Body Mass, Training, Menses, and Bone in Adolescent Runners: A 3-yr Follow-up


Medicine & Science in Sports & Exercise:
doi: 10.1249/MSS.0b013e318201d7bb
Clinical Sciences

ABSTRACT: Endurance runners with low bone mass during adolescence may risk attaining a low peak bone mineral density (BMD) in adulthood. Alternatively, they may mature late and undergo delayed bone mineral accumulation.

Purpose: The purpose of this study was to evaluate 40 adolescent runners (aged 15.9 ± 0.2 yr) at two time points, approximately 3 yr apart, to assess bone mass status and identify variables associated with bone mass change.

Methods: Follow-up measures included a questionnaire to assess menstrual status, training, and sports participation history, height and weight, and a dual-energy x-ray absorptiometry scan to assess total body, total hip, and lumbar spine BMD, bone mineral content (BMC), BMD z-score, and body composition. We used −1 and −2 BMD z-score cutoffs to categorize runners with low bone mass.

Results: Eighty-seven percent of girls with low BMD at baseline had low BMD at the follow-up. Girls with low compared with normal baseline BMD had lower follow-up adjusted total body (2220.4 ± 65.8 vs 2793.1 ± 68.2 g, P < 0.001), total hip (27.0 ± 1 vs 33.9 ± 1.0 g, P < 0.05), and lumbar spine (47.8 ± 2.0 vs 66.3 ± 2.2 g, P < 0.001) BMC values. Variables related to 3-yr training volume, menstrual function, age, developmental stage, and change in body mass explained 29%-54% of the variability in BMC change.

Conclusions: The majority of adolescent runners with low BMD at baseline had low BMD after a 3-yr follow-up. Our observations suggest that "catch-up" accrual may be difficult and, thus, emphasize the importance of gaining adequate bone mineral during the early adolescent years.

Author Information

1Graduate Group in Nutritional Biology, University of California Davis, Davis, CA; 2US Department of Agriculture, ARS, Western Human Nutrition Research Center, University of California Davis, Davis, CA; 3Graduate Program in Orthopaedic and Sports Physical Therapy, Rocky Mountain University of Health Professions, Provo, UT; and 4School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA

Address for correspondence: Michelle T. Barrack, Ph.D.; E-mail:

Submitted for publication October 2009.

Accepted for publication October 2010.

©2011The American College of Sports Medicine