Regional Bone Mineral Content Research Articles

Muscle-to-Bone Ratio in NCAA Division I Collegiate Football Players by Position.

Dengel, DR, Studee, HR, Juckett, WT, Bosch, TA, Carbuhn, AF, Stanforth, PR, and Evanoff, NG. Muscle-to-bone ratio in NCAA division I collegiate football players by position. J Strength Cond Res XX(X): 000-000, 2024-The purpose of this study was to compare the muscle-to-bone ratio (MBR) in National Collegiate Athletic Association Division I football players (collegiate football players [CFP]) to healthy, age-matched controls. In addition, we examined MBR in CFP by position. A total of 553 CFP and 261 controls had their total and regional lean mass (LM), fat mass (FM), and bone mineral content (BMC) determined by dual x-ray absorptiometry (DXA). College football players were categorized by positions defined as offensive linemen (OL), defensive linemen (DL), tight end, linebacker (LB), running back (RB), punter or kicker, quarterback (QB), defensive back (DB), and wide receiver (WR). There were significant differences between CFP and controls for total LM (80.1 ± 10.0 vs. 56.9 ± 7.8 kg), FM (22.2 ± 12.5 vs. 15.2 ± 7.1 kg), and BMC (4.3 ± 0.5 vs. 3.1 ± 0.5 kg). Although there were significant differences in body composition between CFP and controls, there was no significant differences in total MBR between CFP and controls (18.6 ± 1.4 vs. 18.8 ± 1.7). Regionally, CFP had significantly lower trunk MBR than controls (26.7 ± 2.7 vs. 28.7 ± 4.2), but no difference was seen in leg or arm MBR. Positional differences in CFP were noted as total MBR being significantly higher in DL (19.0 ± 1.4) than in DB (18.1 ± 1.3), WR (18.1 ± 1.3), and LB (18.2 ± 1.3). OL had a significantly higher total MBR (19.2 ± 1.3) than DB (18.1 ± 1.3), LB (18.2 ± 1.3), QB (18.1 ± 1.0), and WR (18.1 ± 1.3). In addition, RB had significantly higher total MBR (18.8 ± 1.3) than DB (18.1 ± 1.3) and WR (18.1 ± 1.3). This study may provide athletes and training staff with normative values when evaluating total and regional MBR with DXA.

Off- to in-season body composition adaptations in elite male and female endurance and power event athletics competitors: an observational study

BackgroundMonitoring elite athletes’ body composition (BC) is vital for health and optimizing performance in sports emphasizing leanness, such as athletics. This study aims to investigate and compare sex- and event-specific off-to in-season BC changes in endurance and power event athletics competitors.MethodsElite male and female endurance athletes (> 800 m runners; n = 21) and power event athletes (sprinters, jumpers; n = 32) underwent dual-energy X-ray absorptiometry (DXA) scans for whole and regional lean mass (LM), fat mass (FM), bone mineral content (BMC), and density (BMD) during off-season (September-October) and in-season (April-May). Linear mixed models tested between-group off-season differences in BC, within-group off-season to in-season changes, and between-group differences in change. To assess meaningful or least significant changes (LSC) in BC, DXA precision errors were determined from two consecutive total body scans in a subsample of athletes (n = 30).ResultsMale athletes (n = 26) gained significantly (p < 0.05) more body mass (BM; mean difference 1.5 [95% confidence interval (CI):0.5–2.4] kg), LM (843 [95% CI:-253:1459] g), and trunk LM (756 [-502:1156] g) than female athletes (n = 27). The proportion of changes in athlete’s BC exceeding the LSC threshold for LM and trunk LM were 70% and 65% in males, and 48% and 26% in females. Significant (p < 0.05) within-group off-season to in-season increases in LM were found for male endurance and power athletes, and female power athletes. All groups significantly increased BMD (p < 0.05). Only male and female power athletes had significant in- to-off-season increases in BMC. 80% of all athletes who had a meaningful increase in BMC belonged to the power event group. No significant within- or between group change in FM was observed.ConclusionsThe present study found that male athletes gained more BM, LM and trunk LM than females. Within-group increases in regional and whole-body LM and BMC were predominantly found among power event competitors. Incorporating individual meaningful changes alongside traditional statistics provided additional insights into sex and event-group differences. Future research on elite athletic event groups should include DXA measurements closer to major outdoor-season competitions, coupled with site-specific measures (ultrasound, MRI) for better detection of subtle changes in LM and FM.

