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J Sports Sci. 2018 Feb;36(4):456-461. doi: 10.1080/02640414.2017.1313998. Epub 2017 Apr 13.

Bone health in elite Kenyan runners.

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a Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Science , University of Cape Town , Cape Town , South Africa.
b Department of Physical Education and Sport , University of the Basque Country, UPV/EHU , Vitoria-Gasteiz , Spain.
c School of Medicine , University of the Free State , Bloemfontein , South Africa.
d Institute of Sport and Exercise Medicine, Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences , Stellenbosch University , Western Cape , South Africa.
e MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa.


Impact loading in athletes participating in various sports has been positively associated with increased bone mineral density (BMD), but this has not been investigated in elite Kenyan runners. Body composition and site-specific BMD measures quantified with dual x-ray absorptiometry were measured in 15 elite male Kenyan runners and 23 apparently healthy South African males of different ethnicities. Training load and biomechanical variables associated with impact loading, such as joint stiffness, were determined in the elite Kenyan runners. Greater proximal femur (PF) BMD (g · cm-2) was higher (P = 0.001, ES = 1.24) in the elite Kenyan runners compared with the controls. Six of the 15 (40%) Kenyan runners exhibited lumbar spine (LS) Z-Scores below -2.0 SD, whereas this was not found in the apparently healthy controls. PFBMD was associated with training load (r = 0.560, P = 0.003) and ankle (r = 0.710, P = 0.004) and knee (r = 0.546, P = 0.043) joint stiffness. Elite Kenyan runners exhibit greater PFBMD than healthy controls, which is associated with higher training load and higher joint stiffness. Our results reaffirm the benefits of impact loading on BMD at a weight-bearing site, while a high prevalence of low LSBMD in the elite Kenyan runners is hypothesised to be the result of a mismatch between energy intake and high training load. Future research investigating energy availability in Kenyan runners and the possible association with musculoskeletal injury should be investigated.


Running; biomechanics; exercise; performance

[Indexed for MEDLINE]

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