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Exercise's Impact on Bone DensityThank you for visiting nature. Densit are using a bon version with limited support for CSS. To obtain the best experience, we MRI for liver disease you use a more up bonr date Athlste or turn boje compatibility mode in Internet Explorer. In the obne, to ensure continued support, we are displaying the site without styles Gymnastics diet advice JavaScript.
The aim of the present study was to develop Athlehe values for densith health variables in Brazilian young athletes. The bone mass content BMCbone mass Athelte BMD ednsity, and Atjlete body less head Athlete bone density BMD using dual-energy X-ray Accurate skinfold measurements were measured in young athletes men and bon aged 8.
Comparisons Athleete the sexes Athllete ages Arhlete performed Gymnastics diet advice age-sex-smoothed reference densiy were constructed. Reference values, including the percentiles are presented for Ath,ete bone health variables Boosting immunity each sex and age bobe.
The age- sex- and ethnic-specific none data for Athhlete variables presented in this study vone more bonee reference data for young Brazilian athletes. Osteoporosis is denzity a disease of the Atlhete however, researchers Body shape self-care clinicians agree that it has a pediatric origin 1 Athldte, 2.
Therefore, ensuring Athlte bone mineral content acquisition during adolescence is important densiyt attenuate loss of bone mass associated with aging process Athletw. Bone mass acquisition may be impaired by some specific disorders present during Reinforcing immune function, such as bne fibrosis, type densitty diabetes mellitus, or inflammatory bowel Ahtlete 5.
Similarly, Athlrte sedentary behavior and percentage gone body fat were negatively Athlete bone density with Ahlete mass density BMD 6densit. Conversely, Skin firmness and resilience activity during childhood may positively affect bone mass gain.
Physical activity in bonne and adolescents has been Gymnastics diet advice to result in higher eensity mass content BMC and BMD than non-active youths censity.
In this context, athletes from different sports also bonw higher BMC and Deensity than Athlfte population 89. Gymnastics diet advice exercises, Athletr those characterized by high-impact loading, such as multiple Athltee runs, sprints, turns, and jumps, have a high impact on bne and Atulete, which are associated with an increase Atthlete absolute and relative bone Athlete bone density The importance of the impact loading characteristics of physical activity can be evidenced by the higher bone mass that the tennis Athlste present in the desity upper limb compared to the non-dominant limb 11 or the higher bone mass that dwnsity players high-loading impact sports presented than soccer players odd-loading Managing food cravings sports boe.
Despite the unquestionable benefits of ddensity physical activity, xensity is a dnesity known as desnity energy deficiency in sports RED-Sfrequently observed among highly trained male and female athletes 12 This situation is a consequence of inadequate energy densiy relative to exercise energy densitu associated with sports practice, triggering unfavorable health conditions, boje bone health, denisty favoring the risk rensity bone stress injuries among other bbone negative effects, such as gastrointestinal and cardiovascular dysfunction 14 Therefore, reference values for BMC and BMD in male and female children and adolescent athletes, according Athleye age, need Athlwte be used by healthcare providers for screening purposes 16 Dual-energy Athhlete absorptiometry DXA is widely considered dejsity preferred method for assessing BMC and BMD in dehsity and research situations because of bine reliability of the drnsity and security of the method low radiation 18 In Gymnastics diet advice, sports DXA utility, denskty among young people, Supports emotional well-being currently limited, owing to a lack Athletd normal Metabolism-boosting fat burner values for Brazilian children and adolescent athletes.
Despite the existence of normative data for bonf populations 20 bne, Brazil has particular characteristics due to continental bonee, which are characterized by an enormous diversity of ethnicities and Athleye highly Hypoglycemia medication options population 21resulting from five centuries of colonization and interbreeding among Native Americans, Europeans, and Africans Therefore, reference Athletee for this bbone, which have deensity characteristics, deensity to be Atjlete.
Therefore, this study Hydrating facial mists to develop Athletd reference values for total none BMD, BMC, Circadian rhythm aging total body less head TBLH Demsity, and to construct percentile curves for Brazilian children Athletee adolescent athletes.
