Optimizing Bone Health : Impact of Nutrition , Exercise , and Hormones

INTRODUCTION Just 20 years ago, few athletic trainers, dietitians, and exercise physiologists were concerned with bone health, beyond the occasional fracture an athlete might incur. Relatively few exercise professionals worked with elderly, frail populations with diagnosed osteoporosis, which was often considered an inevitable consequence of advanced aging. Then, Dr. Barbara Drinkwater and colleagues (1984) caught our attention with their landmark publication documenting astoundingly low bone mineral density (BMD) values in young, competitive athletes who on average had not menstruated during the previous 3.5 years. The average BMD in the lumbar area of the spine in these otherwise healthy young women was equivalent to that of a 51-year-old woman. A burst of subsequent research in this area was aided by advances in the technology of BMD measurement and in pharmacological treatment of diagnosed osteoporosis, which together have transformed osteoporosis into a treatable, even preventable, disease.