Bone Mineral Density in Active and Retired Ballet Dancers

Abstract

Many members of both the balletic, and non-balletic worlds believe that ballet dancers are at risk for low bone mineral density (BMD), and therefore, osteoporotic fracture. However, the athletic nature of ballet dancing, particularly the jumping component, provides a substantial osteogenic stimulus. Further, ballet is often commenced at a young age, when physical activity may allow a child to optimize peak bone mass. Thus, we reviewed the literature seeking answers to four key questions: 1. Do dancers exhibit lifestyle risk factors that may cause them to have diminished BMD? 2. What is the effect of prolonged amenorrhea on BMD? 3. Do dancers, as a group, have greater or lesser bone mineral than their non-balletic counterparts? 4. Do the hours spent in childhood ballet classes influence adult BMD?We concluded that factors such as primary amenorrhea, low body weight, low energy intake, low calcium intake, and eating disorders can all lead to low BMD in dancers. However, in studies of retired dancers the effect of these risk factors on hip and lumbar spine BMD appears to be somewhat modulated, which may reflect that high impact activity during a key prepubertal age has a beneficial effect. The practical implication of these findings is that ballet, in moderation, and not associated with abnormal eating behavior or prolonged menstrual disturbance, can be seen as a positive lifestyle choice that may serve to decrease the risk of osteoporosis in later life.