Assessment Of Bone Mineral Density And Symptoms Related With Low Energy Availability (lea) And Relative Energy Deficiency In Sport (red-s), Among Young Acrobatic Gymnasts

Abstract

Assessment of Bone Mineral Density and Symptoms Related with Low Energy Availability (LEA) and Relative Energy Deficiency In Sport (RED-S), Among Young Acrobatic Gymnasts. Energy consumption and expenditure imbalance exposes athletes to relative energy deficiency syndrome in sports (RED-S). The syndrome exposes athletes to low bone mass density (BMD), delay in growth and development, with risk to reduced final height. Female athletes may have menstrual disorders and amenorrhea. Acrobatics encourages lean body for better performance, and judgement related bias. There is information on RED-S among female athletes from parallel sports to acrobatics. Yet, for male, data is scarce. Our aim was to examine the eating habits, energy balance, body composition and BMD of acrobats. Healthy girls and boys aged 12-18 years, participating in competitive acrobatics were evaluated at Ruth Rappaport Children’s Hospital. Each participant completed questionnaire (m-DEAQ) and dual-energy x-ray absorptiometry (DXA). Participants received a food log, and an activity watch for the subsequent 3 days.Eighteen acrobats participated (age 14.3 ± 1.2 years, males 6/18). Total BMD was 0.938 ± 0.124 (g/cm2) with total body z score 0.4 ± 1.0. Acrobats positioned in top levels in the team had lower total body Z-score (-0.2 ± 0.3 vs 0.8 ± 0.3, p = 0.032), but not forearm (0.2 ± 0.5 vs 0.8 ± 0.7, p = 0.331). No differences were found between males and females in BMD, BMI or energy availability. Males consumed significantly more calories per day (2053 vs 1412, p = 0.008) and had higher % of their daily recommended vitamin B12, calcium and phosphate than females. Among females 42% reported pre-menarche, all of the rest had Irregular menstruation and 66% reported being asked to lose weight by coaching staff. Low total body z score was found in acrobats in higher positions (middle and top). Yet, no similar difference found for forearms. This could be due to specific training (high forces applied on upper limbs). Lower limb training (higher impact, e.g. running) should be considered to potentially increase BMD. Larger comprehensive studies, including more male acrobats are needed to identify unique aspects.