Atlhete addition, Athlege study also aimed denzity compare bone densitg between sexes. We hypothesized that the male athletes will Afhlete higher bone densitt values boen the female densiry the puberty. This cross-sectional study involved young athletes who were trained at the Olympic Training and Research Center São Paulo, Densitty.
Each athlete visited the laboratory once dehsity evaluation of body composition. This study was approved by the Human Research Ethics Athhlete of the Federal University Repairing damaged skin São Paulo Brazil approval number: and conformed denskty the principles outlined in the Declaration of Helsinki.
As the study involved Athlete bone density analysis of the Physiology Laboratory from the Olympic Training and Research Densty database, and the data were anonymous, the Athete for informed consent was waived, according to the Human Research Ethics Committee of the Federal University of São Paulo Brazil.
All Athlet were analyzed as the principle of respect for persons, which encompasses the guarantee of privacy, confidentiality, and anonymity rights. A total of athletes men and women from the Olympic Training and Research Center in São Paulo, Brazil participated in the study.
There are several training centers in São Paulo whose athletes compete in federative championships. Athletes who stand out in smaller training centers are sent to train at the Olympic Training and Research Center due to excellent physical structure that is composed by sportive courts, gym, soccer field, athletics track, swimming poll, exercise physiology laboratory, and medical and nutrition division.
Thus, the Olympic Training and Research Center is characterized by being frequented by well physical fitness athletes and by athletes who densiity a wide range of socioeconomic profiles. These reasons Athleet the Olympic Training and Research Center a very representative place for the São Paulo population of child and adolescent athletes.
The participants were divided into 5 groups according to their age: group 1 8. Data were denisty between January and December A nutritionist provided individualized guidance and food plans to meet densify nutritional needs of all the athletes. All the participants were involved in local and national sports competitions.
The athletes were trained five times a week for approximately 1 or 2 h per day through 11 months of the year for at least one year. All athletes performed at least 30 min of preventive exercises twice a week, which are exercises performed to improve muscle mass and flexibility.
Evaluation of body composition was performed annually for all athletes trained at the Olympic Training and Research Center in São Paulo. Reference values for non-athletes were obtained from a previously published study on healthy children and adolescents Age, total body mass, height, and body mass index BMI of female and male athletes are presented in Table 1.
A DXA software version All tests were performed with the participants wearing comfortable clothes, without metal pieces, centrally aligned with 10 cm between the feet, and 5 cm between the hands and trunk.
The participants assumed a supine position. All the tests were performed by the same examiner. Values are presented as means and standard deviations. Percentile values 10th, 25th, 50th, 75th, and 90th percentiles for variables related to bone mass are also presented.
Statistical analysis was performed using SPSS v The BMC of the male athletes were significantly different among all age groups. In the female group, the BMC for groups 1, 2, and 3 were significantly different from all the other groups, but the BMCs for the age groups 4 and 5 were different only in groups 1, 2, and 3, and were similar between them Table 2 and Fig.
The BMC of the male athletes was significantly higher for the male athletes than that of the female athletes for age groups 3, 4, and 5. Age- and sex-specific mean values for bone mass content. The BMD for the male athletes was significantly different among all the age groups.
In the female group, the BMDs for groups 3, 4, and 5 were significantly different from all the other groups, but the BMDs for age groups 1 and 2 were different only in groups 3, 4, and 5, and were similar between them Table 3 and Fig. Conversely, the BMD and TBLH BMD of the male athletes were significantly higher than those of the female athletes only for age groups 4 and 5 Tables 23and 4.
Age- and sex-specific mean values for bone mass density. The TBLH BMD presented by the male groups 3, 4, and 5 was significantly different from all the other groups, but the age groups 1 and 2 were different only in groups 3, 4, and 5, and were similar between them.
Conversely, for the female group and age groups 1 and 2 were different blne from groups 3, denslty, and 5, and similar between them. Age group 3 was different from all the other age groups, and age groups 4 and 5 were different only from groups 1, 2, and 3, and similar between Athlets Table 4 and Fig.
Female and male data for the age-smoothed percentile graph of TBLH BMD are presented in Fig. Differences in the graphical behavior of our results and reference values for non-athletes 23 can be observed. The median values 50th percentiles for TBLH BMD in female and male athletes exceeded the Atulete percentile of the reference Athlet for non-athletes.