Relationship between Femur Mineral Content and Local Muscle Strength and Mass.

Among the stimuli able to prevent early decreases in bone mineralization, exercise has a noticeable role per se as the source of mechanical stimulus or through lean tissue enlargement by its increasing of tensional stimulus. However, prevention strategies, including exercise, generally do not establish the moment in life when attention should begin to be paid to bone integrity, according to age group- and sex-related differences. Thus, this study analyzed the relationship between variables from the diagnosis of total and regional body composition, muscle strength, and bone mineral content (BMC) of femurs in young adult males. Thirty-four young Caucasian men (24.9 ± 8.6 years) had their body composition and bone density assessed by dual X-ray absorptiometry. The subjects performed a one-repetition maximum test (1-RM) in a bench press, front pulley, seated-row, push press, arm curl, triceps pulley, leg flexion, leg extension, and 45° leg press for the assessment of muscle strength in upper and lower limbs in single- and multi-joint exercises. Lean tissue mass in the trunk and upper and lower limbs were related to femoral BMC (Pearson coefficient ranging from 0.55 to 0.72, p < 0.01), and 1-RM values for different exercises involving both upper and lower limbs also correlated with femoral BMC (Pearson coefficients ranging from 0.34 to 0.46, p < 0.05). Taken together, these correlations suggest that muscle mass and strength are positively linked with the magnitude of femoral mass in men, even in early adulthood. Hence, the importance of an enhanced muscle mass and strength to the health of femoral bones in young adults was highlighted.

Bone Health, Body Composition and Physiological Demands in 70-85-Year-Old Lifelong Male Football Players.

The effects of lifelong football training on bone health, body composition and physiological demands were evaluated. A total of 20 veteran football players (VPG; 73.4 ± 3.7 years) and 18 untrained age-matched men (CG; 75.6 ± 4.2 years) were enrolled. Whole-body and regional dual-energy X-ray absorptiometry scans of arms, legs, proximal femur and lower spine (L1-L4) were recorded in all participants. We observerd higher bone mineral density (BMD) in the whole-body, arms and femoral regions and higher bone mineral content (BMC) in the legs and lower spine compared to the CG (p < 0.05), also higher total lean body mass (p < 0.05) and lower total body fat percentage (p < 0.05), were found. No differences in food habits were evidenced between the VPG and the CG, as evaluated using 3-day food records. Resting heart rate (RHR), blood pressure (BP) and activity profile during a football match were recorded using a global positioning system only in the VPG. The mean heart rate (HR)of theoretical maximal HR (ThHRmax), and peak of ThHRmax were 83.9 ± 8.6% and 98.6 ± 10.2%, respectively; the mean of total distance covered was 3666 ± 721 m, and the means of accelerations and decelerations were 419 ± 61 and 428 ± 65, respectively. Lifelong participation in football training improves regional BMD and BMC in legs, femur and lumbar spine compared to the CG. A high number of intense actions in term of HR and accelerations and decelerations suggests an elevated energy expenditure that in turn correlates to the healthier body composition observed in the VPG compared to the CG.

Characteristics of total body and appendicular bone mineral content and density in Japanese collegiate Sumo wrestlers

The purpose of this study was to explore the characteristics of total body and appendicular bone mineral content (BMC, kg) and bone mineral density (BMD, g/cm2) in Japanese collegiate Sumo wrestlers. A total of 54 male college Sumo wrestlers were recruited for the study and assigned to two groups according to their body weight (middleweight, 85–115 kg, n = 23 and heavyweight, > 115 kg, n = 31). The BMC, BMD, fat mass, and lean soft tissue mass (LSTM) values were measured using dual-energy X-ray absorptiometry for the total body and appendicular regions. Heavyweight Sumo wrestlers had significantly higher body weight, fat mass, and LSTM compared to middleweight Sumo wrestlers. The mean total body and regional BMC values were significantly higher in heavyweight than in middleweight Sumo wrestlers. The total body and leg BMD was significantly higher in heavyweight than in middleweight Sumo wrestlers, and was significantly correlated with body weight, but not arm BMD. The present study indicates that BMC and BMD might not sharply elevate among even heavyweight athletes, although heavier Sumo wrestlers had a greater BMC and BMD.

