Article

Bone Health and the Female Athlete Triad in Adolescent Athletes

Massachusetts General Hospital and Harvard Medical School, Boston, MA.
The Physician and sportsmedicine (Impact Factor: 1.09). 02/2011; 39(1):131-41. DOI: 10.3810/psm.2011.02.1871
Source: PubMed

ABSTRACT

Peak bone mass (PBM) is a negative predictor of osteoporosis and lifelong fracture risk. Because osteoporosis is such a prevalent disease with life-threatening consequences, it is important to try to maximize PBM. Adolescence is a critical period for bone acquisition. This article discusses some of the differences in male and female skeletal development and modifiable factors that enhance bone accrual in this age group, particularly in athletes. Hormonal influences, effects of physical activity, and nutritional contributions are included, with a focus on the adolescent athlete. Emphasis is placed on the importance of appropriate energy availability in this age group. We also review prevention and treatment strategies for the female athlete triad (ie, the inter-relationship of decreased energy availability, menstrual irregularity, and low bone density) in adolescents and athletic women. Recommendations for maximizing bone density in both male and female adolescents are discussed.

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    Full-text · Conference Paper · May 2011
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    ABSTRACT: Taekwondo is characterized as an intermittent combat sport. In accordance with the current rules (World Taekwondo Federation; WTF) the combat is composed by three 2-min rounds with 1-min interval between them. Due to its short duration, some studies suggested that the determinant actions in this sport are maintained by the anaerobic metabolism (Reilly et al., 2005; Butios and Tasika, 2007; Bouhlel et al., 2006), although the recovery period, maintained by the aerobic metabolism, is also relevant (Matsushigue et al., 2009) and its quantification would allow an estimate of energy expenditure. Thus, the purpose of this study was to quantify the oxygen consumption in simulated taekwondo combat and compare this data with the values of estimated VO2max. Ten experienced national/international level male taekwondo athletes (mean ± SD; age = 21.9±5.8 years; body mass = 67.2±8.9 kg; height = 176.2±5.3 cm) were submitted to 2 testing sessions: (a) a shuttle run test to estimate maximal oxygen uptake validated for taekwondo athletes (Cetin et al., 2005); b) a simulated combat (three 2-min rounds, with 1-min intervals), as per the current WTF rules. During this activity, carried out within official area, the following measurements were taken: heart rate and oxygen consumption (VO2). The data were analyzed using the SPSS software. The descriptive analysis involved mean and standard deviation calculations. The variables were compared using a one-way analysis of variance (ANOVA) with repeated measurements. When necessary, the Bonferroni multiple comparison test was used in order to identify possible differences between rounds. The statistical significance level used was p < 0.05. The estimated VO2max was 57.3±5.4 ml.kg-1.min-1. During the match VO2 values were: 1st round = 44.4±6.2 ml.kg-1.min-1 (79.1±14.5% VO2max); 2nd round = 52.1± 5.9 ml.kg-1.min-1 (92.3±14.8% do VO2max) and 3rd round = 53.4±5.9 ml.kg-1.min-1 (93.9±15.4% do VO2peak) Heart rate (HR) values during rounds were: 1st round 156±9 bpm; 2nd round 169±9 bpm and; 3rd round = 175±10 bpm. The peak heart rate (HRpeak) achieved during the match was: 1st round 172±7 bpm; 2nd round 183±7 bpm and; 3rd round = 189±4 bpm. The VO2 during the match differed among rounds, with lower values in the first round compared to the second and third rounds (p < 0.001 for both comparisons). No difference (p > 0.05) was identified between the second round and third rounds. The HRpeak presented differences between rounds, with lower values in the first round compared to those in the last two (p < 0.001 for both comparisons), and lower values in the second (p < 0.05) compared to those in the third round. The HRmean presented differences between rounds, with lower values in the first round compared to those in the second and third rounds (p < 0.001 for the two comparisons), and lower values in the second (p < 0.05) compared to those in the third round. The results of the present study indicate the increase of aerobic metabolism and cardiovascular demand (as an essential aspect to give support to the former) throughout the rounds, indicating the need to consider the improvement of these systems via specific training for a successful outcome in the final periods of taekwondo combat. References Bouhlel, E.; Jouini, A.; Gmada, N.; Nefzi, A.; Abadía, K. B.; Tabka, Z. Heart rate and blood lactate responses during Taekwondo training and competition. Science and Sports. v.21, p. 285-290, 2006. Butios, S.; Tasika, N. Changes in heart rate and blood lactate concentration as intensity parameters during simulated Taekwondo competition. Journal Sports Medicine Physical Fitness, Torino, v.47, p. 179-185, 2007. Cetin, C.; Karatosun, H.; Baydar M.L.; Cosarcan, K. A regression equation to predict true maximal oxygen consumption of taekwondo athletes using a field test. Saudi Medical Journal, Riyadh, v.26, n. 5, p. 848-850, 2005. Matsushigue, K.A.; Hartmann, K.; Franchini, E. Taekwondo: Physiological responses match analysis. Journal of Strength and Conditioning Research v. 23, n. 4, p. 1112 -1117, 2009. Reilly, T.; Secher, N.; Snell, P.; Williams, C. Physiology of sports: an overview. Physiology of Sports. 2005.
