The interactions of physical activity, exercise and genetics and their associations with bone mineral density: implications for injury risk in elite athletes

Abstract

Low bone mineral density (BMD) is established as a primary predictor of osteoporotic risk and can also have substantial implications for athlete health and injury risk in the elite sporting environment. BMD is a highly multi-factorial phenotype influenced by diet, hormonal characteristics and physical activity. The interrelationships between such factors, and a strong genetic component, suggested to be around 50–85% at various anatomical sites, determine skeletal health throughout life. Genome-wide association studies and case–control designs have revealed many loci associated with variation in BMD. However, a number of the candidate genes identified at these loci have no known associated biological function or have yet to be replicated in subsequent investigations. Furthermore, few investigations have considered gene–environment interactions—in particular, whether specific genes may be sensitive to mechanical loading from physical activity and the outcome of such an interaction for BMD and potential injury risk. Therefore, this review considers the importance of physical activity on BMD, genetic associations with BMD and how subsequent investigation requires consideration of the interaction between these determinants. Future research using well-defined independent cohorts such as elite athletes, who experience much greater mechanical stress than most, to study such phenotypes, can provide a greater understanding of these factors as well as the biological underpinnings of such a physiologically “extreme” population. Subsequently, modification of training, exercise or rehabilitation programmes based on genetic characteristics could have substantial implications in both the sporting and public health domains once the fundamental research has been conducted successfully.

Knee Scooter–Related Injuries: A Survey of Foot and Ankle Orthopedic Surgeons

“…Again, this may be attributable to the decline in bone mineral density starting as early as age 25 years in both men and women. 3 Many respondents commonly recommended scooters for patients who are obese, and obesity was identified as a common characteristic among injured patients. Obese individuals might be injured more commonly because they are more likely to have scooters recommended.…”

“…Finally, although respondents indicated that a patient's lifestyle (sedentary vs active) does not influence their likelihood of recommending scooters, sedentary lifestyle was a more commonly reported characteristic among injured patients. Physical activity improves bone mineral density, 3 a From w 2 goodness-of-fit test, with null hypothesis expecting equal distribution of observations among answer choices, excluding "Other" and/or "Unsure." b Expressed as mean + SD.…”

Physical Activity As a Preventive Measure against Cardiovascular Disease in Elderly Patients

“…Результатом этого исследования стал вывод о том, что ЧСС является фактором риска смерти независимо от физической подготовленности и других потенциальных факторов риска. Высокий уровень физической подготовленности служит сильным предиктором долголетия [12], что обусловлено также положительным влиянием на минеральную плотность кости [14].…”

Genetic Basis of Aerobically Supported Voluntary Exercise: Results from a Selection Experiment with House Mice

“…Other human studies have detected QTL associated with physical traits related to exercise abilities, including maximal oxygen consumption (VO 2max ) (Williams et al 2017), bone density (Herbert et al 2019), and more (Lin et al 2017). The list of possible biological traits affiliated with exercise and their associated QTL is extensive (Sarzynski et al 2016;Lightfoot et al 2018).…”