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Evaluating the relationship of calcium and vitamin D in the prevention of stress fracture injuries in the young athlete: a review of the literature.

PM & R : the journal of injury, function, and rehabilitation
October 1, 2010
Adam S Tenforde et al. (4 authors)
Journal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the role of calcium and vitamin D in bone health, specifically their impact on bone density and fracture prevention in young athletes, particularly females.

Results Summary

The study found that increased calcium intake improved bone density and reduced fracture risk in young female athletes and military recruits, with the greatest benefits seen at daily intakes exceeding 1500 mg. Prospective studies supported these findings, though data for male and adolescent athletes were lacking.

Population

Young female athletes (ages 18-35) and female military recruits; males and nonwhite participants were underrepresented.

Effective Dosage

Greater than 1500 mg daily

Duration

Not specified

Interactions

None mentioned

Extracted Claims (8)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Calcium and vitamin D
increase
bone density
all ages
-
have been clearly shown to improve
#1
Calcium and vitamin D
decrease
fractures
all ages
-
have been clearly shown to prevent
#2
increased calcium intake
increase
bone density
young athletes ages 18 to 35 years
-
demonstrated a relationship with an improvement in
#3
increased calcium intake
decrease
fracture risk
young athletes ages 18 to 35 years
-
demonstrated a relationship with a decrease in
#4
calcium/vitamin D supplementation
decrease
stress fractures
female military recruits
-
reduced the incidence of
#5
increased dietary calcium intake
decrease
stress fractures
young female runners
-
demonstrated reduced incidence of
#6
increased dietary calcium intake
increase
bone mineral density
young female runners
-
demonstrated increased
#7
greater than 1500 mg of calcium daily
decrease
stress fracture injuries
female athletes and military recruits
-
exhibited the largest reduction in
#8
Abstract

Calcium and vitamin D are recognized as 2 components of nutrition needed to achieve and maintain bone health. Calcium and vitamin D have been clearly shown to improve bone density and prevent fractures at all ages. However, the literature is conflicting as to the role of these nutrients in young athletes ages 18 to 35 years, both for bone development and for the prevention of bone overuse injuries. Differences in findings may relate to study design. Although retrospective and cross-sectional studies have had mixed results, the authors of prospective studies have consistently demonstrated a relationship of increased calcium intake with an improvement in bone density and a decrease in fracture risk. A randomized trial in female military recruits demonstrated that calcium/vitamin D supplementation reduced the incidence of stress fractures. A prospective study in young female runners demonstrated reduced incidence of stress fractures and increased bone mineral density with increased dietary calcium intake. Findings from both studies suggest female athletes and military recruits who consumed greater than 1500 mg of calcium daily exhibited the largest reduction in stress fracture injuries. To date, no prospective studies have been conducted in male athletes or in adolescent athletes. In most studies, males and nonwhite participants were poorly represented. Evidence regarding the relationship of vitamin D intake with the prevention of fractures in athletes is also limited. More prospective studies are needed to evaluate the role of calcium and vitamin D intake in prevention of stress fracture injuries in both male and female adolescent athletes, particularly those participating in sports with greater incidences of stress fracture injury.

Medical Subject Headings (MeSH)
Athletic InjuriesBone DensityBone Density Conservation AgentsCalciumDietDietary SupplementsFractures, StressHumansMilitary PersonnelRisk FactorsRunningVitamin D
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality75/10
Citation Metrics
Total Citations49
Citations/Year3.3
Relative Citation Ratio2.02
NIH Percentile74.9%
Research Impact Scores
APT Score0.75
Weight Score1.28
Normalized Score0.69
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