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    [Show abstract] [Hide abstract]
    ABSTRACT: Taekwondo is characterized as an intermittent combat sport. In accordance with the current rules (World Taekwondo Federation; WTF) the combat is composed by three 2-min rounds with 1-min interval between them. Due to its short duration, some studies suggested that the determinant actions in this sport are maintained by the anaerobic metabolism (Reilly et al., 2005; Butios and Tasika, 2007; Bouhlel et al., 2006), although the recovery period, maintained by the aerobic metabolism, is also relevant (Matsushigue et al., 2009) and its quantification would allow an estimate of energy expenditure. Thus, the purpose of this study was to quantify the oxygen consumption in simulated taekwondo combat and compare this data with the values of estimated VO2max. Ten experienced national/international level male taekwondo athletes (mean ± SD; age = 21.9±5.8 years; body mass = 67.2±8.9 kg; height = 176.2±5.3 cm) were submitted to 2 testing sessions: (a) a shuttle run test to estimate maximal oxygen uptake validated for taekwondo athletes (Cetin et al., 2005); b) a simulated combat (three 2-min rounds, with 1-min intervals), as per the current WTF rules. During this activity, carried out within official area, the following measurements were taken: heart rate and oxygen consumption (VO2). The data were analyzed using the SPSS software. The descriptive analysis involved mean and standard deviation calculations. The variables were compared using a one-way analysis of variance (ANOVA) with repeated measurements. When necessary, the Bonferroni multiple comparison test was used in order to identify possible differences between rounds. The statistical significance level used was p < 0.05. The estimated VO2max was 57.3±5.4 ml.kg-1.min-1. During the match VO2 values were: 1st round = 44.4±6.2 ml.kg-1.min-1 (79.1±14.5% VO2max); 2nd round = 52.1± 5.9 ml.kg-1.min-1 (92.3±14.8% do VO2max) and 3rd round = 53.4±5.9 ml.kg-1.min-1 (93.9±15.4% do VO2peak) Heart rate (HR) values during rounds were: 1st round 156±9 bpm; 2nd round 169±9 bpm and; 3rd round = 175±10 bpm. The peak heart rate (HRpeak) achieved during the match was: 1st round 172±7 bpm; 2nd round 183±7 bpm and; 3rd round = 189±4 bpm. The VO2 during the match differed among rounds, with lower values in the first round compared to the second and third rounds (p < 0.001 for both comparisons). No difference (p > 0.05) was identified between the second round and third rounds. The HRpeak presented differences between rounds, with lower values in the first round compared to those in the last two (p < 0.001 for both comparisons), and lower values in the second (p < 0.05) compared to those in the third round. The HRmean presented differences between rounds, with lower values in the first round compared to those in the second and third rounds (p < 0.001 for the two comparisons), and lower values in the second (p < 0.05) compared to those in the third round. The results of the present study indicate the increase of aerobic metabolism and cardiovascular demand (as an essential aspect to give support to the former) throughout the rounds, indicating the need to consider the improvement of these systems via specific training for a successful outcome in the final periods of taekwondo combat. References Bouhlel, E.; Jouini, A.; Gmada, N.; Nefzi, A.; Abadía, K. B.; Tabka, Z. Heart rate and blood lactate responses during Taekwondo training and competition. Science and Sports. v.21, p. 285-290, 2006. Butios, S.; Tasika, N. Changes in heart rate and blood lactate concentration as intensity parameters during simulated Taekwondo competition. Journal Sports Medicine Physical Fitness, Torino, v.47, p. 179-185, 2007. Cetin, C.; Karatosun, H.; Baydar M.L.; Cosarcan, K. A regression equation to predict true maximal oxygen consumption of taekwondo athletes using a field test. Saudi Medical Journal, Riyadh, v.26, n. 5, p. 848-850, 2005. Matsushigue, K.A.; Hartmann, K.; Franchini, E. Taekwondo: Physiological responses match analysis. Journal of Strength and Conditioning Research v. 23, n. 4, p. 1112 -1117, 2009. Reilly, T.; Secher, N.; Snell, P.; Williams, C. Physiology of sports: an overview. Physiology of Sports. 2005.
    Full-text · Conference Paper · May 2011
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