Osteoporosis and the aging athlete

Osteoporosis is a clinical syndrome of bone fragility resulting in fractures with minimal or no trauma. Bone strength is directly related to bone mass, therefore factors that influence bone mass will determine the subsequent risk of osteoporotic fracture. Estrogen loss at the menopause is the most common cause of osteoporosis. Factors that limit the process of bone formation during adolescence and early adulthood can interfere with reaching peak adult bone mass and thereby predispose to osteoporosis in later adult years. Bone remodeling (bone resorption followed by formation) during the early and mid-adult years may be altered by many diseases, medications and lifestyle (alcohol, inadequate exercise, low calcium intake), resulting in reduced bone mass and increased risk for osteoporotic fracture. Extremes of physical training can also cause bone loss in women athletes, and can be reversed by estrogen and adequate calcium intake. More research is needed to determine which forms of training optimize the effects of exercise on bone mass.