Bone health for performance -
This offers a challenge for a health care professional to balance rehabilitation with energy availability. Increasing training demands whilst maintaining sufficient nutritional intake. During the initial stages, the focus should be on strength and conditioning, and gradually introduce aerobic training.
It is well established that bone responds to mechanical load it is subjected to. A combination of weight bearing aerobic training, resistance training and impact activities is ideal for bone health Harding et al, Non-weight bearing sports such as cycling, provides no osteogenic stimulus and can have a negative impact on bone health, particularly in combination with LEA Keay et al, , Clear training parameters should be established with athletes to aid compliance to appropriate levels of training, for example training zones, duration and volume.
Cardiovascular training intensity and an increase in volume should only take place in the final stages of the recovery process Keay, Progressive high intensity resistance training has recently been shown to have positive outcomes on bone strength Watson et al, Recommendations in Table A suggest a supervised twice weekly strength sessions focusing on compound movements.
A good technique is vital and this type of training is considered safe even in cases of post menopausal woman with low to very low bone mass Watson et al, Multi-directional impact activity is known to provide the highest osteogenic stimulus to bone Osteoporosis Australia, Prescribing impact exercises can help maintain bone health particularly in non-weight sports like cycling Keay et al, , , but also when treating reduced bone mineral density BMD Beck et al, When prescribing moderate to high impact weight bearing activities an individualised approach and potential risk factors should be considered by using clinical assessment tools, such as the RED-S CAT, but also considering other risk factors associated with reduced BMD e.
steroids and smoking history. A dual energy X ray absorptiometry DXA scan may also be warranted to aid the prescription of impact activities. The following principles and exercise prescription is highlighted below and shown in Table B Beck et al, With the impact loading primarily being researched in post menopausal woman, risk classification is based on T score values.
Click here to view: Table B- Impact Loading Adapted from Beck et al, Progressive impact exercises of approximately 50 contacts should be completed in sets separated by rest periods.
Ideally, completing these exercises days a week, however they should not coincide on a day the athlete is running. The athlete should only progress onto the next exercise if symptom free for at least two successive sessions.
It is important to ensure that an athlete is showing improvements in biomarkers, physical and mental health, but is also conditioned enough to withstand sport, particularly following a BSI.
Useful return to play tools such as the The Relative Energy Deficiency in Sport Decision-based Return-to-Play Model adapted from Creighton et al, and the RED-S Clinical Assessment Tool Mountjoy et al, can help guide a health care professional in returning the athlete to sport.
Table C highlights an example program adapted from Warden et al, Click here to view: Table C — Graded Return to Run Program for Bone Stress Injury adapted from Warden et al, Other elements of rehabilitation that should be considered include back extension strength training, to oppose kyphotic curvature and consequently reduce vertebral fractures in the long term.
In cases with spinal osteoporosis, avoiding flexion and twisting activities is encouraged Briggs et al, A BSI is often the initial complaint to a health care professional prior to a RED-S diagnosis.
Correcting the energy deficit and recovery following a BSI may require cessation from sport, however, exercise is an important aspect in the rehabilitation process, particularly for improvements in bone health and prevention of further BSI.
It requires a careful MDT approach and monitoring of key markers in RED-S recovery. Assessment tools should be used to guide a health care professional in returning an athlete to play. Key aspects of rehabilitation should include high intensity supervised resistance training, multidirectional impact activities and weight bearing aerobic exercise.
Providing the athlete with clear training parameters, particularly for training intensity is vital. Only when the athlete is towards the final stages of recovery should high intensity aerobic training be introduced.
Interestingly, freezing food can destroy this vitamin, whereas cooking does not affect it. Nevertheless, its impact on the healthy skeleton remains controversial. They retained seven studies with cohorts of at least 50 women taking vitamin K supplements, containing μ g to 5 mg per day of vitamin K1, or 45 mg per day of vitamin K2.
The conclusion of the meta-analysis was that vitamin K supplementation is associated with improved bone density and a decreased impact of fractures. They noticed that older people with a high vitamin K intake had a higher bone mineral density BMD than those with a lower dietary intake.
The results mention an average daily intake of µg in men and µg in women, they also show that each increase of µg in this daily consumption is accompanied by an 0. A comparison between female athletes consuming large amounts of proteins 1. As a consequence, it is recommended that vegetarian athletes be carefully monitored, because with this diet, calcium, vitamin D and protein intake can be insufficient.
Indeed, several recent studies show that vegetarian athletes have a lower bone density. Acidifying food — which decreases pH — generates most organic acids methionine, cysteine. Foods with this effect include animal proteins meat, fish, chicken, seafood and eggs , cheeses and cereals.
