Lower tibial cortical BMD, bone strength observed in male runners vs. nonathletes
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ATLANTA — Male runners are more likely to have lower tibial bone mineral density and strength compared with nonathletes, according to a presenter at ENDO 2022.
In an analysis of data from a cohort of men running a mean of 43 miles per week, lower muscle mass, leptin and estrogen were associated with lower tibial failure load in runners, suggesting men with a lower energy intake have worse tibial bone strength.
“Male runners, including recreational runners, should be counseled on the importance of adequate nutrition and caloric intake to optimize hormones, body composition and bone health and to prevent bone stress injuries,” Melanie Schorr Haines, MD, assistant professor at Harvard Medical School and in the neuroendocrine unit at Massachusetts General Hospital, told Healio.
Haines and colleagues analyzed data from 15 men aged 16 to 30 years who ran at least 30 miles per week for 6 months in the past year. The cohort was compared with a control group of 16 men who performed less than 2 hours of weight-bearing exercise per week and did not participate in organized team sports. Distal tibia and radius volumetric BMD and microarchitecture were measured by high-resolution peripheral quantitative CT, estimated bone strength was measured by micro-finite element analysis, and body composition was measured by DXA. Researchers collected testosterone, estradiol and leptin levels for each participant.
The runner and control groups did not differ by age, BMI, lean mass, testosterone and estradiol levels. Mean tibial cortical BMD was lower and porosity was higher in the group of runners compared with controls (P < .01 for both). Mean tibial trabecular volumetric BMD was higher and separation was lower in runners than controls (P < .02).
Of the runners, those with a BMI of 21 kg/m2 or less had lower tibial failure load than those with a BMI greater than 21 kg/m2 (P = .007). Lower levels of muscle mass, serum leptin and estradiol were associated with lower tibial failure load in runners. No association between tibial failure load and testosterone was observed.
“We found that a subset of male runners are not fueling their bodies with enough nutrition and calories for their high level of physical activity,” Haines said. “This may escape clinical attention until consequent bone stress injuries result because their BMI is in the normal range, and they do not have the same overt sign of undernutrition as female athletes do.”
Haines said researchers plan to continue following the group of runners for 12 months to examine whether nutrition, body composition and hormones predict changes in bone density and strength.
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Haines MS, et al. PSAT-162. Presented at: ENDO annual meeting; June 11-14, 2022; Atlanta (hybrid meeting).
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