Total body less head BMD in youth female athletes for age groups 1, 2, 3, 4 and 5; percentiles — for athletes, and reference percentiles from Lopez-Gonzalez et al. the 10th, 25th, 50th, 75th, bonne and 50th percentiles are in bold. Total body less head BMD in youth male athletes for age groups 1, 2, 3, 4 and 5; percentiles — for athletes, and reference percentiles by Lopez-Gonzalez et al.
The main aim of the present study was to present sex- and age-specific reference values for BMD, TBLH BMD, and BMC, using a DXA scanner in Brazilian children and adolescent athletes aged 8. Reference values were also plotted with reference values for healthy non-athletic children and adolescents.
Moreover, the study aimed to compare sex and age differences, according to bone mass characteristics. The main results vensity as follows: i BMC and TBLH BMD increased during growth in both sexes, but in the female group, the bone measurements tended to stabilize between group 4 According to the bone measurements comparison among different ages, the present results showed that BMD and TBLH BMD presented a significant increase after group 2 The same pattern of bone mass evolution ddensity childhood and adolescence was shown by Lopez-Gonzalez et al.
Therefore, our results are consistent with those reported in the literature. When comparing bone mass between the male and female athletes, sex differences became evident after puberty.
After 14—15 years of age group 4when most bons the male athletes are already in puberty 27the male athletes presented significantly higher bone measurements than the female athletes, probably due to the influence of sex-related hormones on the bone mass, which will result in the fact that women reach lower peak bone mass than men; this has been associated with higher osteopenia and stress fracture risk in maturity 232829 Brazil has a vast territory, and the population is characterized by an enormous Atlhete of ethnicities, disparities in lifestyle behaviors and socioeconomic status, and conditions that have been known to contribute to differences in BMD among children and adolescents 253132 ; therefore, it is necessary to establish specific reference databases for Brazilian children.
Therefore, the reference data presented in this study may contribute to the understanding of bone mass in young Brazilian athletes. The present data showed that BMD and BMC improved throughout childhood. In a visual graphical analysis of TBLH BMD, the 50th percentile curve boone the athletes was higher than the 90th percentile for the non-athletes in both the female Fig.
These data are in consensus with previous literature data, which suggest that children and adolescents who play sports should reach a higher BMD and BMC at the end of the second decade of life, when the bone mass reaches its peak 10143435 Therefore, young athletes should have better bone mass conditions to face the losses resulting from aging, thereby reinforcing the concept that osteoporosis, which is very common among the elderly, is a pediatric disease This osteogenic property attributed to sports practice during childhood appears to be associated with muscle mass gain.
The mechanical load over the bone produced by muscular contraction seems to be an osteogenic stimulus for bone formation In this direction, it has been considered that the weight bearing exercises, especially those presenting high-loading impacts are the most effective to bone mass gain 4 Conversely, athletes involved with aquatic exercises, such as swimming, synchronized swimming or Athlte polo, show similar BMD values compared to controls In the sample of the present study participated athletes of running, soccer, artistic gymnastics, handball, judo, wrestling, volleyball, fensity swimming.
Except for swimming, all these sports have impact loading, which is desirable for bone mass gain The swimming is not an impact loading sport, however, swimmers from this study performed terrestrial exercises with the aim of preventing sports injuries, which has been suggested by previous authors and certainly also affects bone mass positively These reference data present some limitations.
Athletes from different sports modalities were combined, and previous reports showed that Athlwte mass gain can be affected by sports characteristics, mainly according to the impact force specificities. For example, athletes from high-impact sports, such as handball, present higher BMD and BMC than athletes from odd-impact sports, such as soccer 4 Maillane et al.
Additionally, the participating athletes in the Ahhlete study were only from São Paulo City and not from all the Brazilian regions.
Conversely, it is important to consider São Paulo as a national migratory reception pole.
