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Better Bones Blog
Dr. Susan E. Brown

Endurance cycling leads to bone loss

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fcyclist-jpgWhile exercise is generally good for bone, a study of male endurance cyclists reports that serious cyclists lose significant hip bone mineral density during the biking season. This new research as well as earlier studies document that over time many endurance cyclists end up with low bone density.

If exercise is good for bone, why do endurance cyclists lose hip bone during the biking season?

Researchers report several factors which contribute to bone loss among serious cyclists. These include:

(1) Cycling is not weight-bearing and yields comparatively low skeletal strain (the skeletal strain of exercise encourages bone formation).
(2) Endurance cyclists do a great deal of this non-weight-bearing exercise, averaging over 13 hours per week, and perhaps do this activity instead of other exercise which might be weight-bearing and bone-building.
(3) Cyclists experienced an increase in parathyroid hormone, likely subsequent to excessive loss of calcium through the skin with sweating. Excess parathyroid hormone tends to increase bone breakdown.
(4) Cyclists likely did not consume enough calories for their heavy training. Also, I would add that they likely did not consume enough of the 20 key bone-building nutrients.
(5) The physiological stress of such training produces bone-damaging stress hormones and pro-inflammatory cytokines.

The Better Bones perspective on this research finding would include, but also go beyond, the above five proposed causal factors. As we see it, intense physical activity places various stresses on the body resulting in increased oxidative damage, increased bone-depleting low grade metabolic acidosis, and increased losses of many nutrients in the sweat. All these factors suggest the need for a higher level of not only calcium, but of all the 20 key bone nutrients. Further, ample antioxidants should be consumed by endurance athletes. These nutrients should be taken, perhaps in liquid form, just before or during the exercise itself. In addition, special attention should be given to reducing any exercise-induced metabolic acidosis with the Alkaline for Life® Diet and the use of alkalizing mineral compounds as necessary.

 

Reference:
Barry, DW, and Kohrt, WM. 2008. BMD decreases over the course of a year in competitive male cyclists. J Bone Miner Res, 23(4):484-491.

 

Better Bones Blog
Dr. Susan E. Brown

How to tell if you are losing bone without a bone density test

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While most doctors tend to monitor bone density with the dual-energy x-ray absorptiomentry (DEXA) test, there is another, less expensive test helpful in determining if you are currently losing bone. This test, called the cross-linked N-teleopeptide (or NTx for short), is a simple urine or blood test known as a “marker of bone resorption.” When you lose bone, small fragments of bone protein show up in the urine and blood, and measuring these bone protein fragments gives an indication of rate of bone breakdown. In most cases a high rate of bone breakdown, also known as bone resorption, indicates that there is an ongoing loss of bone mass.

The bone resorption markers most commonly used are the urine NTx osteomark marker and the urine deoxypyridinium cross-links (Dpd). Your physician can order either of these tests. Generally, a score that’s near or even a bit below the premenopausal mean for women, and one near or even a bit below the young adult mean for men, is ideal. In both tests, the higher the number, the greater the likelihood of a more rapid rate of ongoing bone loss. For more details see my articles on bone density testing and bone resorption testing.