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  • Title: Sport Specialization and Low Bone Mineral Density in Female High School Distance Runners.
    Author: Rauh MJ, Tenforde AS, Barrack MT, Rosenthal MD, Nichols JF.
    Journal: J Athl Train; 2020 Dec 01; 55(12):1239-1246. PubMed ID: 33176358.
    Abstract:
    CONTEXT: Sport specialization may contribute to sport injury and menstrual dysfunction in female high school distance runners. Despite the recent growth in sport specialization, including among high school-aged runners, the association of sport specialization with bone mineral density (BMD) remains poorly described. OBJECTIVE: To evaluate whether sport specialization was associated with BMD in female high school distance runners. DESIGN: Cross-sectional study. SETTING: Six high schools. PATIENTS OR OTHER PARTICIPANTS: Sixty-four female runners (age = 15.6 ± 1.4 years) who competed in cross-country or track distance events and were not currently on birth control medication. MAIN OUTCOME MEASURE(S): Each runner completed a survey on menstrual history and sport participation. Height and weight were measured, and dual-energy x-ray absorptiometry was used to measure whole-body, spine, and hip BMD. Each runner was assigned a sport specialization status: low (participation in ≥1 nonrunning sport and distance-running sport(s) for ≤8 mo/y); moderate (participation in both distance-running sport(s) ≥9 mo/y and ≥1 nonrunning sport(s) or limited to distance-running sport(s) for ≤8 mo/y); or high (participation only in distance-running sport(s) for ≥9 mo/y). Multivariable logistic regression was performed to determine the adjusted odds ratio and 95% confidence interval for sport specialization to BMD values, adjusting for body mass index and gynecological age. RESULTS: Overall, 21.9%, 37.5%, and 40.6% of participants were high, moderate, or low sport specializers, respectively. Low BMD (spine or whole-body BMD z score < -1.0 [standardized by age and sex normative values]) was present in 23 (35.9%) runners. Compared with low sport specializers, high sport specializers were 5 times more likely (adjusted odds ratio = 5.42, 95% confidence interval = 1.3, 23.3; P = .02) to have low BMD. CONCLUSIONS: A high level of sport specialization in high school female distance runners may be associated with a heightened risk for low BMD. Further investigation of this association is warranted due to the health concerns about low BMD in adolescent female runners.
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