Abstract
Intensive physical training can cause stress fractures in both osteoporotic patients and healthy, young adults. Female military recruits are especially vulnerable to such fractures, with a reported frequency of 5–15% during prolonged periods of intense physical activity. In this Practice Point commentary, I discuss a randomized, controlled study of nutritional supplementation for prevention of stress fractures in female US navy recruits. Lappe et al. reported that intervention with a high dose of calcium (2g daily) plus a normal dose of vitamin D3 (800IU daily) reduced the incidence of stress fractures by 20% (P<0.003) during the 8-week study period. The authors also confirmed additional risk factors for stress fractures, such as smoking, low physical fitness and amenorrhea. Predisposing risk factors and nutritional intervention strategies that influence stress fracture occurrence in young adults at the time of their peak bone mass, therefore, seem very similar to those known to affect osteoporotic fractures in the elderly.
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References
Friedl KE (2005) Biomedical research on health and performance of military women: accomplishments of the Defense Women's Health Research Program (DWHRP). J Womens Health (Larchmt) 14: 764–802
Lappe J et al. (2008) Calcium and vitamin D supplementation decreases incidence of stress fractures in female navy recruits. J Bone Miner Res 23: 741–749
Peris P (2003) Stress fractures. Best Pract Res Clin Rheumatol 17: 1043–1061
Rome K et al. Interventions for preventing and treating stress fractures and stress reactions of bone of the lower limbs in young adults. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD000450. 10.1002/14651858.CD000450.pub2
Bischoff-Ferrari HA et al. (2005) Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA 293: 2257–2264
Boonen S et al. (2007) Need for additional calcium to reduce the risk of hip fracture with vitamin D supplementation: evidence from a comparative metaanalysis of randomized controlled trials. J Clin Endocrinol Metab 92: 1415–1423
Tang BM et al. (2007) Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet 370: 657–666
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Bouillon, R. How effective is nutritional supplementation for the prevention of stress fractures in female military recruits?. Nat Rev Endocrinol 4, 486–487 (2008). https://doi.org/10.1038/ncpendmet0897
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DOI: https://doi.org/10.1038/ncpendmet0897