Bone Mineral Density in Competitive Athletes

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Jose Antonio
Alex Leaf
Cassandra Carson
Anya Ellerbroek
Tobin Silver
Corey A. Peacock
Pete Bommarito
Sarah Knafo
Jaime Tartar


MMA, football, T-score, paddling, body composition


Introduction: The purpose of this investigation was to characterize the bone mineral density in a wide variety of competitive athletes.
Methods: A cohort of 135 athletes was assessed for body composition via dual-energy x-ray absorptiometry (DXA). These included professional mixed martial arts fighters (MMA), elite stand-up paddlers, collegiate football players, collegiate swimmers, collegiate track and field athletes, collegiate and world-class distance runners as well as a group of men and women who participated in regular heavy resistance training.
Results: In general, bone mineral density (BMD) as determined by the T-score was highest in mixed martial arts fighters (T-score = 3.1 ± 0.9) and football players (T-score = 2.7 ± 0.7) followed by resistance-trained (RT) males (T-score = 1.9 ± 1.2). RT males had a greater average T-score than RT females (T-score 1.5 ± 1.3). Based on the data from this investigation, we conclude that RT males have greater BMD as determined by the T-score than RT females. Also, MMA fighters and football players are unique in that they tend to demonstrate very high BMD (1.57 ± 0.10 and 1.60 ± 0.12 g/cm2, respectively) with a concomitantly high T-score. Conclusions: It is evident that the high-impact nature of football and MMA competition is conducive to producing very high bone mineral densities. However, inasmuch as this investigation is cross-sectional in nature, it is not clear if athletes are self-selected for higher bone mineral density and/or if it is the result of years of training in their respective sport.

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1. Grabowski P. Physiology of Bone. Endocr Dev. 2015;28:33-55.

2. Leib ES, Lewiecki EM, Binkley N, Hamdy RC, Densitometry ISfC. Official positions of the International Society for Clinical
Densitometry. J Clin Densitom. 2004;7(1):1-6.

3. Petersen BA, Hastings B, Gottschall JS. Low load, high repetition resistance training program increases bone mineral density in untrained
adults. J Sports Med Phys Fitness. Jan-Feb 2017;57(1-2):70-76.

4. Beavers KM, Beavers DP, Martin SB, et al. Change in Bone Mineral Density During Weight Loss with Resistance Versus Aerobic Exercise
Training in Older Adults. J Gerontol A Biol Sci Med Sci. Apr 03 2017.

5. Tsuzuku S, Shimokata H, Ikegami Y, Yabe K, Wasnich RD. Effects of high versus low-intensity resistance training on bone mineral density in
young males. Calcif Tissue Int. Jun 2001;68(6):342-347.

6. Bolam KA, Skinner TL, Sax AT, Adlard KN, Taaffe DR. A Comparison of Bone Mineral Density in Amateur Male Boxers and
Active Non-boxers. Int J Sports Med. Aug 2016;37(9):694-699.

7. Dolan E, Crabtree N, McGoldrick A, Ashley DT, McCaffrey N, Warrington GD. Weight regulation and bone mass: a comparison between professional jockeys, elite amateur boxers, and age, gender and BMI matched controls. J Bone Miner Metab. Mar 2012;30(2):164-

8. Ackerman KE, Skrinar GS, Medvedova E, Misra M, Miller KK.Estradiol levels predict bone mineral density in male collegiate athletes:
a pilot study. Clin Endocrinol (Oxf). Mar 2012;76(3):339-345.

9. Platen P, Chae E-h, Antz R, Lehmann R, Kuhlmorgen J, Allolio B. Bone mineral density in top level male athletes of difference sports.
European Journal of Sports Science. 2001;1(5):1-15.

10. Andreoli A, Monteleone M, Van Loan M, Promenzio L, Tarantino U, De Lorenzo A. Effects of different sports on bone density and muscle mass in highly trained athletes. Med Sci Sports Exerc. Apr 2001;33(4):507-511.

11. Felsenberg D, Boonen S. The bone quality framework: determinants of bone strength and their interrelationships, and implications for
osteoporosis management. Clin Ther. Jan 2005;27(1):1-11.

12. Ammann P, Rizzoli R. Bone strength and its determinants. Osteoporos Int. 2003;14 Suppl 3:S13-18.

13. Small RE. Uses and limitations of bone mineral density measurements in the management of osteoporosis. MedGenMed. May 2005;7(2):3.

14. Frost HM. Bone's mechanostat: a 2003 update. Anat Rec A Discov Mol Cell Evol Biol. Dec 2003;275(2):1081-1101.

15. Ruff C, Holt B, Trinkaus E. Who's afraid of the big bad Wolff?:"Wolff's law" and bone functional adaptation. Am J Phys Anthropol.
Apr 2006;129(4):484-498.

16. Skerry TM. One mechanostat or many? Modifications of the site-specific response of bone to mechanical loading by nature and nurture. J Musculoskelet Neuronal Interact. 2006 Apr-Jun 2006;6(2):122-127.

17. Chen JH, Liu C, You L, Simmons CA. Boning up on Wolff's Law: mechanical regulation of the cells that make and maintain bone. J Biomech. Jan 2010;43(1):108-118.

18. Chilibeck PD, Sale DG, Webber CE. Exercise and bone mineral density. Sports Med. Feb 1995;19(2):103-122.

19. Layne JE, Nelson ME. The effects of progressive resistance training on bone density: a review. Med Sci Sports Exerc. Jan 1999;31(1):25-30.

20. Nieves JW, Formica C, Ruffing J, et al. Males have larger skeletal size and bone mass than females, despite comparable body size. J Bone Miner
Res. Mar 2005;20(3):529-535.
21. Seeman E, Hopper JL, Young NR, Formica C, Goss P, Tsalamandris C. Do genetic factors explain associations between muscle strength, lean mass, and bone density? A twin study. Am J Physiol. Feb 1996;270(2 Pt 1):E320-327.

22. Mikkola TM, Sipilä S, Rantanen T, et al. Genetic and environmental influence on structural strength of weight-bearing and non-weight- bearing bone: a twin study. J Bone Miner Res. Apr 2008;23(4):492- 498.

23. Mikkola TM, Sipilä S, Rantanen T, et al. Muscle cross-sectional area and structural bone strength share genetic and environmental effects in older women. J Bone Miner Res. Feb 2009;24(2):338-345.

24. Simas V, Hing W, Pope R, Climstein M. Effects of water-based exercise on bone health of middle-aged and older adults: a systematic review and meta-analysis. Open Access J Sports Med. 2017;8:39-60.

25. Gómez-Bruton A, Gónzalez-Agüero A, Gómez-Cabello A, Casajús JA, Vicente-Rodríguez G. Is bone tissue really affected by swimming? A systematic review. PLoS One. 2013;8(8):e70119.

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