Novel Body Composition Approaches with DXA: Comparison with Classical Total Body Scans

Traditionally, total body (TB) DXA scans to assess body composition include the entire body, however novel abbreviated scan acquisition methods are available in new software. For example, total body less head (TBLH) is recommended given the head contains lean mass that cannot be altered by intervention. Recently, to reduce scan time and radiation exposure, a neck to knee (N-K) acquisition option is available. Finally, scans limited to the lower extremity might be useful to evaluate regional mass change after surgery/injury and in sarcopenia assessment. The purpose of this study was to evaluate comparability of measured and estimated body composition results using TBLH, N-K and lower extremity (LE; pelvis to toes) acquisition techniques. We hypothesized that body composition data with the 3 novel methods would not differ from the traditional TB method. Each subject had 4 scans: TB, TBLH, N-K and LE. A subset of 30 had repeat N-K and LE scans with repositioning between. A Lunar iDXA (GE, Madison, WI) with enCORE v18.0 was used to acquire and analyze scans. TB scans were acquired per ISCD guidance. TBLH and N-K scans were acquired using automated software features that limited the anatomy scanned; N-K estimates non-scanned leg mass. LE scans were started at L3 and auto stopped past the toes. Automated analysis, with manual correction, was used for all but LE scans which were analyzed manually by compressing all upper body ROIs above the pelvis then placing lower body ROIs at the top of pelvis, bisecting the femur neck and separating the legs. Pearson Correlation and Bias plots were used to compare regional lean, fat and BMC measurements from the 3 novel scans to TB. Precision determined by the ISCD Precision Calculator was compared to TB historical control by F-test. The study sample included 82 subjects, 41F/41M mean (SD) age 51.0 (18.4) years and BMI 25.5 (3.7) kg/m2. Mean lean, fat and bone mass were very similar among all approaches with some statistical, but likely not clinical, differences (Tables 1&3). Composition from all regions with the 3 novel methods was highly correlated with TB measurement, r=0.99-1.0, p< 0.001 with mean bias of 14-237g lean, 7-121g fat and 0.3-13.3g BMC (Table 2). N-K and LE precision was excellent ranging from 0.45-2.31 %CV (Table 3). These 3 novel approaches to either measure or estimate regional body composition are consistent with traditional TB measurement and may be considered as substitutes when appropriate.

Sex differences in systemic bone and muscle loss following femur fracture in mice.

Fracture induces systemic bone loss in mice and humans, and a first (index) fracture increases the risk of future fracture at any skeletal site more in men than women. The etiology of this sex difference is unknown, but fracture may induces a greater systemic bone loss response in men. Also sex differences in systemic muscle loss after fracture have not been examined. We investigated sex differences in systemic bone and muscle loss after transverse femur fracture in 3-month-old male and female C57BL/6 J mice. Whole-body and regional bone mineral content and density (BMC and BMD), trabecular and cortical bone microstructure, muscle contractile force, muscle mass, and muscle fiber size were quantified at multiple time points postfracture. Serum concentrations of inflammatory cytokines (IL-1β, IL-6, and TNF-α) were measured 1-day postfracture. One day postfracture, IL-6 and Il-1B were elevated in fracture mice of both sexes, but TNF-α was only elevated in male fracture mice. Fracture reduced BMC, BMD, and trabecular bone microstructural properties in both sexes 2 weeks postfracture, but declines were greater in males. Muscle contractile force, mass, and fiber size decreased primarily in the fractured limb at 2 weeks postfracture and females showed a trend toward greater muscle loss. Bone and muscle properties recovered by 6 weeks postfracture. Overall, postfracture systemic bone loss is greater in men, which may contribute to sex differences in subsequent fracture risk. In both sexes, muscle loss is primarily confined to the injured limb and fracture may induce greater inflammation in males.

Reproducibility of total and regional body composition using dual-energy X-ray absorptiometry in rheumatoid arthritis and ankylosing spondylitis

