A robust skeletal framework is vital for athletes, supporting them through intense training, mitigating injury risks, and potentially enhancing overall performance. While physical activity is generally recognized for its benefits for bone health, many endurance athletes have difficulty achieving or maintaining optimal bone health. Endurance sports are often characterized by repetitive, low-impact loading patterns, which may not necessarily be beneficial for bone health. Furthermore, the considerable energy demands of endurance sports creates nutritional challenges in terms of adequate energy and nutrient intakes to promote or maintain bone health. The aims of the current symposium are: 1) to provide insight into exercise factors promoting or impairing bone health in endurance sports; 2) to highlight nutritional factors crucial for bone health of endurance athletes; 3) to show how exercise and nutritional factors influence bone health of elite cyclists. As such, this symposium provides insights into fundamental aspects of bone health in endurance sports, as well as its practical implications in elite sports. This symposium is of interest for sports scientist and experts in the field of bone health, strength & conditioning, sport nutrition, physiotherapy, and sports medicine.
ECSS Paris 2023: IS-PN04
The career of competitive athletes is short, but it spans an important period for bone health, particularly in relation to the attainment of peak bone mass. For those athletes involved in high-intensity, high-impact activities, it is likely that involvement in their sport will positively influence their bone accrual during adolescence and early adulthood. The picture might not, however, be quite so positive for endurance athletes. Endurance athletes involved in both weight bearing sports, such as running, and non-weight-bearing sports, such as swimming and cycling, have been reported to have lower bone mass than other types of athlete or non-athletic controls. Although it is not necessarily straightforward to compare the bone health of athletes to population norms or even across sports, it is possible that the bone-loading characteristics and patterns experienced by endurance athletes during training and competition might place them at a relative disadvantage regarding their bone health. The major concern during the competitive years of an athlete is the potential for an increased risk of stress fracture injury, which can be significant injuries requiring a significant time off from training and competition. This is, of course, predominantly a concern for those athletes involved in weight bearing sports, since it is unusual to find large numbers of stress fracture injuries in non-weight-bearing sports, such as cycling and swimming. The major concern once an endurance athlete retires relates to an increased incidence of osteopenia and osteoporosis, which in turn increases the risk of fragility fracture occurrence. It is far from clear, however, whether the exercise training engaged in by endurance athletes during their competitive years significantly damages their bone health into later life in terms of an increased risk of these negative bone health outcomes. This talk will explore the relationship between the exercise factors, particularly in relation to loading characteristics, that might place different endurance athletes (e.g., distance runners, cyclists, swimmers, and triathletes) at an increased risk of poor bone health and its associated consequences. The talk will conclude by highlighting where future research efforts might best be employed to further our understanding of this vitally important issue for endurance athletes.
Read CV Craig SaleECSS Paris 2023: IS-PN04
Bone is a nutritionally modulated tissue, requiring sufficient energy, macro and micro-nutrients for optimal metabolism, namely capacity to dynamically respond to fluctuating environmental demands, while simultaneously maintaining the structural integrity required to withstand habitual loading without injury. Endurance athletes face a number of challenges to meeting bone-specific nutritional requirements, which may contribute, at least in part, to the compromised bone health and high risk of bone injury reported for some groups of endurance athletes. Energy availability is a particular relevant issue to consider in this regard, given the high energetic demand of endurance training programs. Maintaining a lean phenotype is often considered desirable in many endurance sports, with athletes frequently restricting energy intake in an attempt to achieve or maintain a low body mass, further limiting the amount of energy available to support basic physiological processes, including bone metabolism. Low energy availability is often accompanied by an inadequate intake of macro and micro-nutrients that are key to bone health, including protein, carbohydrate and calcium. Furthermore, endurance exercise induces a range of acute metabolic perturbations, including to calcium, pH and redox status, all of which may increase bone catabolism and may potentially be counteracted with targeted nutritional strategies. This talk will summarize the bone-specific nutritional challenges that endurance athletes face, provide nutritional recommendations to support bone health in this group, and describe future research priorities within this area of investigation.
Read CV Eimear DolanECSS Paris 2023: IS-PN04
Elite cycling, characterized by prolonged periods of low-impact activity in combination with high energy demands, presents unique challenges to maintaining bone health. This sport inherently lacks the high-impact mechanical loading found in weight-bearing activities, which is crucial for stimulating osteogenesis and preserving bone mineral density. Consequently, the skeletal system in cyclists is not subjected to the stresses that typically promote bone strength. Moreover, elite cyclists are prone to energy deficits due to the high energy demands of training and competition, often coupled with insufficient energy intake. This scenario can lead to a state of low energy availability, which may disrupt bone remodeling processes and accelerate bone loss. The interplay between suboptimal mechanical stress and inadequate dietary intake can thus create a perfect storm for bone deterioration, potentially heightening the risk of fractures during the career, and osteoporosis later in life. This presentation aims to dissect these intricate concerns and provide a blueprint for addressing them. The latest research on counteractive strategies will be presented, including nutritional strategies and exercise interventions to introduce necessary mechanical stimuli to the bones. Integrating these strategies will yield a framework aimed at preventing and addressing bone health issues among elite cyclists, with the dual benefit of not only extending their time in competition but also securing their bone health for life beyond their professional career.
Read CV Jan-Willem van DijkECSS Paris 2023: IS-PN04