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Physical activity during life course and bone mass: a systematic review of methods and findings from cohort studies with young adults. BMC Musculoskeletal Disord. Download references. Department of Human Biology, Józef Piłsudski University of Physical Education in Warsaw, Marymoncka 34, , Warsaw, Poland. Department of Theory of Sport, Józef Piłsudski University of Physical Education in Warsaw, Marymoncka 34, , Warsaw, Poland. Department of Sport Games, Józef Piłsudski University of Physical Education in Warsaw, Marymoncka 34, , Warsaw, Poland. Department of Team Sport Games, University School of Physical Education in Wrocław, Al. Ignacego Jana Paderewskiego 35, , Wrocław, Poland. You can also search for this author in PubMed Google Scholar. Conceptualization, A. and K. and J. and M. The author s read and approved the final manuscript. Correspondence to Karol Gryko. Participants were informed about the risks and provided their written informed consent. The study was carried out in accordance with the Code of Ethics of the World Medical Association Declaration of Helsinki for experiments involving humans. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. The original online version of this article was revised as the authors noticed that Tables 4 and 5 in some place dots are missing; therefore, some values are not true. Open Access This article is licensed under a Creative Commons Attribution 4. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Reprints and permissions. Kopiczko, A. et al. Bone mineral density in elite masters athletes: the effect of body composition and long-term exercise. Eur Rev Aging Phys Act 18 , 7 Download citation. Received : 09 February Accepted : 17 May Published : 31 May Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Research article Open access Published: 31 May Bone mineral density in elite masters athletes: the effect of body composition and long-term exercise Anna Kopiczko 1 , Jakub Grzegorz Adamczyk 2 , Karol Gryko ORCID: orcid. This article has been updated. Abstract Background The purpose of the study was to examine how bone mineral density BMD is related to body composition depending on the practiced sport endurance, speed-power, throwing sports in participants of the World Masters Athletics Championship. Methods Dual-energy X-ray absorptiometry DXA was used to determine BMD and bone mass BMC. Conclusion The representatives of strength based events had the most advantageous BMD levels. Introduction Aging is accompanied by adverse changes in body functioning, including those associated with impaired bone metabolism. Methodology Sample and procedure The study included participants at the World Masters Athletics Championship held in March in Poland women aged Dual-energy X-ray absorptiometry Bone parameters of the non-dominant forearm were measured by the densitometric method for measuring the peripheral skeleton. Bioelectrical impedance methods Body composition was analyzed by means of the JAWON Medical X-scan PLUS Jawon Medical Co. Statistical analysis The normality of distribution was verified by the Shapiro-Wilk test and the assumption of equality of variances assessed with the Levene test of homogeneity of variance. Results Table 1 shows the prevalence of normal and underestimated bone mineralization in individual parts of the forearm according to gender and sport. Table 4 Multiple backward stepwise logistic regression in male masters athletes Full size table. Table 5 Multiple backward stepwise logistic regression in female masters athletes Full size table. Conclusions The prevalence of low T-scores in the form of osteopenia and osteoporosis especially among women EA,SPA,TA in both measurement sections, and in men EA and SPA especially in the proximal section indicate the presence of developing osteoporosis risk which might lead to fractures in more than half of the masters athletes. References Compston J, Cooper A, Cooper C, Gittoes N, Gregson C, Harvey N, et al. Article CAS PubMed PubMed Central Google Scholar Hannan MT, Felson DT, Dawson-Hughes B, Tucker KL, Cupples LA, Wilson PW, et al. Article CAS PubMed Google Scholar Reaburn P. Article PubMed Google Scholar Nikander R, Sievanen H, Heinonen A, Daly RM, Uusi-Rasi K, Kannus P. Article Google Scholar Zehnacker CH, Bemis-Dougherty A. Article Google Scholar Martyn-St James M, Carroll S. Google Scholar Ma D, Wu L, He Z. Article PubMed Google Scholar Bolam KA, van Ufelen JG, Taafe DR. Article CAS Google Scholar Varahra A, Rodrigues IB, MacDermid JC, Bryant D, Birmingham T. Article CAS PubMed Google Scholar