For a few years now it has been recognized that an excessive acid intake leads to the mobilization of the bone buffer system, which regulates pH by neutralizing excessive acid. There is thus a positive correlation between a low-acid diet and a higher bone density.
Several studies conclude that adapting the diet over a long period could contribute to decreasing the risk of osteoporosis, regardless of whether physical exercise is performed.
Remember that milk puddings do not contain much calcium and are very sweet. Soy milk cannot be substituted for cow's milk. It is not recommended because it contains a high level of phytoestrogens. Expose your forearms and face to sunlight for at least 20 minutes every day.
If amenorrhea occurs, consult a doctor as soon as possible. Add the sliced fennel. Place half the sliced tomato in the centre of each piece of foil. Top with the halibut fillets. Add salt and pepper, a sprig of lemon thyme, a pinch of chilli, drizzle with olive oil and the lime juice, sprinkle with the zest.
It is also very rich in proteins. Since vitamin D promotes calcium absorption, it would be wise to add a dairy product yoghurt, fromage blanc, yoghurt drink, etc. Split the vanilla pod in two lengthwise and add to the milk.
Cook on a low heat, stirring regularly for 30 minutes. Once the rice is cooked, add 20 g of granulated sugar and the lemon zest. Pour this mixture onto the rice and stir it in with a spatula. Set aside. Cook until the caramel turns light brown.
Pour into an ovenproof dish. Because it is high in protein and carbohydrate, you can also eat it as a snack after intense exercise with a high level of muscle solicitation.
PhD, Research Department — French Institute of Sport, Expertise and Performance INSEP , Paris. Medical Department — French Institute of Sport, Expertise and Performance INSEP , Paris.
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Address : 11, avenue du Tremblay Paris France. OpenEdition is a web platform for electronic publishing and academic communication in the humanities and social sciences. Desktop version Mobile version. OpenEdition Books INSEP-Éditions Recherche Nutrition and Performance in Sport Topic 6.
Bone health. Topic 5. Muscle and tendon pains. Topic 7. Eating disorders. Nutrition and Performance in Sport Christophe Hausswirth. Chapter 2.
Nutrition, sport and health. Search inside the book. Table of contents. Cite Share. Cited by. information page reviewed by. Topic 6. Bone health Christophe Hausswirth , Amélie Fosse , Axel Heulin , Yann Le Meur , Véronique Rousseau , Eve Tiollier and École Lenôtre.
Text Author s. Full text. How do bones adapt to physical activity? Is there a difference between men and women in terms of bone growth? Is there any correlation between the sport practised and bone health or calcium intake?
Do calcium and vitamin D contribute to better bone health? Therefore, vitamin 12 deficiency leads to insufficient bone mineralization or to demineralization, and thus to poorer bone health.
What foods are good sources of calcium? What factors influence endogenous vitamin D synthesis? latitude time spent outdoors skin pigmentation age use of sun screen clothing 16 In countries located above a latitude of 40° north or below 40° south, UVB rays are not strong enough to promote endogenous vitamin D synthesis during the darker months.
How can vitamin D nutritional status be improved? Fish and other food Portion g Vitamin D amount per portion UI Salmon 75 — Halibut, trout, herring 75 — Tuna 75 Egg 75 52 Milk and substitutes Portion ml Vitamin D amount per portion UI Natural milk Powdered milk Is vitamin K important for bone health?
Do proteins have an effect on bones? Can food acidity have an impact on bone health? Practical applications 1. Maintain your calcium intake Sources of calcium Main and secondary sources Remember that milk puddings do not contain much calcium and are very sweet.
To reduce loss of calcium 2. Expose your forearms and face to sunlight for at least 20 minutes every day 3. Maintain an adequate protein intake 5.
Recipe Halibut "en papillote", fennel compote Photo credit: Thibaut Ruggeri. Author s Christophe Hausswirth. By the same author Avant-propos in Améliorer sa récupération en sport , , Foreword in Nutrition and Performance in Sport , , Avant-propos in Nutrition et performance en sport : la science au bout de la fourchette , , All texts.
Amélie Fosse. By the same author Thème 1. La récupération énergétique in Nutrition et performance en sport : la science au bout de la fourchette , , Thème 2. La compétition in Nutrition et performance en sport : la science au bout de la fourchette , , All texts.
Axel Heulin. Sports Traumatology Centre, Puteaux, France. Yann Le Meur. By the same author Thème 3.
Véronique Rousseau. Eve Tiollier. École Lenôtre. By the same author Topic 2. Altitude in Nutrition and Performance in Sport , , Topic 3.
Competition in Nutrition and Performance in Sport , , Topic 1. Energy recovery in Nutrition and Performance in Sport , , All texts. Read Open Access. Freemium Recommend to your library for acquisition.
Nutrition and Performance in Sport Science at the Tip of the Fork Christophe Hausswirth ed.
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