Our study aimed to assess the reproducibility of total and regional body composition in patients with rheumatoid arthritis (RA) and with ankylosing spondylitis (AS) and to compare them to healthy subjects. The study enrolled 80 subjects including 32 healthy subjects, 31 RA patients, and 17 AS patients. Each subject had two scans in one day under the same standard conditions and none ate nor drunk before being repositioned on the table. The reproducibility was assessed through the coefficient of variation (CV), the least significant change (LSC), the intraclass correlation (ICC), and the smallest significant difference (SDD). Total body composition measurements obtained by dual-energy X-ray absorptiometry (DXA) were highly reproducible, and there was no statistically significant difference between reproducibility in healthy subjects, patients with RA, and patients with AS. For total body fat mass (FM), lean mass (LM), and bone mineral content (BMC) in the total population, CV values were 1.71%, 1.25%, and 1.74%, respectively; ICC values were 0.998, 0.996, and 0.993, respectively; LSC values were 4.88%, 3.7%, and 5.2%, respectively; and SDD values were ± 1.23 Kg, ± 1.47 Kg, and ± 126.0 g, respectively. For regional body FM, LM, and BMC in the total population, CV values in the arms were 8.46%, 4.17%, and 3.79%, respectively; in the legs 6.24%, 3.59%, and 2.04%, respectively, and in the trunk 5.02%, 2.92%, and 5.24%, respectively. Total body tissue mass, FM percentage, FM, LM, and BMC measurements obtained by DXA are highly reproducible in RA and AS.

Body composition assessment in athletes with physical impairment who have been practicing a wheelchair sport regularly and for a prolonged period

BackgroundToday several important aspects related to the impact of long-term wheelchair sports on whole-body and regional body composition in athletes with a physical impairment are poorly understood. ObjectiveThis cross-sectional study aimed at investigating the impact of the long-term regular practice of wheelchair sports on body composition in male wheelchair athletes (WA) as compared with both non-athletic participants with a physical impairment and non-athletic able-bodied participants. MethodsNine WA were each matched pairwise by age, duration of injury and body mass index (BMI) with a participant with a physical impairment not engaged in any wheelchair sport (N-WA) and by age and BMI with an able-bodied (AB) participant. Whole-body and regional bone mineral content (BMC), fat-free soft tissue mass (FFSTM), fat mass (FM) and percentage FM (%FM) were assessed by means of Dual-Energy X-ray Absorptiometry. ResultsWA had significantly lower FM and %FM vs. N-WA at the whole-body level (P = 0.01 for both) and in the trunk region (P = 0.001 and P = <0.001, respectively). The only difference in body composition variables between WA and AB was found in the legs where WA had significantly higher FM (P = 0.014) along with lower BMC (P = 0.009) and FFSTM (P = 0.005) vs. AB in the legs. ConclusionsThe results of the present study showed that the regular, long-term practice of wheelchair sport may be associated with beneficial body composition adaptations in athletes with a physical impairment at the whole-body and trunk level.

Bone mineral density and specific physical performance in Korean national amateur male boxers

Background The objective of this study was to investigate the relationships between bone mineral density, the level of anaerobic capacity and muscle strength in Korean national amateur male boxers. Methods We carried out a cross-sectional population-based study where fifty-six Korean national amateur male boxers were enrolled. The participants’ whole-body bone and regional mineral density (BMD) and bone mineral content (BMC) were assessed using dual-energy X-ray absorptiometry as the main outcome. The anaerobic capacity was assessed using the Upper and lower Wingate test, and muscle strength was assessed using Isokinetic muscle strength and Maximal strength. Results Of the fifty-six boxer, 37.5% were classified as LWC, 32.1% as MWC, and 30.3% as HWC. Linear regression analyses showed that the severity of bone variable was associated with upper and lower-body anaerobic capacity. Isokinetic muscle strength and Maximal strength were positively associated with bone variables. Conclusions Within athletes of Korean national amateur male boxers, anaerobic capacity, and muscle strength measurements were positively associated with bone variables. Further research is needed to elucidate mechanisms underlying this positive association that is, undertaking studies involving effective exercise and nutrition supplements treatments, and developing the study designs to facilitate analysis of this relationship.

Lumbar bone mineral asymmetry in elite cricket fast bowlers.

