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Short stature and delayed puberty in gymnasts: Influence of selection bias on leg length and the duration of training on trunk length
Abstract
Delays in bone age, the onset of puberty, and skeletal growth in gymnasts could be, in part, the reason for an interest in gymnastics, rather than being the result of vigorous exercise. We hypothesized that short stature and delayed bone age are present at the start of gymnastics, and training delays growth, producing short stature, even after retirement.
Sitting height and leg length were measured in 83 active female gymnasts, 42 retired gymnasts, and 154 healthy control subjects. Results were expressed as age-specific SD scores (mean +/- SEM).
In the cross-sectional data, active gymnasts had delayed bone age (1.3 +/- 0.1 years), reduced height -1.32 +/- 0.08 SD, sitting height -1.24 +/- 0.09 SD, and leg length, -1.25 +/- 0.08 SD (all P <.001). However, in those training for less than 2 years, the deficit was confined to leg length (-0.8 +/- 0.2 SD). During 2 years of follow-up of 21 gymnasts, only the deficit in sitting height worsened (by 0.4 +/- 0.1 SD). In 13 gymnasts followed up in the immediate 12 months after retirement, sitting height accelerated, resulting in a lessening of the deficit in sitting height by 0.46 +/- 0.14 SD (P <.01). Adult gymnasts who had been retired for 8 years had no deficit in sitting height, leg length, or menstrual dysfunction.
Short stature in active gymnasts is partly due to selection of individuals with reduced leg length. Reduced sitting height is likely to be acquired but is reversible with cessation of gymnastics. A history of gymnastic training does not appear to result in reduced stature or menstrual dysfunction in adulthood.
... Children often commence training 1 to 2 hours per week and progress to 15 to 36 hours per week during the prepubertal and early pubertal years. 2 There is some suggestion that elite female gymnasts may be at risk for short stature and delayed maturation. 3,4 However, it is likely that the short stature and delayed maturation are due partly to selection bias rather than training per se. Despite limited evidence that regular physical training does not alter growth or maturation in active male children, 5,6 little information is available on the effects of regular high-volume, high-impact training on growth in competitive prepubertal and early pubertal male gymnasts. ...
... It has been suggested that prolonged negative energy balance combined with intensive training may result in inhibition of the hypothalamo-pituitarygonadal axis, which may contribute to short stature caused by delayed maturation. 3,4 Poor dietary habits, caloric restriction, and eating disorders associated with maintaining a small lean physique are common characteristics of young elite female rather than male gymnasts. 3,22 For instance, Bass et al 3 found that in elite female gymnasts, energy intake was associated with growth velocity and the delay in bone age. ...
... 3,4 Poor dietary habits, caloric restriction, and eating disorders associated with maintaining a small lean physique are common characteristics of young elite female rather than male gymnasts. 3,22 For instance, Bass et al 3 found that in elite female gymnasts, energy intake was associated with growth velocity and the delay in bone age. In the present study the lack of difference in the rate of growth between male gymnasts and members of the control group suggests that the dietary intakes of the gymnasts (which were within the Recommended Daily Allowance) were sufficient to support the dual requirements of growth and daily training. ...
Short stature in competitive prepubertal and early pubertal male gymnasts: The result of selection bias or intense training?
Robin M. Daly, PhD, Peter A. Rich, PhD, Rudi Klein, PhD, and Shona L. Bass, PhD
As more children become involved in intense physical training, concern has increased regarding potential risks to linear growth and final adult stature, biologic
maturation, and reproductive function.1 Gymnastics is a sport characterized by involvement at an early age and a relatively rapid transition to high-volume, high- impact training. Children often commence training 1 to 2 hours per week and progress to 15 to 36 hours per week during the prepubertal and early pubertal
years.2 There is some suggestion that elite female gymnasts may be at risk for short
stature and delayed maturation.3,4 However, it is likely that the short stature and delayed maturation are due partly to selection bias rather than training per se. Despite limited evidence that regular physical training does not alter growth or
maturation in active male children,5,6 little information is available on the effects of regular high-volume, high-impact training on growth in competitive prepubertal and early pubertal male gymnasts.
Growth during the prepubertal period is predominantly regulated by growth
hormone, insulin-like growth factor-I, and thyroxine.7 Because both low energy intake and physical train- ing have been shown to alter the concentrations of
growth-regulating hormones,8 it is possible that pro- longed energy restriction associated with intense exercise could have a
Objectives: To determine whether high-volume, high-impact physical training in prepubertal and early pubertal male gymnasts is associated with reduced statural and segmental growth and reduced serum insulin-like growth factor-I (IGF-I) and increased cortisol (C) levels.
Study design: Height, sitting height, leg length, and segmental lengths (humerus, radius, femur, and tibia) and breadths (biacromial and bi-iliac), diet, serum IGF-I, testosterone, and C were measured in competitive male gymnasts and normoactive children (Tanner stage ≤2) every 3 to 4 months over an 18-month period.
Results: At baseline, gymnasts (n = 31) were 0.7 years older than members of the control group (P < .05, n = 50) but were no different in terms of bio- logic maturity. Age-adjusted z scores showed that the gymnasts were short- er than members of the control group (–0.5 ± 0.2 SD, P < .05) because of reduced leg length (–0.8 ± 0.2 SD, P < .001) but not sitting height. Segmental lengths and bi-iliac breadth age-
adjusted z scores were also reduced in the gymnasts (P ranging < .05 to < .001). No difference was detected for serum IGF-I or C. After 18 months of follow-up, no differences were found for rates of change in height, sitting height or leg length, segmental lengths, IGF-I, or C between those gymnasts and control subjects who remained prepubertal and early pubertal (gymnasts n = 18; control group n = 35). However, the magnitudes of baseline differences in anthropometric measures (z scores) persisted throughout the study.
Conclusion: Short stature in these competitive male gymnasts was due to a reduced leg length but not sitting height. The lack of a difference in growth rates, IGF-I, and diet over the 18-month period indicates that the short stature reported in male gymnasts is due to selection bias rather than gymnastics training. (J Pediatr 2000;137:510-6)
... Gymnastics coaches have long recognized that some gymnasts appear to experience catch-up growth following vacation periods or time off due to injury. Catch-up growth observed during reduced training schedules or following retirement is reported in two cohort studies (3,29) and the case studies discussed earlier (16,41). Catch-up growth has also been documented in other athletes once training was reduced (27,42). ...
... There is also evidence that reduced growth and subsequent catch-up growth is isolated to the sex steroid dependent acceleration of trunk growth, potentially resulting in site-specific deficits in height depending on the time of exposure (3,19) ( Figure 2). For instance, several longitudinal studies have reported that the progressive deficits in stature in elite pre-and peri-pubertal female gymnasts were due predominantly to a greater increase in the deficit in trunk length (not leg length) (3,18). ...
... There is also evidence that reduced growth and subsequent catch-up growth is isolated to the sex steroid dependent acceleration of trunk growth, potentially resulting in site-specific deficits in height depending on the time of exposure (3,19) ( Figure 2). For instance, several longitudinal studies have reported that the progressive deficits in stature in elite pre-and peri-pubertal female gymnasts were due predominantly to a greater increase in the deficit in trunk length (not leg length) (3,18). These results could be easily interpreted as normal late maturationparticularly when apparent in gymnasts who continued to train. ...
Today, elite young gymnasts undertake training programs of progressive volume and intensity from an early age. For example, talented young female gymnasts often commence training at age 5 or 6 and train more than 20 to 30 hours per week year-round throughout childhood and adolescence. Despite the "normal" short stature of top-level gymnasts and the obvious health benefits of physical activity during growth, there is concern that elite level or those gymnasts involved in heavy training regimens may be at risk for adverse effects on growth and maturation. This concern has been the source of much debate in the literature and is complicated by the difficulties in distinguishing between the genetic predisposition to short stature and late or delayed maturation, and the effect of environmental factors such as nutrition and exercise that may influence growth and maturation. The effect of gymnastics training on growth and maturation is often reported as averaged data: an approach that does not identify individual growth patterns. Finding no difference between groups is not proof that there is "in fact" no difference. Accepting the null hypothesis without the appropriate critical review of both the methodological and statistical power to detect differences is a flawed endeavor. We believe there is compelling "circumstantial" evidence to build a case that preparation for advanced gymnastics competition may place some children and youth at risk of reduced growth and delayed maturation.<br /
... Reports in the literature describe the weekly training volumes of young prepubertal and/or early pubertal artistic gymnasts to be as long as 36 h/week [25] . It is not surprising, therefore, that some authors have described elite female gymnasts as being at risk of delayed maturation [23,26,27] . Growth potential has been found to be reduced and menarche has been reported to be delayed in artistic gymnasts [4,8,26] . ...
... Longitudinal data for female gymnasts that span late childhood and adolescence are limited. Results of two short-term longitudinal studies have suggested that gymnasts advance through puberty with a less intense pubertal growth spurt [26,27] . Other studies have suggested that this delay is not attributable to the gymnastics training per se, but rather to genetic factors or to caloric intake which is inadequate to meet the energy demands of both growth and physical training [28,29] . ...
Die in den letzten Jahrzehnten beobachtete Entwicklung, dass Kinder bereits in jungen Jahren verstärkt Leistungssport betreiben, hat Bedenken hinsichtlich der möglichen Auswirkungen des Leistungssports auf das Wachstum und die körperliche Reifung dieser Kinder hervorgerufen. Kennzeichnend für die Pubertät beim Menschen sind starke hormonelle Veränderungen, die sowohl zur körperlichen als auch zur sexuellen Reifung führen. Da Leistungssport vor der Pubertät in Kombination mit den möglichen metabolischen Folgen einer Ernährungsrestriktion die Funktion des Hypothalamus-Hypophysen-Systems verändern kann, hat man die Vermutung geäussert, dass es für die Verzögerung der Menarche und der sexuellen Reifung bei Sportlerinnen u.a. entscheidend ist, in welchem Alter diese mit dem Leistungssport beginnen. Andererseits behaupten einige Studien, eine verzögerte Menarche sei eher auf genetische Faktoren zurückzuführen. Mädchen, bei denen die körperliche Reifung später einsetzt, wählen häufig eine Sportart, bei der sich ein kleiner oder sehr schlanker Körperbau als vorteilhaft erweist, oder werden von Trainern für eine solche Sportart angeworben. Die Körperzusammensetzung wurde auch als Erklärung für die bei Spitzensportlerinnen beobachtete Verzögerung der Menarche und Menstruationsstörungen herangezogen. Bei jugendlichen Sportlerinnen, die Sportarten betreiben, bei denen das Körpergewicht eine Rolle spielt, wurde über eine höhere Prävalenz von Menstruationsstörungen berichtet als bei Sportlerinnen, die in anderen Sportarten aktiv sind. Es gibt jedoch, wie vor kurzem behauptet, keinen direkten kausalen Zusammenhang zwischen Beleibtheit und Fortpflanzung, und tatsächlich werden die Fortpflanzungsfunktionen bei Frauen von der Energieverfügbarkeit und nicht vom Körperfett geregelt. Zur weiteren Untersuchung dieser Wechselwirkung zwischen kurzfristigen Schwankungen der verfügbaren Energie und der durch den Sport bedingten sekundären Amenorrhö bei jugendlichen Sportlerinnen bedarf es weiterer Forschungsbemühungen. Schlussfolgerung ist, dass angesichts der vielen Faktoren, die sich nachweislich auf die Menarche und die Menstruation auswirken, bisher noch unklar ist, welche Rolle das Sporttraining alleine als ursächlicher Faktor für eine verzögerte Pubertät und Menstruationsstörungen bei jungen Sportlerinnen spielt. Forschungsarbeiten in Form von Längsschnittstudien müssen durchgeführt werden, um festzustellen, ob die zwischen Sportlerinnen und Nichtsportlerinnen beobachteten Unterschiede in der körperlichen Reifung genetisch oder umweltbedingt sind und welches Gleichgewicht zwischen diesen beiden Faktoren herrscht.
