Article Figures & Data
Figures
- Figure 1.
Selection steps for peer-reviewed publications included in the meta-analysis (format adapted from Moher et al.18).
Tables
- Table 1.
Summary of Included Articles Comparing Bone Mineral Density in Female Athletes and Controls in a Variety of Sports
Author Total Subjects (n) Study Groups (n) Summary of Findings Duncan et al24 75 -
Cycling (15)
Running (15)
Swimming (15)
Triathletes (15)
Control (15)
Investigated influence of exercise types and differences in anatomic distribution of mechanical loading patterns on BMD. Concluded that running is associated with larger site-specific (Lumbar, Neck, Legs) BMD than swimming or cycling. Arm readings also included, which were used for this review. Egan et al25 86 -
NetBall (20)
Rugby (30)
Running (11)
Control (25)
All sports groups had higher BMD values than controls. Upper-body BMD was most pronounced in rugby players and least pronounced in runners. Significant correlations between BMD and fat-free soft tissue mass, body mass, and training volume were observed. Lee et al14 62 -
Basketball (7)
Soccer (9)
Swimming (7)
Volleyball (11)
Active control (17)
Nonactive control (11)
Volleyball and basketball athletes had significantly greater leg and arm measurements than others. All nonswimmers had significantly greater right arm measurements relative to swimmers. Nichols et al26 60 -
Basketball (14)
Gymnastics (15)
Tennis (6)
Volleyball (13)
Control (12)
Examined lean leg mass and regional fat mass as alternative predictors of BMD, and determined lean leg mass to be a better predictor. Included upper-arm BMD measurements. Trutschnigg et al23 44 -
Boxing (11)
Control 1 (16)
Control 2 (17)
Goal of the study was to compare relationships between BMD, lean body mass, fat mass, physical activity energy expenditure, and menstrual status in female boxers and physically active females with low or average fat mass. Boxing (high athleticism) had a positive effect on BMD. Vincente-Rodriguez et al29 51 -
Handball (24)
Control (27)
Compared adolescent handballers with controls who participated only in mandatory physical education, with no other sports or athletic activity. Found enhanced axial and appendicular BMD in young girls who participated in an advanced sporting activity relative to minimally active controls. Taffe & Marcus27 40 -
Gymnastics (18)
Control (22)
Examined relationships between BMD and strength in collegiate women with different exercise levels. Concluded that association between muscle strength and BMD in young women is dependent on exercise status. Taffe et al28 58 -
Gymnastics (13)
Swimming (26)
Control (19)
Examined the role of skeletal loading patterns on BMD by comparing eumenorrheic athletes training by opposite forms of skeletal loading (gymnastics and swimming, with a nonactive control group). Gymnasts had higher BMD than swimmers or controls at several body sites. Slemenda & Johnston30 44 -
Ice skating (22)
Control (22)
Examined young figure skaters and controls (aged 10–23 years). Found similar upper-body BMD between figure skaters and controls, and greater lower-body BMD in figure skaters. Fehling et al22 45 -
Gymnastics (13)
Swimming (7)
Volleyball (8)
Control (17)
Compared impact loading with active loading collegiate athletes and controls. Gymnasts had significantly greater BMD than all other groups at right and left arm sites. Impact loading groups had greater BMD in lower body than the active loading (swimming) and control groups. No observed differences between active loading group (swimming) and control groups. -
BMD, bone mineral density.
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- Table 2.
Modeling the Effect of Competitive Level of Female Athletes on Bone Mass Density in the Upper Arm of Female Participants Using Weighted Least Squares Linear Regression*
Variable Effect (β) 95% CI for β Elite athleticism† 0.140 0.047–0.234 Competive‡ 0.010 −0.095 to 0.115 Active control§ 0.045 −0.051 to 0.14 Upper extremity impact¶ 0.037 −0.025 to 0.099 Age 0.009 −0.001 to 0.019 BMI 0.023 −0.001 to 0.047 Constant 0.132 −0.437 to 0.701 F (p) = 6.353 (P < .000) R2 = 0.536 -
↵* The β coefficient indicates the estimated effect size of each variable. The model indicates that elite athleticism, defined as participation in Division I–level competitive sport at the time of measurement, significantly predicts an increase of bone mass density in the upper arm by 0.140 g/cm−2, when age, impact level of sport, and body mass index are controlled. Each variable was entered as the mean for each study group.
↵† Elite athletes included NCAA Division I competitors.
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↵‡ Competitive collegiate athletes included NCAA Division II or III competitors.
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↵§ Noncompetitive athletes, eg, joggers, noncompetitive swimmers, and intramurals.
↵¶ Basketball, boxing, gymnastics, handball, and volleyball = 1 versus 0 for low impact and control.
BMI, body mass index.
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