Bone responds to mechanical loading by increasing bone mineral density (BMD) and/or bone area to enhance bone strength at the site of the greatest strain. Such localised adaptation has not been demonstrated at the spine. The aim of this study is to determine if BMD and/or bone mineral content (BMC) differs between dominant (ipsilateral to bowling/throwing arm) and non-dominant sides of the vertebrae in cricket fast bowlers, and whether this asymmetry differs according to stress fracture or disc injury history. A further aim was to determine if regional BMD and BMC in the lumbar spine differ between fast bowlers, other cricketers, rugby players and non-active controls, to highlight the site-specific response of lumbar vertebra to unilateral activity. 23 fast bowlers, 14 other cricketers, 22 rugby players and 20 controls underwent an antero-posterior (AP) and lateral DXA scans of their lumbar spine to assess BMD, BMC and area. A custom analysis measured BMD and BMC of the dominant and non-dominant sides (lateral 33%) of the AP lumbar spine. BMD and BMC were compared between groups, injury status, vertebrae and sides using ANOVA. Analysis of medical records showed that 6 fast bowlers had a history of lumbar stress fracture. Significantly greater BMD and BMC was found in the L4 non-dominant vertebra compared with the dominant vertebra in fast bowlers. BMD and BMC differed significantly according to vertebra, side and group, with fast bowlers having significantly greater BMD and BMC at the L3 and L4 non-dominant vertebra compared with other groups (L3: 13.3%-45.3%, L4: 15.7%-44.0%) compared with other groups. Fast bowlers who never suffered lumbar stress fracture had 3.6% and 1.7% greater BMD in the dominant and non-dominant sides of lumbar vertebrae respectively compared with those who did suffer lumbar stress fracture, but evidence of this was weaker (P = 0.08). The lumbar spine responds to a unique unilateral high loading activity through site-specific increased bone mass at the site of most strain. Fast bowlers had increased lumbar BMD, particularly on the non-dominant side of L4, although this adaptation was less marked in those with history of lumbar stress fracture. Site-specific low bone mineral density within the lumbar side may be implicated in the aetiology of lumbar stress fracture.

Investigating a relationship between body composition and spinal curvature in farmed adult New Zealand king salmon (Oncorhynchus tshawytscha): A novel application of dual-energy X-ray absorptiometry

Characterising the pathology of skeletal anomalies in farmed finfish is key to elucidating the underlying causes. Spinal curvature is frequently observed in farmed New Zealand king salmon (Oncorhynchus tshawytscha), but its cause is currently unknown and knowledge about its pathology is limited. Dual-energy X-ray absorptiometry (DXA) was used to investigate the relationship between spinal curvature and body composition in farmed adult New Zealand king salmon. Differences in fat mass (FM), lean mass (LM) and bone mineral content (BMC) between harvest-sized fish affected and unaffected by spinal curvature were evaluated. As there is presently no evidence of an association between spinal curvature and vertebral mineral loss, between-group differences in BMC were not anticipated. Conversely, as spinal anomalies can alter the swimming and feeding of affected fish, and existing research suggests a role for soft tissues in spinal curvature development, differences in FM and LM were expected. Whole-body and regional (cranial, trunco-cranial, trunco-caudal and caudal spine) measurements of percent FM, LM and BMC were obtained from lateral DXA scans of size-matched adult female king salmon (1890–6903 g) affected (n = 31) and unaffected (n = 31) by spinal curvature. Repeatability was comparable to previous DXA studies. Measurements of FM and LM by DXA and chemical carcass analysis (CCA) were highly similar. As frequently reported in previous animal-based studies, DXA-derived BMC values were significantly lower than those obtained from CCA. Contrary to the overarching hypothesis, there were no significant between-group differences in whole-body or regional FM, LM or BMC, suggesting that there was no relationship between body composition and spinal curvature. Though the relationship between soft tissue changes and spinal curvature remains to be determined, DXA appears to be a viable tool for non-invasive assessment of king salmon body composition. However, studying end-stage disease has recognised limitations, so future investigations should utilise longitudinal designs.

Precision of Dual-Energy X-Ray Absorptiometry Reflection Scans in Muscular Athletes

Background: Offset scanning procedures, such as reflection scanning, allow for dual-energy x-ray absorptiometry (DXA) body composition assessment of individuals who are too broad for standard scanning dimensions. However, limited information is available concerning the precision of this procedure, particularly in athletes. Methodology: Twenty-seven muscular athletes (n = 17 males, BMI: 28.8 ± 2.0 kg/m2, DXA body fat: 12.5 ± 2.7%; n = 10 females, BMI: 22.8 ± 1.6 kg/m2, DXA body fat: 19.2 ± 3.4%) underwent consecutive DXA scans on a GE Lunar Prodigy scanner using the reflection scanning technique. The fully automated output was obtained for each scan, and an additional version of each scan's output was saved after manual adjustment of regions of interest (ROI). Metrics of reliability and precision were calculated for total and regional body mass (BM), lean mass (LM), fat mass (FM) and bone mineral content (BMC). These metrics included the precision error (PE), least significant change, ΔMean, technical error of measurement, intraclass correlation coefficient, smallest worthwhile effect and minimum difference considered real. Results: Reflection scanning produced small errors for BM (PE: ∼0.5%), LM (PE < 1%) and BMC (PE: ∼1.2%), with larger errors observed for total FM (PE: ∼3%). Manual ROI adjustment produced lower errors for total BM, LM, FM, and BMC, as well as lower errors for most regional estimates. The utilization of automated ROI revealed concerns unique to reflection scanning, including unnecessary estimation of trunk composition, which appreciably increased error in this region. Regional estimates produced higher errors for all variables as compared to whole-body estimates, although which regions produced the highest errors differed between BM, LM, FM, and BMC. Conclusions: Reflection scanning allows DXA body composition assessment in individuals exceeding traditional scanning dimensions, including broad athletes. Although this procedure introduces error, it may be minimized through manual adjustment of ROIs and consistency of analysis methods.