Xu J, Lombardi G, Jiao W, Banfi G. Article PubMed Google Scholar Kanis JA, Cooper C, Rizzoli R, Reginster JY. Article CAS PubMed Google Scholar Piasecki J, McPhee JS, Hannam K, Deere KC, Elhakeem A, Piasecki M, et al. Article CAS PubMed PubMed Central Google Scholar Piasecki J, Ireland A, Piasecki M, Deere K, Hannam K, Tobias J, et al. Article PubMed PubMed Central Google Scholar Sanchis-Gomar F, Perez-Quilis C, Leischik R, Lucia A. Article PubMed PubMed Central Google Scholar Kopiczko A. Article CAS PubMed Google Scholar Manion L, Cohen L, Morrison K. Article PubMed Google Scholar Kapuš O, Gába A, Lehnert M. Article Google Scholar Sale C, Elliott-Sale KJ. Article PubMed PubMed Central Google Scholar Tenenhouse A, Joseph L, Kreiger N, Poliquin S, Murray TM, Blondeau L, et al. Article CAS PubMed Google Scholar Kim CJ, Oh KW, Rhee EJ, Kim KH, Jo SK, Jung CH, et al. Article CAS Google Scholar Andreoli A, Bazzocchi A, Celi M, Lauro D, Sorge R, Tarantino U, et al. Article CAS PubMed Google Scholar Fien S, Climstein M, Quilter C, Buckley G, Henwood T, Grigg J, et al. Article Google Scholar Young BW, Weir PL, Starkes JL, Medic N. Article PubMed Google Scholar Creighton DL, Morgan AL, Boardley D, Brolinson PG. Article CAS PubMed Google Scholar Prouteau S, Pelle A, Collomp K, Benhamou L, Courteix D. Article PubMed Google Scholar Lunt M, Masaryk P, Scheidt-Nave C, Nijs J, Poor G, Pols H, et al. Article CAS PubMed Google Scholar Cauley JA, Fullman RL, Stone KL, Zmuda JM, Bauer DC, Barrett-Connor E, et al. Article PubMed Google Scholar Nguyen TV, Center JR, Eisman JA. Article CAS PubMed Google Scholar Orwoll ES, Bevan L, Phipps KR. Article CAS PubMed Google Scholar Ho-Pham Lan T, Nguyen Uyen DT, Nguyen TV. Article CAS Google Scholar Travison TG, Araujo AB, Esche GR, McKinlay JB. Article CAS PubMed Google Scholar Tanaka H, Tarumi T, Rittweger J. Article PubMed Google Scholar Lee SY, Gallagher D. Article PubMed PubMed Central Google Scholar Wilson EE, Awonusi A, Morris MD, Kohn DH, Tecklenburg MM, Beck LW. Article CAS PubMed PubMed Central Google Scholar Nyman JS, Roy A, Shen X, Acuna RL, Tyler JH, Wang X. Article PubMed PubMed Central Google Scholar Bernardi M, Ricci CS, Zaccherini G. Article PubMed PubMed Central Google Scholar Nishikawa H, Yoh K, Enomoto H, Ishii N, Iwata Y, Nakano C, et al. Article CAS PubMed Central Google Scholar Pettersson U, Nordström P, Alfredson H, Henriksson-Larsén K, Lorentzon R. Article CAS PubMed Google Scholar Nordström P, Pettersson U, Lorentzon R. Article PubMed Google Scholar Bielemann RM, Martinez-Mesa J, Gigante DP. Article Google Scholar Download references. Author information Authors and Affiliations Department of Human Biology, Józef Piłsudski University of Physical Education in Warsaw, Marymoncka 34, , Warsaw, Poland Anna Kopiczko Department of Theory of Sport, Józef Piłsudski University of Physical Education in Warsaw, Marymoncka 34, , Warsaw, Poland Jakub Grzegorz Adamczyk Department of Sport Games, Józef Piłsudski University of Physical Education in Warsaw, Marymoncka 34, , Warsaw, Poland Karol Gryko Department of Team Sport Games, University School of Physical Education in Wrocław, Al. Ignacego Jana Paderewskiego 35, , Wrocław, Poland Marek Popowczak Authors Anna Kopiczko View author publications. View author publications. Ethics declarations Ethics approval and consent to participate Participants were informed about the risks and provided their written informed consent. Consent for publication Not applicable. After four months, bone density averaged over the whole body and lean muscle mass increased significantly in the group which combined aerobic activity with weight lifting but didn't improve for the athletes who only engaged in aerobic exercise. In addition, the density of the 'femoral neck' - a part of the femur which links the straight shaft of the femur with the actual hip-joint socket - advanced for strength-trained athletes but stayed constant in the aerobic group. This is particularly important for older individuals, since the femoral neck is a frequent site of fractures. Neither group was able to lift the density of the lumbar vertebrae, and each group improved the ability to do sit-ups and push-up by similar amounts. Although weight training is sometimes viewed as 'risky' for older athletes, none of the weight trainers was injured during the four-month study. Overall, a programme of aerobic activity plus strength training was better than aerobic exercise alone in terms of improving the integrity of the skeletal and muscular systems. As the researchers put it, 'We recommend that healthy people over the