... Few studies have been conducted to determine energy intake of gymnasts. 22,23 In these studies, mean energy intake was 1651 kcal for 7-to 10-year-old gymnasts, 1793 kcal for 11to 14-year-old gymnasts 21 and 1458 kcal for 11-year-old gymnasts. 23 An earlier study investigated 22 elite gymnasts and a control group. ...
... 22,23 In these studies, mean energy intake was 1651 kcal for 7-to 10-year-old gymnasts, 1793 kcal for 11to 14-year-old gymnasts 21 and 1458 kcal for 11-year-old gymnasts. 23 An earlier study investigated 22 elite gymnasts and a control group. Dietary energy intakes were 725 kcal lower than the control group. ...
... In the small amount of research conducted with former gymnasts, we point out B et al. 35 , who veri ed, in their study with Australian gymnasts who had been retired from training and competition for eight years, that the gymnasts presented an average height of 163.1 cm; in other words, the equivalent of the 75th percentile, which reinforces our ndings. Especially regarding the percentile of the present group studied, the former gymnasts presented heights of 156.2 cm, 159.2 cm, and 166.1 cm, in the 25th, 50th and 75th NCHS percentiles, respectively. ...
... e statement of T et al. 7 ? that more than 18 weekly training hours might possibly interfere in the potential set for height has no support from the results obtained in our study (TABLE 1), nor in the other studies 35,39 . ese authors state that they have found no evidence to prove that training would adversely a ect the height development among AG athletes. ...
Abstract The purpose of this study was to identify the potential impact of the high performance training on the anthropometric and maturational characteristics of female artistic gymnasts and to compare the adult target height with international standards of growth. A sample consisted of 23 elite Brazilian female former gymnasts was evaluated. From a historic retrospective, about 29.56 yrs. ago (average of all) they devoted themselves to the training for 9.3 (2.6) years, with a weekly 24.26 (4.2) training hours, and had been retired from competition around at 13.61 (5.12) years old. From the anthropometric data of the gymnasts (while still competing), their parents and their older sister (1) and younger sister (2), the target height was calculated by Tanner method {[(father’s height -13 cm) + mother’s height] ÷ 2}. Additionally, training history, age of menarche occurrence, and growth classifying in accordance with the international standards was recorded, aimed at comparisons. The average stature shown normal adult stature (NCHS), and some cases surpassed the standard 75th, 90th and 95th percentile. They are higher than their mother (p = 0.039), but not their sister 1 (0.952) or sister 2 (p = 0.998), but the age of menarche was significantly later only than their sisters 1 (p = 0.008) and 2 (p = 0.017). According to the Brazilian percentiles reference (IBGE), the final height of the former gymnasts was always higher of the standard, slightly smaller than their sisters 2 (5th and 10th), but was taller than their mothers and sisters 1. In conclusion, there is no evidence of artistic gymnastics high performance training having adverse effects on the final adult height.
... Reports in the literature describe the weekly training volumes of young prepubertal and/or early pubertal artistic gymnasts to be as long as 36 h/week [25] . It is not surprising, therefore, that some authors have described elite female gymnasts as being at risk of delayed maturation [23,26,27] . Growth potential has been found to be reduced and menarche has been reported to be delayed in artistic gymnasts [4,8,26] . ...
... Longitudinal data for female gymnasts that span late childhood and adolescence are limited. Results of two short-term longitudinal studies have suggested that gymnasts advance through puberty with a less intense pubertal growth spurt [26,27] . Other studies have suggested that this delay is not attributable to the gymnastics training per se, but rather to genetic factors or to caloric intake which is inadequate to meet the energy demands of both growth and physical training [28,29] . ...
... Few studies have been conducted to determine energy intake of gymnasts. 22,23 In these studies, mean energy intake was 1651 kcal for 7-to 10-year-old gymnasts, 1793 kcal for 11to 14-year-old gymnasts 21 and 1458 kcal for 11-year-old gymnasts. 23 An earlier study investigated 22 elite gymnasts and a control group. ...
... 22,23 In these studies, mean energy intake was 1651 kcal for 7-to 10-year-old gymnasts, 1793 kcal for 11to 14-year-old gymnasts 21 and 1458 kcal for 11-year-old gymnasts. 23 An earlier study investigated 22 elite gymnasts and a control group. Dietary energy intakes were 725 kcal lower than the control group. ...
Aim
The aim of the present study is to compare the energy and nutrient intake of rhythmic and artistic gymnasts with a control group that is composed of healthy non‐gymnasts.
Methods
Seventy‐seven gymnasts (29 male children and 48 female children) and a control group of age‐ and sex‐matched non‐gymnasts were included in the study. Data were collected using a questionnaire. To determine participants' energy and nutrients intake, a 24‐hour recall was administered. Participants' bodyweight and height were measured, while body mass index was assessed by z ‐scores. Mean, standard deviations and daily reference intake ratios of energy and nutrients are presented in tables according to participant's gender. The software SPSS 15.0 was used for data analysis.
Results
There was no significant difference between mean body mass index for the gymnast and control group in male children ( P > 0.05), while there was a significant statistical difference between the gymnast and control group in female children ( P < 0.05). Both male and female gymnasts had low energy intake and gained energy from fat and proteins rather than carbohydrates. Among both genders, gymnasts' intakes of vitamin E, niacin, thiamine, folate, potassium, calcium and iron intakes were inadequate.
Conclusions
This study is the first large‐sample study determining dietary intake of gymnasts in Turkey. According to the results, nutrition education should be given to gymnasts and their parents. Nutritional status should be monitored and evaluated by a dietitian.
... Size difference have also been shown between those gymnasts who persist in the sport and those who drop out (26), indicating a possible process of self-selection towards small stature (26). Most recent studies have found no evidence to suggest training causes changes in changes in adult stature variables (2,9,10,18) In our UK longitudinal study of gymnasts' growth we found that during adolescence, from 9 to 16 years of age, both boys and girls had average heights below the 50th centile for the UK population. The differences were most pronounced around the average age of peak height velocity ( PHV), 12 in girls and 14 in boys. ...
... In contrast, the late maturing gymnast will have increases and maintenance of growth velocities well above that expected for their chronological age. We contend that studies indicating short stature due to differences in segmental growth during puberty (2,8) are difficult to interpret if the tempo and timing of growth is proceeding at different rates within individuals. More clarification is also required in the definition and use of the term 'catch-up' growth, which infers delayed growth. ...
Concern over possible growth inhibition effects of competitive sports has been and continues to be a source of much debate in the scientific literature (3,7,10,21). This is not a new debate. At the beginning of the twentieth century studies in boys, suggested both a stimulatory influence on statural growth and also the potential for negative influences (15). More recently, concerns with regard to potential harmful effects of training on growth have centered on girls, specifically, growth in female gymnasts (21). The concerns now being expressed relate to reports that intensive physical training in gymnasts, whose training is initiated at young ages, may delay subsequent growth and maturation, and perhaps even reduce final adult stature. We maintain that no viable evidence is available to support the contention that sports training adversely effect growth. We disagree with those who argue that so called ‘catch-up’ growth observed after reduced or cessation of training provides compelling evidence that growth is affected (7). However, before discussing the evidence for and against this argument, it should be pointed out that one common element often overlooked is the natural variations in timing and tempo of maturity status observed within a normal healthy population. To understand fully the studies that are about to be discussed one has to first have a clear understanding of the growth process itself.
... Reports in the literature describe the weekly training volumes of young prepubertal and/or early pubertal artistic gymnasts to be as long as 36 h/week [25] . It is not surprising, therefore, that some authors have described elite female gymnasts as being at risk of delayed maturation [23,26,27] . Growth potential has been found to be reduced and menarche has been reported to be delayed in artistic gymnasts [4,8,26] . ...
... Longitudinal data for female gymnasts that span late childhood and adolescence are limited. Results of two short-term longitudinal studies have suggested that gymnasts advance through puberty with a less intense pubertal growth spurt [26,27] . Other studies have suggested that this delay is not attributable to the gymnastics training per se, but rather to genetic factors or to caloric intake which is inadequate to meet the energy demands of both growth and physical training [28,29] . ...
The increasing involvement of young children in intense physical training over the past several decades has generated concerns as to its potential effects on children's growth and maturation. Puberty in humans is characterized by large hormonal changes resulting in both physical and sexual maturation. Since intense training prior to puberty, together with the potential metabolic effects of dieting, can alter hypothalamic-pituitary function, the time at which athletic training is initiated has been implicated as a factor in delayed menarche and sexual maturation in female athletes. On the other hand, some studies have suggested that delayed menarche is likely due to genetic factors. Girls who mature later often self-select or are recruited by coaches into sports that favor small or very lean bodies. Body composition has also been used to explain both delayed menarche and menstrual irregularities observed among elite athletes. A higher prevalence of menstrual dysfunction has been reported for adolescent athletes participating in weight-dependent sports as compared to that observed in other sports. However, as recently suggested, there is no direct cause-effect association between fatness and reproduction and, in actual fact, energy availability, and not body fat, regulates reproductive function in females. More research is warranted to further investigate this interaction between short-term changes in fuel availability and athletic amenorrhea in female adolescents. It is concluded that, given the many factors that have been shown to influence menarche and menstruation, the role played by physical training alone as a causative factor in the later onset of puberty and menstrual irregularities in active young females is still unclear. Research involving longitudinally designed studies is required to identify whether the maturity differences observed between female athletes and non-athletes are the result of nature or nurture, and what the balance between the two factors is.
... However, there is no scientific basis for the very popular belief that certain sports can alter an individual's ultimate height, just as basketball training increases height and gymnastics decreases it. The choice of these sports depends on the individual's biotype, and thus, taller people are more likely to succeed in playing basketball, while shorter people are more likely to practice and succeed in gymnastics (Bass et al., 2000). The fact that children acquire the habit of exercise at a young age is more important than anything else for their future lives. ...
... Serum leptin has been proposed to be responsible for this association, as their serum levels gradually rise prior to puberty in adolescents, suggesting a threshold effect (62,63). Nevertheless, a serum leptin spike has been reported in shorter or thinner children without any sudden weight gain, questioning this biological marker and the need for more studies in alternative hallmarks (64,65). ...
Background:
The timing of growth is a key factor for correct orthodontic treatment planning. Cervical vertebrae maturation (CVM) is no exception, although the reported chronological ages vary in the literature.
Objective:
We aimed to estimate the average chronological age for each Baccetti's CVM staging.
Search methods:
Search on MEDLINE-PubMed, Scopus, LILACS, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL) was conducted until July 2021. The review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Selection criteria:
Observational or interventional studies reporting chronological age classified through Baccetti's CVM method were included.
Data collection and analysis:
Methodological quality was assessed, and pooled estimates were carried out through random-effects meta-analysis of single means. The impact of sex and continent were also investigated through subgroup analyses.
Results:
Forty-one studies were included (9867 participants, 4151 men, and 5716 women). The average chronological age was 9.7 years old (95% confidence interval [CI]: 9.4 to 10.1) in CS1, 10.8 years old (95% CI: 10.5 to 11.1) in CS2, 12.0 years old (95% CI: 11.7 to 12.2) in CS3, 13.4 years old (95% CI: 13.2 to 13.6) in CS4, 14.7 years old (95% CI: 14.4 to 15.1) in CS5, and 15.8 years old (95% CI: 15.3 to 16.3) in CS6. A significant difference was found between the sexes in all CVM stages. We also found significant differences across continents.