REGIONAL BODY COMPOSITION AND MUSCLE STRENGTH ARE RELATED TO BONE MINERAL CONTENT IN ELDERLY

ABSTRACT Introduction: The increase, or maintenance, of lean body mass and muscle strength are major determinants of functional independence in the elderly, since they are associated with bone remodeling, and therefore with a reduced risk of falls and fractures. However, the regional relationship between lean body mass/strength and bone mineral content (BMC) has not sufficient theoretical support. Objective: To analyze whether regional body composition and muscle strength are factors potentially related to BMC. Methods: Ten older men (63.3±6.4 years, 169.4±6.8 cm and 79.3±10.5 kg) underwent body composition assessments using dual energy X-ray absorptiometry (DXA) to obtain regional and whole-body lean mass and BMC measures. The subjects also underwent the one-repetition maximum (1RM) test involving flat bench press, 45° leg press, arm curl and knee extension. Regional/whole-body composition and 1RM values were correlated to BMC using Pearson's coefficient (r). The level of significance for the correlations was p ≤0.05, the confidence interval was 95% (Z1-a/2=1.96), and the sample power was 80% (1-b). Results: The flat bench press 1RM was related to BMC in the left (r=0.764) and right (r=0.748) arms, while the 45° leg press 1RM was associated with BMC in the left (r=0.677) and right (r=0.714) legs and trunk (r=0.810), with sample power of 77.7%, 66.8%, 12.7%, 40.4% and 97.0%, respectively. Whole-body BMC was related to abdominal skinfold (r=0.819), lean mass of left arm (r=0.834), left (r=0.845) and right (r=0.868) legs, and whole-body lean mass (r=0.787), with sample power of 98.4%, 99.6%, 99.9%, 100.0% and 90.1%, respectively. Conclusion: The results supported regional lean body mass as a parameter related to BMC, with potential similar to that consistently reported for whole-body lean mass. Results also suggested that muscle strength plays an important role in improving or maintaining regional and whole-body BMC. Level of Evidence II; Development of diagnostic criteria in consecutive patients (with “gold” benchmark standard applied).

Osteogenic impact of football training in 55- to 70-year-old women and men with prediabetes.

The effects of football training on bone health were examined in 55- to 70-year-old sedentary women and men with prediabetes. Patients (n=50) with prediabetes (age; 61±9years, BMI 29.7±0.6kg/m2 , body fat content; 37±1%, VO2max ; 22.7±0.8mL/min/kg and mean arterial pressure; 104±3mmHg) were randomized into a football training group (FTG; n=27, 14 women) and a control group (CON; n=23, 11 women). At baseline, 73% and 24% were diagnosed with femur osteopenia and osteoporosis, respectively. FTG performed football training twice weekly 30-60-minute sessions in 16weeks, and both FTG and CON received professional dietary advice. Pre- and post-intervention whole-body and regional bone mineral content (BMC) and density (BMD) were determined with DXA-scans, and venous blood samples were drawn and analyzed for plasma bone turnover markers. Change scores were greater (P<0.05) in FTG compared to CON in leg BMD (0.023±0.005 vs -0.004±0.001g/cm2 ) and in leg BMC (32±8 vs -4±6g). Between-group changes in favor of FTG (P<0.05) also occurred in the femur neck BMD (3.2%) and femur shaft BMD (2.5%). Whole-body BMC and BMD were unchanged in both groups during the intervention. In FTG, resting plasma osteocalcin, P1NP, and CTX-1 rose (P<0.05) by 23±8, 52±9 and 38±7%, with greater change scores (P<0.05) than in CON. Finally, P1NP (formation)/CTX-1 (resorption) ratio increased (P<0.05) in FTG (127±15 vs 150±11) from pre- to post-intervention, with no change in CON (124±12 and 123±12). In conclusion, football training provides a powerful osteogenic stimulus and improves bone health in 55- to 70-year-old women and men diagnosed with prediabetes.

