The impact of high level basketball competition, calcium intake, menses, and hormone levels in adolescent bone density: a three-year follow-up

Aim. The main goal of the present work is to establish the positive influence high-impact physical exercise, specifically high-level basketball, on bone acquisition in adolescent female and verify if the long-term exposure to such programs is the major modifiable factor explaining bone acquisition during adolescence. Methods. A prospective cohort study comparing the development of bone mass in the lumbar spine, proximal femur and distal radius was carried out over a three-year period in two groups of adolescents: elite basketball players and age-matched controls. Baseline hormone levels and bone remodelling were evaluated. Bone mass, hours of physical exercise, diet, unhealthy habits, anthropometry and menstrual cycle were assessed at baseline and yearly. Differences in acquisition of bone mass were assessed by two-way repeated measures analysis of variance (ANOVA). Results. Elite basketball training and competition appears to increase bone mass in girls aged 14-18 years. The most pronounced benefits were observed in lumbar spine and proximal femur, sites most directly involved in the exercise and subjected to greatest impact. Conclusion. The intensive basketball training and competition in adolescent females increases bone mass in the lumbar spine and femur, skeletal sites submitted to high impact in this sport. No significant gain in bone mass was observed in age-matched, normally active, controls.