Conclusions:
For each CVM staging a chronological age range was successfully estimated. Girls presented an earlier skeletal maturation compared to boys. The skeletal maturation differs also according to continents, except for CMV stage 1, pointing to the need for personalized ranges according to each region.
Registration:
Registration number: PROSPERO: CRD42021225422.
... Physical growth is related to the overall stature change during adolescence. This is due to increased length and strength of weight bearing long bones and spine [26,27] which are reflected in leg length and sitting height respectively [28]. So, in the present study stature, leg length and sitting height were used as assessment criteria. ...
Background
Yogasana improves both mental and physical health. There is sparse systematic research on the growth of yogasana practising adolescents.
Objectives
This study aims to assess the differential skeletal growth pattern among pre-adolescent and adolescent girls as a result of yoga practice.
Methods
A cross-sectional anthropometric study was conducted on stature (height), sitting height and leg length of 757 school-going girls (4-15 years old), divided in two groups, Yoga Group (YG) (n=380) and age matched Control Group (CG) (n=377) participants participating in recreational games other than yoga. Descriptive and inferential statistical analyses were applied. Unpaired t-test was performed for assessment of level of significance and Pearson's correlation (r) test was performed to to identify the association between growth pattern of stature and leg length at specific ages.
Results
The physical growth showed an ascending trend in both Yoga group (YG)² participants and control group (CG)³ . At the onset of adolescence (10–12 years) the mean stature and leg length of YG participants were retarded (p < 0.05). Sitting height in YG was significantly (p < 0.05) low only in 10-year-olds. The similar trends were observed in stature and leg length in YG participants at 10 years (5th and 10th percentile) and 12 years (90th and 95th percentile). There was strong positive relationship between stature and leg length of YG participants (10 years, r = 0.86, p < 0.01; 11 years, r = 0.86, p < 0.01; 12 years, r = 0.72, p < 0.01). The stunted growth in YG participants during adolescence may be related to retarded growth of leg length.
Conclusions
Intense yogasana practice with greater skeletal stress possibly hinders stature in adolescent girls from 10 to 12 years. This may compromise with the natural growth pattern, necessitating special care during yoga training among adolescents while selecting the type, intensity and duration of yogasanas practice.
... Boy kısalığının genetik yatkınlık ve gecikmiş olgunlaşmadan kaynaklandığı ayırımındaki güçlükler ile beslenme, çevresel faktörler gibi büyüme ve olgunlaşmayı etkileyebilecek diğer unsurlar arasında karmaşa vardır (Caine, Bass ve Daly, 2003). Ancak birkaç prospektif çalışmada, elit düzeyde cimnastik antrenmanları ve buna eşlik eden düşük enerjili diyetler, bazı genç kadın cimnastikçilerin büyüme ve olgunlaşma zamanlamasını ve temposunu değiştirebileceği bildirilmiştir (Daly, Caine, Bass ve ark, 2005;Bass, Bradney, Pearce, 2000;Lindholm, Hagenfeldt ve Ringertz 1994;Theintz, Howald, Weiss ve ark, 1993). Elit kadın cimnastikçiler 5 veya 6 yaşından itibaren, özellikle ergenlik döneminde, haftada 20-30 saate kadar varan antrenman yüküne maruz kalırlar (Caine, Bass ve Daly, 2003). ...
Artistik cimnastik erken yaşta özelleşmeyi gerektiren estetik sporlar arasında yer almaktadır. Cimnastiğin doğası gereği erken çocukluk döneminden itibaren yapılan mekanik yüklenmeler tüm dünyada yaygın bir uygulamadır. Ancak kadın ve erkek cimnastikçileher ne kadar benzer antrenman yüküne maruz kalsalar da antrenman yoğunluğu ve algılanan zorlanma düzeyi cinsiyete göre farklılık göstermektedir. Bu farklılıklar cimnastikçilerin biyolojik büyüme ve olgunlaşma sürecini etkileyip etkilemediğine dair tartışmalar yaratmıştır. Bu nedenle bu derlemenin amacı, özellikle artistik cimnastik antrenmanlarının büyüme ve olgunlaşma üzerine olası etkilerine dair mevcut araştırmaları özetleyerek olası faktörleri belirlemektedir.Materyal & Metot:Bu derleme araştırılırken PubMed, Google Scholar ve Elsevier veri tabanı kullanıldı. Anahtar kelimeler “artistik cimnastik” “cimnastik” “büyüme” “gelişme” “olgunlaşma” “kadın cimnastikçiler” erkek cimnastikçiler” “ergen cimnastikçiler” “ağırlık antrenmanı” “ergenlik ve cimnastik” “cimnastik ve boy uzunluğu” “cimnastikçilerde hormonal düzenleme” “cimnastik ve diyet” “kadın cimnastiği ve menarş” “cimnastik ve iskelet sistemi” terimlerinin varyasyonları kombine olarak yazılarak, toplam 75bilimsel makale incelendi. Sonuç:Yapılan incelemelerin sonuçlarına dayanarak cimnastik antrenmanlarının cimnastikçilerde büyümeyi ve olgunlaşmayı etkilediğine dair kesin bir kanıt olmadığı sonucuna varıldı.
... Boy kısalığının genetik yatkınlık ve gecikmiş olgunlaşmadan kaynaklandığı ayırımındaki güçlükler ile beslenme, çevresel faktörler gibi büyüme ve olgunlaşmayı etkileyebilecek diğer unsurlar arasında karmaşa vardır (Caine, Bass ve Daly, 2003). Ancak birkaç prospektif çalışmada, elit düzeyde cimnastik antrenmanları ve buna eşlik eden düşük enerjili diyetler, bazı genç kadın cimnastikçilerin büyüme ve olgunlaşma zamanlamasını ve temposunu değiştirebileceği bildirilmiştir (Daly, Caine, Bass ve ark, 2005;Bass, Bradney, Pearce, 2000;Lindholm, Hagenfeldt ve Ringertz 1994;Theintz, Howald, Weiss ve ark, 1993). Elit kadın cimnastikçiler 5 veya 6 yaşından itibaren, özellikle ergenlik döneminde, haftada 20-30 saate kadar varan antrenman yüküne maruz kalırlar (Caine, Bass ve Daly, 2003). ...
Purpose: Artistic Gymnastics is among the aesthetic sports that require specialization at an early age. Due to the nature of gymnastics, mechanical loading from early childhood is a common practice all over the world. However, although female and male gymnasts are exposed to similar training load, training intensity and rating of perceived exertion differ by gender. These differences have created debate as to whether gymnasts influence the process of biological growth and maturation. Therefore, the purpose of this review is to summarize existing research on the possible effects of artistic gymnastics training on growth and maturation, in particular, and identify possible factors. Material & Method: PubMed, Google Scholar and Elsevier databases were used to investigate this review article. "Artistic gymnastics" "gymnastics" "growth" "development" "maturation" "female gymnasts" male gymnasts" "adolescent gymnasts "adolescence and gymnastics" "gymnastics and height " "hormonal regulation in gymnasts " "combining variations of the terms “gymnastics and diet”, "female gymnast and menarche" "gymnastics and skeletal system" has been written with the combination of the variations of the terms as keywords and a total of 75 scientific articles were reviewed. Result: According to the results of the research, it was concluded that there is no conclusive evidence that gymnastics training affects
growth and maturation in gymnasts.
... It is widely recognized that elite gymnasts follow intense training routines from a young age, specifically, 7-to 18-year-old girls may be subjected to training loads of as high as 21-37 h a week for 11-12 months a year [2,3]. Growing numbers of authors are expressing concerns that intense training from an early age is responsible for delays in the growth, maturation, and body composition of young female athletes in general and elite gymnasts in particular, as they tend to have started gymnastics very young (5 to 6 years old) [4,5] and continue or intensify their training throughout childhood and adolescence [6,7]. ...
The aim of this study was to analyze dietary intake and body composition in a group of elite-level competitive rhythmic gymnasts from Spain. We undertook body composition and nutritional analysis of 30 elite gymnasts, divided into two groups by age: pre-teen (9–12 years) (n = 17) and teen (13–18 years) (n = 13). Measures of height, weight, and bioimpedance were used to calculate body mass index and percent body fat. Energy and nutrient intakes were assessed based on 7-day food records. The two groups had similar percentages of total body fat (pre-teen: 13.99 ± 3.83% vs. teen: 14.33 ± 5.57%; p > 0.05). The energy availability values for pre-teens were above the recommended values (>40 kcal/FFM/day) 69.38 ± 14.47 kcal/FFM/day, while those for the teens were much lower (34.7 ± 7.5 kcal/FFM/day). The distribution of the daily energy intake across the macronutrients indicates that both groups ingested less than the recommended level of carbohydrates and more than the recommended level of fat. Very low intakes of calcium and vitamin D among other micronutrients were also noted. The main finding is that teenage gymnasts do not consume as much energy as they need each day, which explains their weight and development. Moreover, they are at a high risk of developing low energy availability that could negatively impact their performance and future health.
... Bass et al., em estudo com 125 ginastas olímpicos e 154 controles, observaram que a prática desse esporte era mais procurada por atletas que tinham o comprimento da perna menor e a sua prática não influenciava a estatura final após a puberdade. 38 Um outro estudo 39 acompanhou por 18 meses adolescentes pré--púberes e púberes, atletas do sexo masculino que faziam ginástica de alto impacto e não atletas que não faziam exercícios físicos de forma regular. A estatura dos atletas da ginástica, na avaliação inicial, era inferior à dos não atletas, embora estivessem no mesmo estágio de desenvolvimento puberal (Tanner). ...
Objective
To describe the current scientific knowledge on the effects of physical exercise on the growth of children and adolescents since intrauterine life.
Source of data
A search was carried out in the Medline, Embase, Scielo, and Cochrane databases of studies published from 1990 to 2018. The authors included studies with different designs: clinical trials, cohort, cross‐sectional and review studies.
Synthesis of data
Studies that addressed the subject of physical exercise or physical activity, and weight–height growth or bone or muscle tissue growth were identified. These studies were analyzed, classified, and presented by age group: fetuses, preterm newborns, preschoolers, schoolchildren, and adolescents. It was observed that almost all studies indicated the safety of physical exercises, of mild to moderate intensity, for pregnant women, as well as children and adolescents, including both aerobic and anaerobic exercises. The retrieve studies did not demonstrate that the practice of physical exercises or certain sports, especially basketball and floor gymnastics, influenced the linear growth of children or adolescents. Some studies showed an increase in bone and muscle tissue growth in child and adolescent athletes.
Conclusions
Despite the small number of studies with adequate methodology, especially randomized clinical trials, evidence appears to indicate that physical exercise is safe for both the pregnant woman and the child, from fetal life to adolescence. Physical exercise does not appear to impair the child's linear growth and contributes to the ideal shaping of bone and muscle tissues, ensuring possible beneficial effects throughout life.
... However, the fact that gymnasts are small can't all be credited to self-selection (Tanner et al., 1983;Moss, 2016). A study published (Bass et al., 2000) found that, while the sport does draw women who are short and have delayed bone age (means that your skeletal maturation is lagging behind your actual age), gymnastics training can have some impact on growth. ...
SUMMARY: Success in artistic gymnastics certainly depends on the morphological characteristics of the athletes, some of which are basic body height and weight. The aim of this study is to determine whether there is a statistically significant difference in body
height and weight between the male and female participants on the Olympic Games from 1996 to 2016. The following variables were chosen: body weight (kg), body height (cm). The results did show significant differences between women's artistic gymnastics in body weight and height over a 20-year period. In men's artistic gymnastics we didn't find the difference. This research is important in setting comparative parameters in the selection process and sport specialization regarding morphological characteristics according to different events of gymnasts at the elite level.