Whey Protein Supplementation and Higher Total Protein Intake Do Not Influence Bone Quantity in Overweight and Obese Adults Following a 36-Week Exercise and Diet Intervention

Controversy exists concerning the effects of higher total protein intake (TPro) on bone health, which may be associated with reduced bone mineral density (BMD). However, whey protein (WP) may induce bone formation because of its basic component, milk basic protein. This study assessed the effects of WP supplementation, TPro, and change in TPro (postsupplementation - presupplementation) on BMD and bone mineral content (BMC; total body, lumbar spine, total femur, and femoral neck) in overweight and class I obese middle-aged adults following an exercise intervention. This analysis used data from a double-blind, randomized, placebo-controlled 36-wk WP supplementation trial, wherein participants consumed a 1.7-MJ (400-kcal) supplement (0, 20, 40, or 60 g WP/d) along with their otherwise unrestricted diet while participating in a resistance and aerobic exercise intervention (3 d/wk). TPro was the summation of WP and habitual dietary intakes (4-d food record). Statistical analyses for WP were based on group and bone data [n = 186, 108 women; mean ± SD age: 49 ± 8 y; body mass index (BMI; in kg/m2): 30.1 ± 2.8], whereas TPro was based on dietary and bone data (n = 113, 70 women; age 50 ± 8 y; BMI 30.1 ± 2.9). WP supplementation, regardless of dose, did not influence BMD or BMC following the intervention. By using a multiple linear regression model, TPro (expressed as g/d or g · kg-1 · d-1) and change in TPro (expressed as g/d) were not associated with responses over time in total or regional BMD or BMC. By using a cluster analysis approach [<1.0 (n = 41), 1.0-1.2 (n = 28), and ≥1.2 g · kg-1 · d-1 (n = 44)], TPro was also not associated with responses in total or regional BMD or BMC over time. WP supplementation and total dietary protein intake did not negatively or beneficially influence bone quantity in overweight and obese adults during a 9-mo exercise intervention. This trial was registered at clinicaltrials.gov as NCT00812409.

WHOLE BODY AND REGIONAL BONE MINERAL CONTENT AND DENSITY IN WOMEN AGED 20-75 YEARS.

Dual-energy X-ray absorptiometry (DXA) allows measurement of whole body (WB) and regional bone mineral content (BMC) and density (BMD). To measure WB and regional bone area, BMC and BMD (arms, legs, ribs and pelvis) in women of different ages. 140 women participated (age range 20-75 yrs). Three subgroups were built: 20-44 yr (30 premenopausal women), 45-59 (80 women), and 60-75 (30 women). WB DXA was performed on a Hologic QDR 4500 A bone densitometer (Hologic Inc., Bedford MA). WB BMD T-scores were calculated by using the manufacturer-provided and the NHANES 1999-2004 reference databases, while the WB BMC Z-scores - based on the latter. Statistical analysis was performed on an IBM SPSS Statistics 19.0 for Windows platform (Chicago, IL). WB BMC and BMD Z-scores were consistently lower than the reference databases showing a difference of about 0.4 - 0.5 SD. The arms, legs and ribs lost more BMC after the age of 50-55, while the pelvis - much earlier. The total decreases in BMC were highest in the pelvis (26.36 %), followed by the arms (16.81 %) and whole body (15.91 %), while the bone area decreased mostly in the pelvis (13.23 %). The age-related declines in regional BMC, bone areas and BMD follow different patterns in appendicular and axial bones.

