree products, reduces the expression of peroxisome proliferator-activated receptor gamma (PPARγ), inhibits adipocyte differentiation, and enhances differentiation into osteoblast.
Age-related bone loss is associated with osteoblast insufficiency during continuous bone remodeling. It has been suggested that the formation of osteoblasts in bone marrow is closely associated with adipogenesis, and age-related changes in this relationship could be responsible for the progressive adiposity of bone marrow which occurs with osteoporosis. In addition, the consumption of oleuropein, a major polyphenol in olive leaves and olive oil, has been associated with a reduction in bone loss.
We have analyzed the effects of oleuropein-at concentrations between 10(-6) and 10(-4) M-on the processes of osteoblastogenesis and adipogenesis in MSCs from human bone marrow.
The results show an increase in osteoblast differentiation and a decrease in adipocyte differentiation when there is oleuropein in the culture media. The gene expression of osteoblastogenesis markers, RUNXII, osterix, collagen type I, osteocalcin, or alkaline phosphatase (ALP), was higher in osteoblast-induced oleuropein-treated cells. Also, the ALP activity and extracellular matrix mineralization were higher when oleuropein was present in the media. Oleuropein in MSCs induced adipocytes to produce a decrease in the expression of the genes involved in adipogenesis, the PPARγ, lipoprotein lipase, or fatty acid-binding protein 4, and minor fat accumulation.
Our data suggest that oleuropein, highly abundant in olive tree products included in the traditional Mediterranean diet, could prevent age-related bone loss and osteoporosis.

Santiago-Mora R, Casado-Díaz A, De Castro MD, Quesada-Gómez JM
Osteoporos Int Feb 2011
PMID: 20495905

Olive Oil Mitigates Osteoporosis in Rats

Abstract

Olive oil effectively mitigates ovariectomy-induced osteoporosis in rats.

Osteoporosis, a reduction in bone mineral density, represents the most common metabolic bone disease. Postmenopausal women are particularly susceptible to osteoporosis when their production of estrogen declines. For these women, fracture is a leading cause of morbidity and mortality. This study was conducted to evaluate the protective effects of olive oil supplementation against osteoporosis in ovariectomized (OVX) rats.
We studied adult female Wistar rats aged 12-14 months, divided into three groups: sham-operated control (SHAM), ovariectomized (OVX), and ovariectomized rats supplemented with extravirgin olive oil (Olive-OVX) orally for 12 weeks; 4 weeks before ovariectomy and 8 weeks after. At the end of the experiment, blood samples were collected. Plasma levels of calcium, phosphorus, alkaline phosphatase (ALP), malondialdehyde (MDA), and nitrates were assayed. Specimens from both the tibia and the liver were processed for light microscopic examination. Histomorphometric analysis of the tibia was also performed.
The OVX-rats showed a significant decrease in plasma calcium levels, and a significant increase in plasma ALP, MDA, and nitrates levels. These changes were attenuated by olive oil supplementation in the Olive-OVX rats. Light microscopic examination of the tibia of the OVX rats revealed a significant decrease in the cortical bone thickness (CBT) and the trabecular bone thickness (TBT). In addition, there was a significant increase in the osteoclast number denoting bone resorption. In the Olive-OVX rats these parameters were markedly improved as compared to the OVX group. Examination of the liver specimens revealed mononuclear cellular infiltration in the portal areas in the OVX-rats which was not detected in the Olive-OVX rats.
Olive oil effectively mitigated ovariectomy-induced osteoporosis in rats, and is a promising candidate for the treatment of postmenopausal osteoporosis.

Saleh NK, Saleh HA
BMC Complement Altern Med 2011
PMID: 21294895 | Free Full Text