... In contrast, anthropometric characteristics and body image perception were significantly different between RG and C. In particular, RG were leaner and a little less tall than C, in line with their allegedly slower development and growth and with the demands of the discipline (32,33). ...
Background: Although the positive effects of sports on body image perception are well described in the literature, rhythmic gymnasts
have been reported to be at greater risk of developing body dissatisfaction and possibly eating disorders. The reason is that
athletes engaged in aesthetic sports may be subject to greater pressure to be thin in order to adhere to the norms of that sport.
Objectives: The aim of the present study was to evaluate body image perception and body composition in a sample of premenarcheal
rhythmic gymnasts and to assess the influence of sport practice.
Methods: A cross sectional study was carried out on a total sample of 135 girls: 64 were preadolescent rhythmic gymnasts (10.1 � 1.8 years) divided into competitive and non-competitive athletes, while the other 71 schoolgirls (11.4 � 0.3 years) were included as a control group. Anthropometric traits were directly collected, and BMI and body composition parameters were calculated. Body image perception and body image satisfaction were evaluated through body image indexes. Data were analyzed using ANCOVA adjusted for age and multiple linear regression analysis.
Results: Anthropometric traits andbody composition parameters varied significantly between gymnastsandcontrols andbetween
competitive and non-competitive subgroups, especially when adiposity indicators were compared. In general, rhythmic gymnasts
showed a perception of their body consistent with their anthropometric characteristics and low body dissatisfaction, with competitive girls choosing a thinner silhouette as their ideal. A new index, FIDSPORT, developed by us as a simple measure of what gymnastsmbelieve is the ideal gymnast figure compared to their actual figure, reported higher dissatisfaction between their perceived body and the body considered ideal for their sport. Moreover, rhythmic gymnasts showed a desire for a skinnier body than the control
group. Practice of rhythmic gymnastics and BMI were negatively correlated with general ideal figure.
Conclusions: All participants wanted to be thinner, but the ideal body image of gymnasts was thinner than that of schoolgirls. In
addition, as a result of body satisfaction transiency, the ideal gymnast body image showed even lower values than the general ideal
body image. This trend was well quantified by the FIDSport when compared to the FID(Feel-minus-Ideal-Discrepancy).
... Bass et al., em estudo com 125 ginastas olímpicos e 154 controles, observaram que a prática desse esporte era mais procurada por atletas que tinham o comprimento da perna menor e a sua prática não influenciava a estatura final após a puberdade. 38 Um outro estudo 39 acompanhou por 18 meses adolescentes pré--púberes e púberes, atletas do sexo masculino que faziam ginástica de alto impacto e não atletas que não faziam exercícios físicos de forma regular. A estatura dos atletas da ginástica, na avaliação inicial, era inferior à dos não atletas, embora estivessem no mesmo estágio de desenvolvimento puberal (Tanner). ...
Objective:
To describe the current scientific knowledge on the effects of physical exercise on the growth of children and adolescents since intrauterine life.
Source of data:
A search was carried out in the Medline, Embase, Scielo, and Cochrane databases of studies published from 1990 to 2018. The authors included studies with different designs: clinical trials, cohort, cross-sectional and review studies.
Synthesis of data:
Studies that addressed the subject of physical exercise or physical activity, and weight-height growth or bone or muscle tissue growth were identified. These studies were analyzed, classified, and presented by age group: fetuses, preterm newborns, preschoolers, schoolchildren, and adolescents. It was observed that almost all studies indicated the safety of physical exercises, of mild to moderate intensity, for pregnant women, as well as children and adolescents, including both aerobic and anaerobic exercises. The retrieve studies did not demonstrate that the practice of physical exercises or certain sports, especially basketball and floor gymnastics, influenced the linear growth of children or adolescents. Some studies showed an increase in bone and muscle tissue growth in child and adolescent athletes.
Conclusions:
Despite the small number of studies with adequate methodology, especially randomized clinical trials, evidence appears to indicate that physical exercise is safe for both the pregnant woman and the child, from fetal life to adolescence. Physical exercise does not appear to impair the child's linear growth and contributes to the ideal shaping of bone and muscle tissues, ensuring possible beneficial effects throughout life.
... Sport-specific growth characteristics of athletes have been acknowledged, with female artistic gymnasts characterised as having low height, low mass, broad shoulders and narrow hips (Ackland, Elliott, & Richards, 2003;Bass et al., 2000;Caine, Bass, & Daly, 2003;Claessens, Lefevre, Beunen, & Malina, 2006;Georgopoulos et al., 2002Georgopoulos et al., , 2012Siatras, Skaperda, & Mameletzi, 2009). With training commencing at ages as young as four years (Laing et al., 2005), engagement in physically demanding and highly repetitive training throughout the period of growth is common practice within the sport of gymnastics. ...
Female gymnasts have been evidenced to experience sport-specific growth, of which broad shoulders and narrow hips are common characteristics. In addition to being a central component of handstand performance, postural control mechanisms, including whole-body and lumbo-pelvic stability, have been identified as risk factors for overuse spinal pathology. The study aimed to develop a fundamental understanding of musculoskeletal growth and postural control responses of female artistic gymnasts in order to extend longitudinal insights into overuse spinal pathology risk. Whole-body anthropometric measures were collected for 12 competitive female gymnasts (age at recruitment: nine to 15 years) at three time points across a 12 month period. Musculoskeletal growth was partially defined as the rate of bicristal-to-biacromial breadth ratio development, and informed shoulder- and pelvis-dominant growth sub-groups. Kinematic and kinetic indicators of postural control were determined for a total of 700 handstand trials. The shoulder-dominant (gymnastics-specific) growth group was found to have significantly greater biomechanical risk for general stability (p < 0.001) than the pelvis-dominant group. Significantly greater lumbo-pelvic risk was demonstrated for the pelvis-dominant group (p < 0.001). Extended idiosyncratic examination of proportional sport-specific growth measures alongside multi-faceted risk monitoring was advocated for the effective development of future overuse pathology prevention protocols.
... However, the fact that gymnasts are small can't all be credited to self-selection (Tanner et al., 1983;Moss, 2016). A study published (Bass et al., 2000) in the Journal of Pediatrics found that, while the sport does draw women who are short and have delayed bone age (delayed bone age means that your skeletal maturation is lagging behind your actual age), gymnastics training can have some impact on growth. Atiković et al. (2017) show also in the last 15 years, there has been identified linear and second-order polynomialregression increase in the age structure of participants in MAG and WAG in the largest world competitions. ...
Purpose. Success in sports certainly depends on the morphological characteristics of the athletes, some of which are basic body height and weight, which are evaluated with respect to the current age of athletes. The aim of this study is to determine whether there is a statistically significant difference in the body height and weight between the disciplines of the male and female participants on the Olympic Games 2016 in Rio de Janeiro, Brazil. Basic procedures. The sample included all the Olympic Athletes in Rio de Janeiro 2016, (191
athletes; WAG, n = 97 and MAG, n = 94). The following variables were chosen: body weight (kg), body height (cm). Main findings. The results not showed significant differences between six apparatus in men's artistic gymnastics and four in womens artistic gymnastics in body height and weight. In the Olympic Games 2016, women are on average shorter than men for 12.34 cm and weight less for 14.75 kg. Correlations between body height and weight amounts to (MAG: R=.712; p < 0.01) and (WAG: R=.755; p < 0.01). Conclusions. This research is important in setting comparative parameters in the selection process and sport specialization regarding morphological characteristics according to different events of gymnasts in the elite level.
... This was probably the case with the OG2008 and the OG2012 after which 'new' competitors entered the game. If it is known that female gymnasts' biological maturation comes later compared to the average population (Malina, 1994;Malina, 1998;Bass et al., 2000;Courtei, Jaffre, Obert, & Benhamou, 2001;Baxter-Jones, Thompson, & Malina, 2002;Bass, Daly, & Cane, 2002;Caine, Bass, & Daly, 2003;Baxter-Jones, Maffulli, & Mirwald, 2003;Daly, Caine, Bass, Pieter, & Broekhoff, 2005;Erlandson, Sherar, Mirwald, Maffulli, & Baxter-Jones, 2008), and, accordingly, their biological maturity characterized by the stability of the motor programs (Arkaiev & Suchilin, 2009), it is possible that a number of 'new' female seniors was not biologically mature. Younger gymnasts, particularly those who have not yet gone through puberty, tend to be lighter and smaller (Claessens et al., 1991(Claessens et al., , 2006, more pliable and flexible, have better strength-to-weight ratio than older gymnasts. ...
Vault is an apparatus that slightly differs from other in women’s artistic gymnastics in the way of judging, duration of performance, but also in the requirements for certain biomotor abilities of the competitors. Accordingly, the question of number of competitors in the Vault Qualifications arises. Of all the major competitions in the period from 2008 to 2015 only at the competitions that were Individual All-Around Finals and Individual Event Finals (WC2009 and WC2013) a high percentage of Vault Qualifiers (WC2009 = 81.03%; WC2013 = 90.90%) has been identified. At other competitions (OG2008, WC2010, WC2011, QOG2012, OG2012, WC2014, WC2015) only approximately 20% of the elite competitors competed Vault Qualifications. Furthermore, due to identification of the impact of Competitor type (Vault Qualifiers or All-Around competitors), Competition (OG2008, WC2009, WC2010, WC2011, QOG2012, OG2012, WC2013, WC2014, WC2015) and their interaction with vaults Difficulty Scores, Execution Scores and Total Scores between-between 2*9 factorial ANOVA was applied. Finally, it was concluded that biomotor skills and competitors’ selected tactics probably generated the obtained significant differences. The results should be guidelines in planning and programming of training sessions for female elite competitors who aspire towards the Vault Finals.
... However, among living humans, an individual's genetically-determined growth trajectory can be modified substantially by the redirection of energy from growth to more essential functions, eliciting major delays [100, 103-104, 117, 119-120, 123-124]. One of the most powerful sources of growth impairment is the simultaneous effect of childhood malnutrition and infection [125], while the combination of high-impact loading and inadequate energy intake can also have lasting influences on growth and body size [126][127][128][129][130]. The developmental canalization of growth is such that catch-up growth may occur following less severe or prolonged stress, either through a markedly accelerated rate of growth or by the extension of the growth period [2,103,119,[131][132][133]. ...
Early life conditions play an important role in determining adult body size. In particular, childhood
malnutrition and disease can elicit growth delays and affect adult body size if severe
or prolonged enough. In the earliest stages of farming, skeletal growth impairment and
small adult body size are often documented relative to hunter-gatherer groups, though this
pattern is regionally variable. In Central/Southeast Europe, it is unclear how early life stress,
growth history, and adult body size were impacted by the introduction of agriculture and
ensuing long-term demographic, social, and behavioral change. The current study
assesses this impact through the reconstruction and analysis of mean stature, body mass,
limb proportion indices, and sexual dimorphism among 407 skeletally mature men and
women from foraging and farming populations spanning the Late Mesolithic through Early
Medieval periods in Central/Southeast Europe (~7100 calBC to 850 AD). Results document
significantly reduced mean stature, body mass, and crural index in Neolithic agriculturalists
relative both to Late Mesolithic hunter-gatherer-fishers and to later farming populations.
This indication of relative growth impairment in the Neolithic, particularly among women, is
supported by existing evidence of high developmental stress, intensive physical activity,
and variable access to animal protein in these early agricultural populations. Among subsequent
agriculturalists, temporal increases in mean stature, body mass, and crural index
were more pronounced among Central European women, driving declines in the magnitude
of sexual dimorphism through time. Overall, results suggest that the transition to agriculture
in Central/Southeast Europe was challenging for early farming populations, but was followed
by gradual amelioration across thousands of years, particularly among Central European
women. This sex difference may be indicative, in part, of greater temporal variation in
the social status afforded to young girls, in their access to resources during growth, and/or
in their health status than was experienced by men.