Reliability of 2 Different Positioning Protocols for Dual-Energy X-ray Absorptiometry Measurement of Body Composition in Healthy Adults

Dual-energy X-ray absorptiometry (DXA) is an accepted time-efficient method of body composition assessment for total body and regional fat mass (FM), lean mass (LM), and bone mineral content (BMC), but for longitudinal monitoring the measurements must be sufficiently reliable. The aim of this study was to compare the reliability of a new positioning protocol (Nana et al) with the current reference (National Health and Nutrition Examination Survey [NHANES]) protocol and investigate their within-protocol precision. Thirty healthy adults (16 females and 14 males) underwent 4 whole-body DXA scans in succession with full repositioning between scans. The scan order was randomized, with 2 scans undertaken in accordance with the current NHANES protocol and 2 using the Nana et al protocol. Magnitudes of typical errors of measurement and changes in the mean of DXA body composition estimates were assessed as standardized effect sizes. The Nana et al protocol repositioning produced trivial typical errors for total body across all LM estimates except for FM in the arms and trunk which were moderately substantial. The NHANES protocol produced similar typical errors for all measurements in LM except for FM and BMC in the trunk and arms which were substantially larger than the smallest worthwhile effect. The difference between protocols produced substantially large typical errors in estimations of both total body FM and regional FM and BMC, but differences in LM were all less than the smallest worthwhile effect. Although both protocols demonstrated acceptable intratest reliability, the Nana et al protocol produced enhanced precision in regional (arms and trunk) FM and BMC. The protocols were substantially different in body composition assessment especially for FM and thus should not to be interchanged. Anecdotally, subjects felt more comfortable and supported during the scan with the Nana et al protocol.

Comparison of the Lunar Prodigy and iDXA Dual-Energy X-ray Absorptiometers for Assessing Total and Regional Body Composition

The objective of the study was to assess the agreement of the Lunar Prodigy with the newer Lunar iDXA dual-energy X-ray absorptiometer for determining total body and regional (arms, legs, trunk) bone mineral density (BMD), bone mineral content (BMC), fat mass (FM), lean tissue mass (LTM), total body mass, and percent fat. Ninety-two healthy adult males (n = 36) and females (n = 56) were scanned consecutively on the iDXA and the Prodigy dual-energy X-ray absorptiometers. For iDXA, relative to Prodigy, paired t tests indicated significantly lower estimates for total body and regional BMD and BMC (p < 0.001). Measures of total body and trunk FM, LTM, and percent fat did not differ between the instruments. In regional analyses, estimates of FM and percent fat were greater, and that of LTM was lower, in the arms (p < 0.001). In contrast, iDXA estimates of LTM were higher in the legs (p < 0.001). All body composition measures were significantly correlated (p < 0.001). Bland-Altman analyses indicated that significant bias existed between iDXA and Prodigy for total body and regional BMD estimates (p < 0.001) such that iDXA underestimated BMD to a greater extent in persons with higher values. In addition, iDXA overestimation bias existed for FM in total body, arms, and legs, and the overestimation was primarily observed in participants with greater body fat (p < 0.001). When combining or comparing data from iDXA with those from Prodigy, investigators should be aware that certain total body and regional estimates are significantly different. The greatest percent differences were observed for arm BMD, FM, and percent fat.

Three-Compartment Body Composition in Academy and Senior Rugby League Players.

To compare the body size and 3-compartment body composition between academy and senior professional rugby league players using dual-energy X-ray absorptiometry (DXA). Academy (age 18.1 ± 1.1 y, n = 34) and senior (age 26.2 ± 4.6 y, n = 63) rugby league players received 1 total-body DXA scan. Height, body mass, and body-fat percentage alongside total and regional fat mass, lean mass, and bone mineral content (BMC) were compared. Independent t tests with Cohen d effect sizes and multivariate analysis of covariance (MANCOVA), controlling for height and body mass, with partial eta-squared (η2) effect sizes, were used to compare total and regional body composition. Senior players were taller (183.2 ± 5.8 vs 179.2 ± 5.7 cm, P = .001, d = 0.70) and heavier (96.5 ± 9.3 vs 86.5 ± 9.0 kg, P < .001, d = 1.09) with lower body-fat percentage (16.3 ± 3.7 vs 18.0 ± 3.7%, P = .032, d = 0.46) than academy players. MANCOVA identified significant overall main effects for total and regional body composition between academy and senior players. Senior players had lower total fat mass (P < .001, η2 = 0.15), greater total lean mass (P < .001, η2 = 0.14), and greater total BMC (P = .001, η2 = 0.12) than academy players. For regional sites, academy players had significantly greater fat mass at the legs (P < .001, η2 = 0.29) than senior players. The lower age, height, body mass, and BMC of academy players suggest that these players are still developing musculoskeletal characteristics. Gradual increases in lean mass and BMC while controlling fat mass is an important consideration for practitioners working with academy rugby league players, especially in the lower body.