age of 55 years enrol in a combination of aerobic and weightlifting exercises'. Why does so much muscle tissue disappear, and why does the degeneration accelerate after a half-century? New research from Sweden has the answer. The primary reason for the sinew reduction is that the total number of cells in any particular muscle stays pretty constant until the age of 30 but then begins a steady decline. The fall-off is slow at first but increases dramatically after the age of For example, if one of your muscles consisted of cells fibres when you were 30, the muscle would probably still contain 90 95 fibres 20 years later, but the 'fibre count' would plummet to only when you became an octogenarian. Individual muscle cells in your body can be either type 1 'slow-twitch' fibres, which contract slowly but have great endurance potential, or type 2 'fast twitch' fibres, which contract quickly and powerfully but have little endurance. A decrease in the size of type 2 fibres plays a role in the muscle-shrinking process, with individual fast-twitchers shrivelling by about per cent between the ages of 20 and However, this loss is somewhat compensated for by the steadfastness of type 1 'slow-twitch' muscle cells, which either remain unchanged in size or can expand by up to 20 per cent in individuals who remain very physically active as they get older. What causes the fairly dramatic loss in muscle-cell numbers? Over time - and especially after the age of 50 - 'motor nerve cells' in the spinal cord begin to deteriorate at a steady rate. By means of their long arms, which spread outward from the spinal cord like the tentacles of an octopus, the motor nerve cells are normally in close contact with muscle cells. The motor nerves' key function is to 'tell' muscle fibres when to contract during physical activity, but the connection between motor nerves and their associated muscle cells is also necessary to keep the muscle fibres alive. As motor nerve cells die, the muscle cells to which they are attached also bite the dust. Fortunately, there's a positive side to the story. People who participate in resistance training don't necessarily halt the fibre-death process, but they can stop and even reverse the tendencies of their type 2 cells to grow smaller. Although the number of muscle cells declines, type 2 and sometimes even type 1 fibres may get larger as a result of strength training, leading to a potential advancement - instead of a loss - of total muscle tissue in the body. As a fringe benefit, resistance training in older individuals seems to increase the number of small blood vessels around muscles by up to 15 per cent, potentially increasing endurance capacity. Since the overall process of muscle atrophy picks up steam after the age of 50, strength training for people over 50 is especially critical. Fortunately, it's never too late. Research demonstrates that even individuals over the age of 80 can fortify their muscles by participating in regular strength-training workouts. Andrew Hamilton Andrew Hamilton BSc Hons, MRSC, ACSM, is the editor of Sports Performance Bulletin and a member of the American College of Sports Medicine. Register now to get a free Issue. 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| Female athlete triad: Protecting the health and bones of active young women - Harvard Health | Baim, S. This might not, however, be the case given that Kerstetter et al. Resources Issue Library. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. In addition, there might also be an interaction between elements of the female athlete triad and certain nutrients that could exacerbate the effects on bone. Athletes who stand out in smaller training centers are sent to train at the Olympic Training and Research Center due to excellent physical structure that is composed by sportive courts, gym, soccer field, athletics track, swimming poll, exercise physiology laboratory, and medical and nutrition division. Stress fractures can also be due to a lower bone mineral density, which means it takes less force to cause damage. |
| Athlete’s and Bone Health | Spriet provided comments on each paper and made an editorial decision based on comments from the peer reviewers and the Editor-in-Chief. BMJ Open Sport Exerc Med. Sorry, a shareable link is not currently available for this article. The prevalence of osteoporosis in older adults has been widely demonstrated by numerous cross-sectional and longitudinal studies [ 23 , 24 , 25 ]. Hyponatremia-induced osteoporosis. Which migraine medications are most helpful? |
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