... Para muitos atletas a ingestão de energia e nutrientes pode ser insuficiente para satisfazer as necessidades de um crescimento e maturação normal, assim como do exercício intenso (28) . Frequentemente a alimentação de ginastas de elite é nutricionalmente densa e equilibrada, mas pode ser insuficiente em termos energéticos (29,30) . ...
... Ou seja, jogar basquete não acelera o crescimento e praticar ginástica olímpica não retarda o ganho estatural (24) . Vários trabalhos com ginastas de ambos os sexos não indicaram efeitos negativos sobre a altura (14,(25)(26)(27) . Damsgaard et al concluíram que, embora nadadores sejam mais altos que ginastas, tal diferença se deve apenas a fatores constitucionais que favorecem e direcionam a escolha do esporte (28) . ...
OBJETIVO: Apresentar revisão atualizada e crítica sobre o impacto do esporte e da atividade física no crescimento, desenvolvimento puberal e mineralização óssea de crianças e adolescentes. FONTES DE DADOS: Pesquisa bibliográfica nos bancos de dados Medline e Lilacs (1987-2007), selecionando os artigos escritos em inglês, português ou espanhol, a partir dos descritores "esportes" e "exercícios", em combinação com "crescimento", "puberdade" e "mineralização óssea". Foram examinados 252 artigos e 48 deles selecionados. SÍNTESE DOS DADOS: Diferentes modalidades esportivas não aumentam ou diminuem a estatura. Ocorre um viés de seleção, no qual fatores constitucionais determinam a seleção de biótipos privilegiados para determinados esportes. O exercício físico leve a moderado estimula o crescimento e deve ser incentivado. A atividade física extenuante, principalmente quando associada à restrição dietética, afeta o crescimento, o desenvolvimento puberal, a função reprodutiva e a mineralização óssea. A musculação praticada por jovens pré-púberes pode ser prejudicial, se não for realizada sob supervisão, já que há um potencial risco de lesão na cartilagem de crescimento. Entretanto, quando bem supervisionada, pode levar a um aumento de força e resistência muscular. CONCLUSÕES: Os efeitos deletérios dos esportes sobre o crescimento e desenvolvimento só foram observados em atletas de elite submetidos a treinamento intensivo e restrição alimentar. Alterações hormonais e de citocinas inflamatórias são parte da fisiopatologia desse processo. É necessário que estudos longitudinais avaliem as repercussões da atividade física recreacional sobre a estatura final.
... Alcuni autori hanno osservato, durante periodi di riduzione dell'allenamento (Lindholm et al., 1994;Leglise, 1998;Olympic Gymnastics Controversy, 1996) o nei mesi successivi al ritiro delle ginnaste dall'attività (Bass, 2000;Bass et al., 2000;Costantini, 1997;Costantini et al., 1997;Tveit-Milligan et al., 1993) un aumento della velocità di crescita, fornendo ulteriori evidenze di come l'accrescimento potrebbe essere influenzato dall'allenamento. ...
Introduction. Several studies have shown that high-intensity artistic gymnastics training combined with low-calorie intake, could alter the normal growth patterns and maturation of gymnasts. However, it has not been yet demonstrated a cause-effect relationship between the high artistic gymnastics training workout and the alteration of growth.
Objective. The purpose of this study was to assess the influence of artistic gymnastics training on growth patterns in young gymnasts of two different competition level.
Materials and Methods. Twenty-six competitive gymnasts (age ranged 7-14 years) of Sardinia Regional Team (n=10, intermediate level) and of Youth National Italian Team (n=16, elite level) were examined. For all the athletes 21 anthropometric measures were assessed up to 2 times across 12 months.
Results. A significantly higher proportion (x2=1.53, P>0.05) of National gymnasts showed short stature when compared with Regional gymnasts (47.7%, n=7 vs 20.1%, n=2, respectively). The 38.4% (n=10) of the entire sample of gymnasts (n=26) showed a body weight below the fifth percentile (National, n=9; 56.25% vs Regional, n=2; 10%) (x2=5.56, P<0.05). Significant difference (x2=5.10, P<0.005) in the distribution of the growth rate reduction (growth velocity less than 4.50 cm / year), was found between National gymnasts (75%, n=12 ) and Regional gymnasts (30%, n=3).
Conclusions. The high frequency of growth alteration in both gymnasts' groups, particularly in National gymnasts, suggested that prolonged participation in artistic gymnastics training and competition could alter the normal growth pattern in some gymnasts, but not all, regardless of their level of competition.
... Athletes that participate in competitive rhythmic gymnastics are exposed to high levels of physical and psychological stress due to the many hours of training (Georgopoulos et al., 2002;Law, Côté, & Ericsson, 2008). Several studies report that intense training at an early age can cause delays in the physical growth, maturation and body composition of young female athletes (Georgopoulos et al., 2001(Georgopoulos et al., , 2002, particularly in the case of elite gymnasts, whose training begins at 5-6 years of age (Bass et al., 2000) and continues throughout childhood and adolescence (Caine, Lewis, O'Connor, Howe, & Bass, 2001;Georgopoulos et al., 1999Georgopoulos et al., , 2012Law et al., 2008). ...
Abstract The aim was to analyse the physical growth and body composition of rhythmic gymnastics athletes relative to their level of somatic maturation. This was a cross-sectional study of 136 athletes on 23 teams from Brazil. Mass, standing height and sitting height were measured. Fat-free and fat masses, body fat percentages and ages of the predicted peak height velocity (PHV) were calculated. The z scores for mass were negative during all ages according to both WHO and Brazilian references, and that for standing height were also negative for all ages according to WHO reference but only until 12 years old according to Brazilian reference. The mean age of the predicted PHV was 12.1 years. The mean mass, standing and sitting heights, body fat percentage, fat-free mass and fat mass increased significantly until 4 to 5 years after the age of the PHV. Menarche was reached in only 26% of these athletes and mean age was 13.2 years. The mass was below the national reference standards, and the standing height was below only for the international reference, but they also had late recovery of mass and standing height during puberty. In conclusion, these athletes had a potential to gain mass and standing height several years after PHV, indicating late maturation.
... Nas fases púbere e pós-púbere, o ∑SKF e o %GC foram menores nas atletas. Os resultados desse estudo estão de acordo com os relatos de Muller et al., 26 27 Uma alteração característica é o aumento da taxa metabólica ou do dispêndio energético após o período de exercício, que vai repercutir diretamente na diminuição do percentual de gordura corporal. 28 A mobilização de ácidos graxos dos adipócitos e a corporal de meninas atletas de natação e comparados com seus pares não-atletas. ...
OBJECTIVES: to describe body composition alteration patterns (body weight, height, body mass index - BMI), percentage of body fat and skinfold thickness, and to compare menarche's age of athletes and non-athletes. METHODS: we evaluated 165 girls (aged 9 to 17 years old) non-athletes and athletes of swimmers grouped according to maturational groups (pre-puberty, puberty e post-puberty). The anthropometric variables followed standardized rules. The percentage of body fat was estimated by an equation validated for the studied population. The age of menarche was established through the record method. RESULTS: there was no difference between groups in the pre-puberty stage. In the puberty stage, the athletes showed lower triciptal skinfold mean values (athletes = 15.5 + 15.3; non-athletes = 20.1 + 7.0, p < 0.05), and subscapular (athletes = 14.7 + 5.1 e non-athletes = 20.6 + 10.3, p < 0.05), percentage of body fat (athletes = 25.2 + 5.9 e non- athletes = 28.4 6.0, p < 0.05), and the fat mass (athletes = 8.7 + 3.5 and non-athletes = 9.8 + 3.7, p < 0.05). These results remained in the post-puberty stage. Menarche occurred later in the athlete group (athletes = 12,0 + 1,04 e non-athletes = 11,2 + 1,37, p < 0.05). CONCLUSIONS: in athletes, some changes in body composition seem to take place, particularly the amount of body fat which could be associated with late menarche.
Eine langfristige allgemein-athletische Leistungsentwicklung sollte sowohl unter präventiven als auch unter sportlichen Aspekten fest in den Nachwuchsleistungssportsystemen verankert sein. Dieser Artikel gibt einen Überblick über diese Thematik sowie Einblicke in die praktische Umsetzung im Rahmen des Berliner Landeskaderprojekts. Um negativen Entwicklungen entgegenzuwirken, werden häufige Vorurteile gegen Athletik- und Krafttraining im Kindes- und Jugendalter entkräftet.
Recent studies reported an impact of the melanocortin 3 receptor (MC3R) on the regulation of body weight, linear growth and puberty timing. Previously, allele p.44Ile of a frequent non-synonymous variant (NSV) p.Val44Ile was reported to be associated with decreased lean body mass (LBM) and later puberty in both sexes. We Sanger sequenced the coding region of MC3R in 185 children or adolescents with short normal stature (SNS) or 258 individuals with severe obesity, and 192 healthy-lean individuals. Eleven variants (six NSVs) were identified. In-silico analyses ensued. Three rare loss-of-function (LoF) variants (p.Phe45Ser, p.Arg220Ser and p.Ile298Ser) were only found in severely obese individuals. One novel highly conserved NSV (p.Ala214Val), predicted to increase protein stability, was detected in a single lean female. In the individuals with SNS, we observed deviation from Hardy–Weinberg Equilibrium (HWE) (p = 0.012) for p.Val44Ile (MAF = 11.62%). Homozygous p.44Ile carriers with SNS had an increased BMI, but this effect did not remain significant after Bonferroni correction. In line with previous findings, the detected LoF NSVs may suggest that dysfunction in MC3R is associated with decreased body height, obesity and delayed puberty.
Physical activity, including active play and sports participation, is essential for the health and wellbeing of children and adolescents. To date, an abundance of research, albeit from higher income countries, has studied various aspects of physical activity and sports participation in the growing child. The aims of these studies include refining the measurement of physical, identifying its outcomes (e.g. physical and/or mental health, cognition), and determinants (with a particular focus on those that are modifiable), and the development and testing of interventions and policies to positively promote and sustain levels of activity. While many in field understand that a child is not a miniature adult and there has been ample research documenting age related changes in physical activity and its correlates. Comparatively few studies have, however, examined how the process of growth and biological maturation impact physical activity behaviors. Research considering the impact of growth and maturation on physical activity in youth is largely exclusive to sports, with particular emphasis upon the selection and performance in elite youth sport and the impact that intensive athletic training may have on young female athletes participating in esthetic sports, such as gymnastics and figure skating. This book chapter summarizes these topics of physical activity in young people, including some lines of evidence supporting the bidirectional association between growth, biological maturation and physical activity and key emerging directions in research and practice.
A combination of long training hours and a bias toward a prepubescent physique in gymnasts often equates to insufficient caloric intake and an increased incidence of delayed pubertal growth and development. This chapter examines normal pubertal development, explores the normal and pathologic divergences from this path experienced by many gymnasts, and outlines nutritional requirements to sustain healthy growth and development for a gymnast. This chapter also discusses energy needs, macronutrient requirements, vitamin essentials, and consequences of insufficient intake.
Les recommandations internationales préconisent la pratique d'au moins une heure d'activité physique quotidienne chez les jeunes enfants (moins de 6 ans), et de limiter leur comportement sédentaire. Les études qui valident les bienfaits d'une telle pratique pour la santé sont nombreuses. La balance bénéfice-risque apparait largement favorable dès le plus jeune âge, même au-delà de ces recommandations, bien qu'il manque de grandes études à ce sujet. Nous présentons une étude interventionnelle cas/témoin randomisée, sur 50 enfants âgés de 2 à 5 ans, d une zone à dominante rurale, suivi 9 mois en 2005/2006. Elle évalue une méthode pédagogique de sensibilisation familiale à l'activité physique globale des jeunes enfants, dans la pratique de la médecine générale. Le jugement se fait par l'évolution du temps de pratique des jeux extérieurs, de celui passé devant les supports télévisuels, et la modification des perceptions et des habitus en faveur de nos recommandations. Les résultats ne permettent pas de valider notre méthode d'intervention, l'évolution observée n'est pas significative sur un effectif restreint. Néanmoins nous démontrons que nous obtenons des effets positifs avec une consultation de médecine générale centrée sur le sujet, notamment par des inscriptions en activités structurées. Dans cette population les déterminants des pratiques ont été mieux appréciés, ainsi que les principales difficultés. Les paramètres socioprofessionnels ont identifiés les familles indifférentes à ce type de promotion. Une telle action de pédagogie familiale par le médecin généraliste devrait s'inscrire dans une stratégie globale qui puisse les sensibiliser.
Over the past decade, there has been a surge in the number of sports opportunities available to young athletes. Although physicians, parents, and coaches should promote healthy activity and participation, intense training at a young age can predispose exuberant young athletes to certain difficulties. Elite young athletes are at risk for overuse and growth plate injuries in certain sports. Intense training combined with inadequate nutrition may cause growth delay in elite young athletes, but this delay does not appear to affect permanent adult height. Weight training, when done properly, is safe and effective for prepubescent and pubescent athletes. Awareness of neurobehavioral development can help guide the process for appropriate sports participation. Young athletes should be closely monitored for signs of excessive physical and emotional stress so that sports participation can be fun and rewarding.
The Game Sense approach (Australian Sports Commission, 1996) was proposed in the mid-1990’s as a game-based approach different to the dominant transmission pedagogy and practice style instruction. This ambitious approach to coaching/teaching sought to enhance sport participation and retention by aligning practice sessions/lessons with the reasons young people like sport and games– to be able to play. It now forms the pedagogical basis of the Australian Sports Commission Playing for Life Philosophy and programs like Sporting Schools (ASC, 2016). The player-centred narrative of the Game Sense approach has provided a serious challenge to the sport-as-sport techniques (Kirk, 2010) ‘drill and test’ mode of sport pedagogy. However, the Game Sense approach is sometimes perceived by teachers to imply a diminished role of the teacher/coach as facilitator. In this paper I propose an expanded explanation of the Game Sense approach equation based on the explanations of ‘game intelligence’ provided by den Duyn (1997), Maho (1974) and Hopper (2003). I argue that the game-centred/teacher-centred polarisation presented in scholarly work about game-based approaches like Game Sense can lead practitioners to a false premise of implicit teaching realized as “the game as teacher”. In this conceptual paper, I present the case that the Game Sense approach is explicit and deliberate teaching in the form of guided participation. The act of teaching becomes the tasks of clearly articulating learning intentions and the associated forms of ‘doing’ that promote the learning of these intentions. This paper will use the concept of ‘understanding by design’ to inform the theory into practice demonstration of sport and games teaching as explicit, strongly guided and deliberate. In the context of game based pedagogies like the Game Sense approach this means intentional learning design creating play with purpose in a flexible and adaptive way to meet the learning needs of students and players.
Junge Leistungssportler absolvieren heutzutage bereits von frühester Kindheit an ein körperlich anstrengendes Trainingsprogramm. Dieses intensive Training (Volumen und Intensität) hat einen gesteigerten Energieverbrauch zur Folge, den es durch eine höhere Nahrungsaufnahme auszugleichen gilt. Balletttänzer(innen), Eiskunstläufer(innen), Turner(innen) und rhythmische Sportgymnastinnen trainieren ab einem Alter von 5–6 Jahren, und zwar meist mehr als 20–30 Stunden pro Woche. In diesen Sportdisziplinen sowie in Sportarten mit Gewichtsklassen (Ringen, Judo, Boxen bzw. bei Jockeys) entscheiden sich die jungen Spitzensportler bewusst für eine Beschränkung der Nahrungsaufnahme, um sich ihren schlanken, vorpubertären Körperbau zu erhalten bzw. zum sogenannten «Gewichtmachen». Kinder im Wachstum müssen unbedingt ausreichend Energie und Mikronährstoffe aufnehmen, und eine Beschränkung der Kalorien- und Flüssigkeitszufuhr könnte bei trainierenden Kindern und Jugendlichen die Regulierung des Stoffwechsels und des Hormonhaushalts stören und sich somit auf das Wachstum, die Entwicklung und Körperzusammensetzung, den Menstruationszyklus und die Reproduktionsfähigkeit auswirken und das Risiko für Verletzungen, wie z.B. Ermüdungsbrüche, erhöhen. Ferner können diese Strategien, insbesondere bei heranwachsenden Mädchen, Essstörungen (z.B. Anorexie bzw. Bulimia nervosa) verursachen, das Körperbild und die Selbstwahrnehmung beeinflussen und zur Entstehung sozialer und emotionaler Fehlanpassungen führen.
La creciente participación de niños pequeños en el entrenamiento físico intensivo, durante las últimas décadas, ha generado temores con respecto a sus efectos potenciales sobre el crecimiento y la maduración de los niños. La pubertad en el humano se caracteriza por cambios hormonales considerables, que resultan tanto en maduración física como en maduración sexual. Dado que un entrenamiento intensivo antes de la pubertad, junto a los efectos metabólicos potenciales del seguimiento de una dieta, puede alterar la función hipotalámica e hipofisaria, el momento en que se inicia el entrenamiento atlético ha sido implicado como un factor en el retraso de la menarquia y la maduración sexual en atletas femeninas. Por otra parte, en algunos estudios se ha dejado entrever la probabilidad de que el retraso de la menarquia puede deberse a factores genéticos. Las niñas que maduran más tardíamente, a menudo se autoseleccionan o son reclutadas por preparadores para deportes que favorecen cuerpos de tamaños reducidos o muy delgados. También se ha utilizado la composición corporal para explicar el retraso de la menarquia y las irregularidades menstruales que se observan en atletas de elite. Se ha descrito una mayor prevalencia de disfunción menstrual en atletas adolescentes que participan en deportes dependientes del peso, en comparación con lo que se observa en otros deportes. No obstante, tal como se ha dejado entrever recientemente, no existe una relación directa entre causa y efecto entre la obesidad y la reproducción y, en realidad, la función reproductora en las mujeres está regulada por la disponibilidad energética y no por la grasa corporal. Está justificado intensificar la investigación para indagar adicionalmente esta interacción entre los cambios a corto plazo en la disponibilidad de los combustibles y la amenorrea atlética en adolescentes femeninas. Se llega a la conclusión de que, teniendo en cuenta los numerosos factores que, según se ha comprobado, influyen sobre la menarquia y la menstruación, el papel desempeñado por el mero entrenamiento físico como factor causal del inicio más tardío de la pubertad y de las irregularidades menstruales en niñas físicamente activas sigue siendo dudoso. Es imprescindible una investigación basada en estudios diseñados longitudinalmente para identificar si las diferencias en la maduración, observadas entre atletas femeninas y niñas que no practican actividades atléticas, son el resultado de la naturaleza o la nutrición, y cuál es el equilibrio entre ambos factores.
Ces dernières décennies, la participation croissante de jeunes enfants à un entraînement physique intensif a été à l’origine de préoccupations quant aux effets potentiels de cette situation sur la croissance et la maturation. La puberté se caractérise chez l’être humain par d’importantes modifications hormonales responsables de la maturation physique et sexuelle. Un entraînement intensif avant la puberté, ainsi que les effets métaboliques potentiels du régime alimentaire adopté, peuvent altérer la fonction hypothalamo-hypophysaire, et le moment auquel l’entraînement athlétique débute a été impliqué à titre de facteur de retard de la ménarche et de la maturation sexuelle chez les sportives. D’autre part, certaines études ont suggéré qu’un retard de la ménarche est probablement dû à des facteurs génétiques. Les jeunes filles qui sont matures plus tardivement sélectionnent souvent elles-mêmes des sports qui favorisent une petite taille ou une grande minceur, ou sont recrutées par les entraîneurs pour ceux-ci. La composition corporelle a été également utilisée afin d’expliquer simultanément le retard de la ménarche et les irrégularités menstruelles observées chez les sportives de haut niveau. Une prévalence plus élevée des dysfonctions menstruelles a été décrite chez des adolescentes pratiquant des sports dépendant du poids, comparativement à celle observée avec d’autres activités sportives. Toutefois, comme récemment suggéré, il n’existe aucune relation directe de cause à effet entre la corpulence et la reproduction et, de fait, c’est la disponibilité de l’énergie, et non les tissus adipeux, qui régule la fonction reproductive chez la femme. Des recherches supplémentaires sont justifiées afin de mieux explorer cette interaction entre les modifications à court terme de la disponibilité de l’énergie et l’aménorrhée due au sport chez l’adolescente. Nous concluons que, en raison des nombreux facteurs influençant de façon avérée la ménarche et la menstruation, le rôle du seul entraînement physique à titre de facteur causal d’un retard pubertaire et d’irrégularités menstruelles chez les jeunes femmes sportives est encore mal défini. Des recherches comportant des études longitudinales sont nécessaires afin de déterminer si les différences de maturité observées entre des jeunes femmes sportives ou non résultent de la nature ou de la nutrition, et quel est l’équilibre entre ces deux facteurs.
Gender bias against girls in nineteenth-century England has received much interest but establishing its existence has proved difficult. We utilise data on heights of 16,402 children working in northern textile factories in 1837 to examine whether gender bias was evident. Current interpretations argue against any difference. Here our comparisons with modern height standards reveal greater deprivation for girls than for boys. Discrimination is measured in girls' height-for-age score (HAZ) falling eight standard errors below boys' at ages 11, 11.5 and 12 years of age, capturing the very poor performance of factory girls. But this result cannot be taken at face value. We query whether modern standards require adjustment to account for the later timing of puberty in historical populations and develop an alternative. We also test the validity of the age data, considering whether parents were more prone to lie about the ages of their daughters, and question whether the supply of girls was fundamentally different from that of boys. We conclude that neither proposition is justified. Disadvantage to girls remains, although its absence amongst younger children precludes an indictment of culturally founded gender bias. The height data must remain mute on the source of this discrimination but we utilise additional information to examine some hypotheses: occupational sorting, differential susceptibility to disease, poorer nutrition for girls, disproportionate stunting from the effects of nutritional deprivation, and type and amount of work undertaken. Of these we suggest that girls had to do arduous physical labour in the home alongside their factory work. The only (unsubstantiated) alternative is that girls were more likely than boys to be put into factory work below the legal age limit. Both represent forms of gender bias.
Growth is one of the most important indicators of children’s health. Medical practitioners use specially designed charts for growth assessment. Stunting is diagnosed when the height of a child deviates by more than –2 standard deviations from the average of children’s height within the same age and gender category. Approximately 3% of children’s population has substantial delay in growth due to different reasons. The reason can involve either endocrine or non-endocrine disorders. The important reason for stunting could be growth hormone deficiency, which is characterized by more prominent clinical manifestation of short stature. It constitutes about 8-9% of all children with short stature. Currently, it is believed that the growth hormone deficiency is associated with multiple disorders. Typically, those are fat excess, specifically in abdominal localization; muscle mass reduction; reduction of bone mineral density; physical tolerance; increased cholesterol levels and frequency of premature atherosclerosis development. It has been known that cardiovascular morbidity and mortality in hypopituitarism are 2-3 times higher than in general population. It is important to verify the suitability of accepted standards for anthropometric assessments in each region as the ethnical peculiarities can play a role and data can deviate. Summarizing the data in our observation, it was found that 3.3% of children had height lesser than –2 standard deviation scores. The obtained data from 1,500 school-aged children in Yerevan confirms the validity of applying the current method for anthropometrical assessment of children in Armenia.
Pediatric bone research has opened a Pandora's box to reveal skeletal deficits in myriad chronic disorders. Not surprisingly, bone mineral accrual is compromised in the face of risk factors such as malnutrition, immobilization, glucocorticoid therapy, and other endocrinopathies. The list of disorders linked with early osteopenia is likely to expand and will encompass seemingly healthy youth. Children and adolescents screened because of forearm fractures have significantly lower bone density at all skeletal sites than those who have not broken a bone. Further investigation of these youth may help to identify key risk factors for early bone fragility in children without chronic disease. To date, research on acquisitional osteopenia has been largely descriptive, cross-sectional, and limited to small cohorts of patients. In many cases, dual energy X-ray absorptiometry results have not been corrected for all confounding factors such as bone size and skeletal or pubertal delay. Without longitudinal data, little is known about the natural history of childhood osteopenias. Despite recent progress, further studies are needed to develop effective treatment strategies for pediatric osteopenias. Larger cohorts must be studied longitudinally to define the natural history of childhood osteopenias and the reversibility of bone mineral deficits with general measures such as improved nutrition, increased activity, and correction of endocrine deficits or excesses.
This article addresses the problem of whether high-impact artistic gymnastics training could cause delayed growth in young male and female athletes, as is believed to be the case in professional dancers. The main anthropometric characteristics of young gymnasts were measured, and the differences between gymnasts, swimmers, and nonathletes were examined. Twenty competitive gymnasts, 20 competitive swimmers, and 20 nonathletes, aged 10 to 12 yrs old, volunteered to participate in this study. Testing took place in a training field and the equipment consisted of portable anthropometric instruments. Measurements concerned body mass, stature, segment lengths (arm, forearm, trunk, thigh, and calf), body breadths (biacromical, biiliac, wrist, and ankle), circumferences (arm and thigh), and skinfold thicknesses (arm, thigh, and calf). Triceps and calf skinfold thicknesses were used to estimate the body fat percentage (%BF). The lean body mass percentage (%LBM) and the LBM/BF ratio were also evaluated. Moreover, cross-sectional areas of the arm (CSAarm) and thigh (CSAthigh) were calculated, taking into consideration the limb's circumference and four circumferential skinfolds. The results showed that, generally, young male and female gymnasts had smaller body dimensions in some anthropometric characteristics compared to swimmers and nonathletes. This mainly focused on body weight, arm and calf lengths, biiliac/biacromial breadths ratio, skinfold thicknesses, and %BF. However, gymnasts had higher %LBM, LBM/BF ratio, and CSAarm. No significant differences were found in the rest of body dimensions and composition. Although young male and female gymnasts appeared to have some lower anthropometric characteristics compared to the other two groups, it has not clearly demonstrated a delay in their somatic growth and skeletal development.
The growing years may be the most opportune time in life for exercise to result in large increases in bone density, enough to reduce the risk of fracture late in life. However, it is not known if there is an ‘optimal’ time during growth when the skeleton is most responsive to exercise. Comparing the osteotrophic response to exercise between pre- and peripubertal children is complex because: (i) the development of the skeleton within each stage of puberty is characterised by differing temporal patterns of growth in bone size and mass; (ii) the hormonal regulation of the skeleton is unique to each stage of puberty; and (iii) it is difficult to equate the relative mechanical load placed on the prepubertal compared with the pubertal skeleton. There are sound biological bases for the hypotheses being proposed for both the pre- and peripubertal years being the time when the skeleton is most responsive to exercise; that is, exercise may enhance bone formation in a synergistic fashion in the presence of growth hormone (prepubertal years) or sex steroids (peripubertal years). The paucity of data and the complex methodology make it difficult to draw conclusions as to the most opportune time during growth when exercise may lead to the greatest osteotrophic response. The limited data available support the notion that the prepubertal years may be the most opportune time, due to increases in bone density and periosteal expansion of cortical bone.
Recommendations for the improvement of safety and health of athletes who may suffer concussive injuries
In November 2001, the first International Symposium on Concussion in Sport was held in Vienna, Austria. This symposium was organised by the International Ice Hockey Federation (IIHF), the Federation Internationale de Football Association Medical Assessment and Research Centre (FIFA, F-MARC), and the International Olympic Committee Medical Commission (IOC).
The aim of the symposium was to provide recommendations for the improvement of safety and health of athletes who suffer concussive injuries in ice hockey, football (soccer), and other sports. To this end a range of experts were invited to address specific issues of epidemiology, basic and clinical science, grading systems, cognitive assessment, new research methods, protective equipment, management, prevention, and long term outcome, and to discuss a unitary model for understanding concussive injury. At the conclusion of the conference, a small group of experts were given a mandate by the conference delegates and organising bodies to draft a document describing the agreement position reached by those in attendance at that meeting. For the purpose of this paper, this group will be called the Concussion in Sport Group (CISG).
This review seeks to summarise the findings of the Vienna conference and to provide a working document that will be widely applicable to sport related concussion. This document is developed for use by doctors, therapists, health professionals, coaches, and other people involved in the care of injured athletes, whether at the recreational, elite, or professional level.
During the course of the symposium, a persuasive argument was made that a comprehensive systematic approach to concussion would be of potential benefit to aid the injured athlete and direct management decisions.1 This protocol represents a work in progress, and, as with all other guidelines or proposals, it must undergo revision …
Long lasting intensive physical exercise leads to growth retardation. Short-limbed girls are selected for the training as gymnasts. In a preliminary study with 9 gymnasts a significant decrease of the IGF-I concentration was found after intensive 3-day exercise. This experiment was repeated with 16 girls (11.7 +/- 0.8 years old). The higher the initial DHEA-S and E2 concentration of the gymnasts, the higher were the IGF-I basal levels. The intensive training resulted in the following changes (basal after exercise): IGF-I: 247 +/- 86-->188 +/- 77 ng/ml, T3: 2.4 +/- 0.4-->2.1 +/- 0.3 nmol/l, T4: 96 +/- 15-->98 +/- 19 nmol/l, DHEA-S: 930 +/- 636-->1018 +/- 701 nmol/l, testosterone: 1.5 +/- 0.3-->1.9 +/- 0.4 nmol/l, cortisol: 824 +/- 272-->799 +/- 219 nmol/l. During the 3-day intensive training, the parallel decrease of IGF-I and T3 concentrations in each sportswomen is particularly impressive. Apart from the sequelae of 'negative' selection, the low T3-syndrome, the anti-insulin effect of high GH secretion and the elevated cortisol concentration are responsible for the growth depression, retardation in bone age and the higher incidence of skeletal problems in these gymnasts with 'exercise-induced' delay in development.
To determine in female tennis and squash players the effect of biological age (that is, the starting age of playing relative to the age at menarche) at which tennis or squash playing was started on the difference in bone mineral content between the playing and non-playing arms.
Cross-sectional study.
Finnish tennis and squash federations.
105 female Finnish national-level players and 50 healthy female controls.
Differences in bone mineral content in playing and nonplaying (dominant to nondominant) arms (proximal humerus, humeral shaft, radial shaft, and distal radius) were compared in the players and controls and among six groups of players. Players were divided into groups according to the biological age (years before or after menarche) at which their playing careers began: more than 5 years before; 3 to 5 years before; 2 to 0 years before; 1 to 5 years after; 6 to 15 years after; and more than 15 years after.
Compared with controls (whose mean +/- SD differences in bone mineral content were 4.6% +/- 4.6%, 3.2% +/- 2.3%, 3.2% +/- 3.8%, and 3.9% +/- 4.3% at the previously noted anatomical sites), the players had a significantly (P < 0.001) larger side-to-side difference in every measured site (15.5% +/- 8.4%, 16.2% +/- 9.8%, 8.5% +/- 6.6, and 12.5% +/- 7.1%). Among players, the group differences in bone mineral content were significant (P < 0.001 to P = 0.005), with the group means clearly decreasing with increasing starting biological age of playing. The difference was two to four times greater in the players who had started their playing careers before or at menarche (lowest mean difference in bone mineral content, 10.5% +/- 7.2%; highest difference, 23.5% +/- 7.2%) than in those who started more than 15 years after menarche (lowest difference, 2.4% +/- 4.8%; highest difference, 9.6% +/- 4.9%). Adjustment for potential confounding factors (age and height) did not change these trends.
Bones of the playing extremity clearly benefit from active tennis and squash training, which increases their mineral mass. The benefit of playing is about two times greater if females start playing at or before menarche rather than after it. The minimal level and minimum number of years of activity necessary to produce these results, the extent to which this benefit is sustained after cessation of intensive training, and the degree to which these results can be extended to other forms of physical activity and other bone sites should be studied further.
Twenty-two female teenagers engaged in elite gymnast training were prospectively studied during a five-year period and their pubertal development was recorded. Height and weight, as well as stage of development according to Tanner, were registered every six months. FSH, LH, TSH and prolactin were measured in girls who had not yet had their first menstrual period. Twenty-two healthy school girls in the same age group who were not actively engaged in physical exercise served as a control group. Pubertal development was completed during the observation period in all the gymnasts but one, who had primary amenorrhea at the age of eighteen. As a group, the gymnasts had a significantly delayed age of menarche compared to the control group and to normal Swedish girls. They also had significantly less body fat and were shorter and lighter than the control group. They grew much more slowly and did not have the distinct growth spurt seen in the controls. The final height of six of the gymnasts was less than the expected height. The frequency of injuries was high in the gymnasts, which might be a result of hard training combined with late menarche and low body fat.
To determine whether premenopausal daughters of women with postmenopausal osteoporosis have lower bone mass than other women of the same age, we measured the bone mineral content of the lumbar spine and femoral neck and midshaft, using dual-photon absorptiometry, in 25 postmenopausal women with osteoporotic compression fractures and in 32 of their premenopausal daughters; we then compared the results with those in normal controls. As compared with normal postmenopausal women, women with osteoporosis had lower bone mineral content in the lumbar spine, femoral neck, and femoral midshaft by 33, 24, and 15 percent, respectively (P less than 0.001 for each comparison by the one-tailed t-test). As compared with normal premenopausal women, the daughters of women with osteoporosis had lower bone mineral content at these sites by 7, 5, and 3 percent, respectively (P = 0.03, 0.07, and 0.15, respectively, by the one-tailed t-test). In terms of a standardized score, we calculated that the mean (+/- SEM) relative deficits in bone mineral content in the daughters of women with osteoporosis were 58 +/- 18 percent (lumbar spine) and 34 +/- 16 percent (femoral neck) of the relative deficits in their mothers. We conclude that daughters of women with osteoporosis have reduced bone mass in the lumbar spine and perhaps in the femoral neck; this reduction in bone mass may put them at increased risk for fractures. We also conclude that postmenopausal osteoporosis may result partly from a relatively low peak bone mass rather than from excessive loss of bone.
The aim of this investigation was to retrospectively evaluate growth patterns of different groups of gymnasts as compared to schoolgirls and girl swimmers from 1 until 11 years of age.
The gymnastic groups (recreative, young talented, and older talented gymnasts) were smaller than the groups of girl swimmers and schoolgirls already from a young age on. The differences in body height between the groups of sports participants and schoolgirls in the prepubertal period appeared to be mainly based on the genetic growth regulation and seemed to be largely dependent in the gymnastic groups on inheritance of the mothers' height.
Significant differences existed in weight as percentage of normal weight for height between the gymnasts and the swimmers. No relations existed between the standard deviation scores, weight percentage, and socioeconomic status. Contrary to general belief, there was no evidence that physical activity from a young age on directly influences growth until puberty.
Retrospective ages at menarche were obtained from 109 university athletes and their mothers, and from 77 sisters of the athletes. The athletes were participants in seven sports. Mean age (+/- SD) at menarche of the 109 athletes was identical with that of the total sample of 338 athletes from which they were drawn, 13.8 +/- 1.5 years. Mean age at menarche in the mothers was 13.4 +/- 1.7 years. When mothers were grouped as having been athletes (n = 52) or non-athletes (n = 57), menarcheal ages were, respectively, 13.7 +/- 1.8 years and 13.2 +/- 1.5 years. The mother-daughter correlation for age at menarche was 0.25. Corresponding correlations between athletes and mothers who were athletes and between athletes and mothers who were not athletes were 0.24 and 0.22, respectively. Ages at menarche in athletes who had sisters (n = 62) and their sisters (n = 77) were 14.0 +/- 1.4 and 13.6 +/- 1.6 years, respectively. The intraclass sister-sister correlation was 0.44. Familial resemblance in age at menarche in athletes, their mothers and sisters, is identical with that in the general population, and suggests that later menarche commonly observed in athletes is to a large extent familial.
The goal of this prospective study was to assess whether intensive physical training during puberty could alter the growth potential of adolescent female athletes. Height, sitting height, leg length, weight, body fat, and pubertal stage of 22 gymnasts aged 12.3 ± 0.2 years (mean ± SEM), with an average training period of 22 hr/wk, and of 21 swimmers aged 12.3 ± 0.3 years (average training period 8 hr/wk) were recorded half-yearly for a mean period of 2.35 years (range 2.0 to 3.7 years). Adult height predictions were performed with the methods of Bayley and Pinneau; Roche, Wainer, and Thissen, and Tanner et al. Growth velocity of gymnasts was significantly lower than that of swimmers from 11 to 13 years of bone age (p < 0.05), with a mean peak height velocity of 5.48 ± 0.32 cm/yr versus 8.0 ± 0.50 cm/yr for swimmers. Height standard deviation score decreased significantly in gymnasts with time (r = -0.747; p < 0.001). This observation was not associated with a significant alteration of chronologic age/bone age ratio. By contrast, height standard deviation score remained unchanged in swimmers (r = -0.165, p = 0.1). A marked stunting of leg-length growth was observed in gymnasts from 12 years of bone age, resulting in a marked difference in overall sitting-height/leg-length ratio (gymnasts 1.054 ± 0.005 vs swimmers 1.100 ± 0.005; p < 0.001). Concomitantly, predicted height of gymnasts decreased significantly with time (Tanner et al.: r = 0.63, p < 0.001; Bayley-Pinneau: r = 0.44, p < 0.001), whereas those of swimmers did not change. We conclude that heavy training in gymnastics (>18 hr/wk), starting before puberty and maintained throughout puberty, can alter growth rate to such an extent that full adult height will not be reached. The mechanisms underlying these observations are not settled; we suggest that prolonged inhibition of the hypothalamic-pituitary-gonadal axis by exercise, together with or because of the metabolic effects of dieting, is responsible for them.
Various chronic diseases and malnutrition cause growth failure in childhood and adolescence; following recovery, catch-up growth may occur. The extent to which growth failure can be compensated for depends on the timing, severity and duration of the growth failure, as well as on the aetiology and pathogenesis of the disease restricting growth and development. There are three types of catch-up growth. In type 1, when growth restriction ceases, growth occurs to such an extent that the height deficit is rapidly eliminated. Once the original growth curve is attained, growth proceeds normally. In type 2, when growth restriction ceases, there is a delay in growth and somatic development. However, growth continues for longer than usual, compensating for the growth arrest. Type 3 is a mixture of types 1 and 2, and all three types may be complete or incomplete. Two factors make it difficult to record catch-up growth during adolescence: the large variability in timing, expression and duration of pubertal growth and somatic development, and the relationship between the measurement error and the increase in growth observed within a defined time period. To avoid data collection and analysis problems, prospective and long-term study design should be considered. Ideally, data collection should be started in the prepubertal period and continue until final adult height is reached. High technical standards and well-trained personnel should be used. A variety of parameters should be assessed to obtain different dimensions of the growth process and pubertal development.(ABSTRACT TRUNCATED AT 250 WORDS)
Intense physical exercise and diet restriction could result in delayed puberty and have a negative influence on the acquisition of peak bone mass during puberty. Nineteen young women who had been in elite gymnastic training during their prepubertal and pubertal years were investigated with regard to their health, menstrual data and bone mineral areal mass (BMA). Twenty-one women of comparable age served as controls. The age of menarche of the "former" gymnasts and the controls was 14.8 +/- 1.8 and 12.1 +/- 1.4 years, respectively. Fourteen of the gymnasts had been or were using oral contraceptives (OCs) and most of the non-users now had regular menstrual periods. During the years preceding the study, physical activity among the "former" gymnasts had gradually declined. Although the gymnasts had had a delayed puberty, no difference was found in total body or spinal BMA compared to the healthy controls. Their normal BMA in early adulthood could reflect a catch-up due to a combination of decreasing athletic activity, normal menstrual cycles and intake of OCs.
This cross-sectional study was done in order to ascertain whether there is a lifelong beneficial effect on bone mineral density (BMD) of early, long-lasting, and intense physical exercise. Forty-eight male ex-weight lifters, mean age 64 years (range 50-79) participated. They had followed a training program of an average of 10 hours/week (range 4-20) for an average of 13 years (range 1-34). They had all retired from competitive sport an average of 30 years (range 7-50) ago. Sixty-six age-matched volunteers served as controls. The bone mineral density (BMD, areal density, g/cm2) in the total body, spine, and hips and the fat content and lean body mass were measured with the LUNAR DPX bone mass scanner. In ex-weight lifters 50-64 years of age, the BMD was greater than in controls. After 65 years, no difference was found between the former weight lifters and their controls.
This article has no abstract; the first 100 words appear below.
Within the past five years, two U.S. female gymnasts at the Olympic level, Christy Henrich and Julissa Gomez, died from medical problems related to their sport. Christy died from complications of anorexia nervosa and Julissa from complications of spinal trauma due to a vaulting injury. In this Olympic year, it is timely to discuss the psychological and physical problems associated with competitive women's gymnastics. Women's gymnastics provides a useful framework for viewing worrisome trends in other competitive youth sports. In the United States, organized athletic programs involve at least 20 million children and adolescents each year, with more than 2 . . .
Ian R. Tofler, M.B., B.S.
Children's Hospital, New Orleans, LA 70118
Barri Katz Stryer, M.D.
University of California at Los Angeles, Los Angeles, CA 90024
Lyle J. Micheli, M.D.
Children's Hospital Medical Center, Boston, MA 02115
Lisa R. Herman, M.S.
Florida State University, Tallahassee, FL 32306
We are indebted to all those who reviewed the manuscript and made suggestions, especially P. Krener, M.D., M. Drell, M.D., D. Cantwell, M.D., O. Mammen, M.D., and R. Meadow, M.B., B.S.
The purposes of this study were to determine bone mineral density (BMD) of former female college gymnasts (FG; n = 18) and controls (FC; n = 15) by using dual-energy X-ray absorptiometry (Hologic QDR 1000W) and to examine the relationships between current and former activity levels, diet, menstrual history and BMD. Current physical activity, dietary intake, and menstrual irregularity were assessed with the use of standardized questionnaires. A study-designed questionnaire was used to assess past physical activity. The BMDs of the FG were significantly higher (P < 0.001) than the BMDs of FC for the lumbar spine, femoral neck, Ward's triangle, and whole body, even when the influences of current and past physical activity levels were statistically controlled via analysis of covariance. FG and FC did not differ in nutrient intakes, and there were no BMD differences between FG who always had regular menstrual cycles vs. those who had an interruption (> or = 3 mo) of their menstrual cycle in the past. The higher BMD in FG compared with FC suggests that past participation in college gymnastics may provide a residual effect on adult BMD.
Exercise during growth may contribute to the prevention of osteoporosis by increasing peak bone mineral density (BMD). However, exercise during puberty may be associated with primary amenorrhea and low peak BMD, while exercise after puberty may be associated with secondary amenorrhea and bone loss. As growth before puberty is relatively sex hormone independent, are the prepubertal years the time during which exercise results in higher BMD? Are any benefits retained in adulthood? We measured areal BMD (g/cm2) by dual-energy X-ray absorptiometry in 45 active prepubertal female gymnasts aged 10.4 +/- 0.3 years (mean +/- SEM), 36 retired female gymnasts aged 25.0 +/- 0.9 years, and 50 controls. The results were expressed as a standardized deviation (SD) or Z score adjusted for bone age in prepubertal gymnasts and chronological age in retired gymnasts. In the cross-sectional analyses, areal BMD in the active prepubertal gymnasts was 0.7-1.9 SD higher at the weight-bearing sites than the predicted mean in controls (p < 0.01). The Z scores increased as the duration of training increased (r = 0.32-0.48, p ranging between <0.04 and <0.002). During 12 months, the increase in areal BMD (g/cm2/year) of the total body, spine, and legs in the active prepubertal gymnasts was 30-85% greater than in prepubertal controls (all p < 0.05). In the retired gymnasts, the areal BMD was 0.5-1.5 SD higher than the predicted mean in controls at all sites, except the skull (p ranging between <0.06 and <0.0001). There was no diminution across the 20 years since retirement (mean 8 +/- 1 years), despite the lower frequency and intensity of exercise. The prepubertal years are likely to be an opportune time for exercise to increase bone density. As residual benefits are maintained into adulthood, exercise before puberty may reduce fracture risk after menopause.
Cross-sectional studies of elite athletes suggest that growth is an opportune time for exercise to increase areal bone mineral density (BMD). However, as the exercise undertaken by athletes is beyond the reach of most individuals, these studies provide little basis for making recommendations regarding the role of exercise in musculoskeletal health in the community. To determine whether moderate exercise increases bone mass, size, areal, and volumetric BMD, two socioeconomically equivalent schools were randomly allocated to be the source of an exercise group or controls. Twenty boys (mean age 10.4 years, range 8.4-11.8) allocated to 8 months of 30-minute sessions of weight-bearing physical education lessons three times weekly were compared with 20 controls matched for age, standing and sitting height, weight, and baseline areal BMD. Areal BMD, measured using dual-energy X-ray absorptiometry, increased in both groups at all sites, except at the head and arms. The increase in areal BMD in the exercise group was twice that in controls; lumbar spine (0.61 +/- 0.11 vs. 0.26 +/- 0.09%/month), legs (0.76 +/- 0.07 vs. 0.34 +/- 0.08%/month), and total body (0.32 +/- 0.04 vs. 0.17 +/- 0.06%/month) (all p < 0.05). In the exercise group, femoral midshaft cortical thickness increased by 0.97 +/- 0. 32%/month due to a 0.93 +/- 0.33%/month decrease in endocortical (medullary) diameter (both p < 0.05). There was no periosteal expansion so that volumetric BMD increased by 1.14 +/- 0.33%/month, (p < 0.05). Cortical thickness and volumetric BMD did not change in controls. Femoral midshaft section modulus increased by 2.34 +/- 2. 35 cm3 in the exercise group, and 3.04 +/- 1.14 cm3 in controls (p < 0.05). The growing skeleton is sensitive to exercise. Moderate and readily accessible weight-bearing exercise undertaken before puberty may increase femoral volumetric BMD by increasing cortical thickness. Although endocortical apposition may be a less effective means of increasing bone strength than periosteal apposition, both mechanisms will result in higher cortical thickness that is likely to offset bone fragility conferred by menopause-related and age-related endocortical bone resorption.
To the editor [letter]
- Forbes
Differing effects of moderate exercise on bone mass, size and volumetric density in pre-pubertal boys
- Bradney