{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:31:00Z","timestamp":1790800260672,"version":"4.1.0"},"reference-count":35,"publisher":"Elsevier BV","issue":"2","license":[{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Densitometry"],"published-print":{"date-parts":[[2022,4]]},"DOI":"10.1016\/j.jocd.2021.01.013","type":"journal-article","created":{"date-parts":[[2021,1,30]],"date-time":"2021-01-30T11:20:43Z","timestamp":1612005643000},"page":"160-167","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":9,"title":["Low Energy Availability Interferes With Exercise-Associated Bone Effects in Female Long-Distance Triathletes as Detected by HR-pQCT"],"prefix":"10.1016","volume":"25","author":[{"given":"EMF","family":"Gama","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1339-3192","authenticated-orcid":false,"given":"L","family":"Kasuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"FP","family":"Paranhos-Neto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6752-2880","authenticated-orcid":false,"given":"M","family":"Madeira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LMC","family":"Mendon\u00e7a","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Schtscherbyna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MLF","family":"Farias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jocd.2021.01.013_bib0001","series-title":"Department for Culture, Media and Sport","article-title":"A review of the social impacts of culture and sport","author":"Taylor","year":"2015"},{"issue":"2","key":"10.1016\/j.jocd.2021.01.013_bib0002","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1177\/1941738116677732","article-title":"Bone health in athletes","volume":"9","author":"Goolsby","year":"2017","journal-title":"Sports health"},{"issue":"16","key":"10.1016\/j.jocd.2021.01.013_bib0003","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1136\/bjsports-2013-092966","article-title":"How to minimise the health risks to athletes who compete in weight-sensitive sports review and position statement on behalf of the Ad Hoc research working group on body composition, health and performance, under the auspices of the IOC Medical Commission","volume":"47","author":"Sundgot-Borgen","year":"2013","journal-title":"Br J Sports Med"},{"issue":"4","key":"10.1016\/j.jocd.2021.01.013_bib0004","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1016\/j.bone.2009.06.021","article-title":"History of amenorrhoea compromises some of the exercise-induced benefits in cortical and trabecular bone in the peripheral and axial skeleton: a study in retired elite gymnasts","volume":"45","author":"Ducher","year":"2009","journal-title":"Bone"},{"issue":"7","key":"10.1016\/j.jocd.2021.01.013_bib0005","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1249\/00005768-199307000-00003","article-title":"The female athlete triad: disordered eating, amenorrhea, osteoporosis","volume":"25","author":"Yeager","year":"1993","journal-title":"Med Sci Sports Exerc"},{"issue":"5","key":"10.1016\/j.jocd.2021.01.013_bib0006","doi-asserted-by":"crossref","first-page":"i","DOI":"10.1097\/00005768-199705000-00037","article-title":"American college of sports medicine position stand. The female athlete triad","volume":"29","author":"Otis","year":"1997","journal-title":"Med Sci Sports Exerc"},{"issue":"10","key":"10.1016\/j.jocd.2021.01.013_bib0007","first-page":"1867","article-title":"American College of Sports Medicine position stand. The female athlete triad","volume":"39","author":"Nattiv","year":"2007","journal-title":"Med Sci Sports Exerc"},{"issue":"1","key":"10.1016\/j.jocd.2021.01.013_bib0008","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1007\/s40279-017-0790-3","article-title":"Low energy availability in athletes: a review of prevalence, dietary patterns, physiological health, and sports performance","volume":"48","author":"Logue","year":"2018","journal-title":"Sports Med"},{"issue":"2","key":"10.1016\/j.jocd.2021.01.013_bib0009","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1097\/JSM.0000000000000085","article-title":"2014 female athlete triad coalition consensus statement on treatment and return to play of the female athlete triad: 1st International Conference held in San Francisco, CA, May 2012, and 2nd International Conference held in Indianapolis, IN, May 2013","volume":"24","author":"De Souza","year":"2014","journal-title":"Clin J Sport Med"},{"issue":"10","key":"10.1016\/j.jocd.2021.01.013_bib0010","doi-asserted-by":"crossref","first-page":"3123","DOI":"10.1210\/jc.2011-1614","article-title":"Bone microarchitecture is impaired in adolescent amenorrheic athletes compared with eumenorrheic athletes and nonathletic controls","volume":"96","author":"Ackerman","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"10.1016\/j.jocd.2021.01.013_bib0011","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1097\/00005768-200202000-00017","article-title":"Bone mineral density in adolescent female athletes: relationship to exercise type and muscle strength","volume":"34","author":"Duncan","year":"2002","journal-title":"Med Sci Sports Exerc"},{"issue":"3","key":"10.1016\/j.jocd.2021.01.013_bib0012","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1002\/jbmr.3901","article-title":"HR-pQCT measures of bone microarchitecture predict fracture: systematic review and meta-analysis","volume":"35","author":"Mikolajewicz","year":"2020","journal-title":"J Bone Miner Res"},{"issue":"8","key":"10.1016\/j.jocd.2021.01.013_bib0013","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1249\/MSS.0000000000000574","article-title":"Fractures in relation to menstrual status and bone parameters in young athletes","volume":"47","author":"Ackerman","year":"2015","journal-title":"Med Sci Sports Exerc"},{"issue":"4","key":"10.1016\/j.jocd.2021.01.013_bib0014","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/j.jocd.2019.07.001","article-title":"Summary of the 2019 ISCD Position development conference on monitoring treatment, DXA cross-calibration and least significant change, spinal cord injury, peri-prosthetic and orthopedic bone health, transgender medicine, and pediatrics","volume":"22","author":"Shuhart","year":"2019","journal-title":"J Clin Densitom"},{"issue":"Suppl 1","key":"10.1016\/j.jocd.2021.01.013_bib0015","doi-asserted-by":"crossref","first-page":"S7","DOI":"10.1080\/02640414.2011.588958","article-title":"Energy availability in athletes","volume":"29","author":"Loucks","year":"2011","journal-title":"J Sports Sci"},{"issue":"5","key":"10.1016\/j.jocd.2021.01.013_bib0016","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1016\/j.apmr.2007.02.035","article-title":"Prevalence of female athlete triad characteristics in a club triathlon team","volume":"88","author":"Hoch","year":"2007","journal-title":"Arch Phys Med Rehabil"},{"key":"10.1016\/j.jocd.2021.01.013_bib0017","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.bone.2015.06.021","article-title":"Altered trabecular bone morphology in adolescent and young adult athletes with menstrual dysfunction","volume":"81","author":"Mitchell","year":"2015","journal-title":"Bone"},{"issue":"6","key":"10.1016\/j.jocd.2021.01.013_bib0018","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1249\/JSR.0b013e3182779193","article-title":"Bone health in endurance athletes: runners, cyclists, and swimmers","volume":"11","author":"Scofield","year":"2012","journal-title":"Curr Sports Med Rep"},{"key":"10.1016\/j.jocd.2021.01.013_bib0019","doi-asserted-by":"crossref","DOI":"10.1002\/14651858.CD006033.pub5","article-title":"Steroidal contraceptives: effect on bone fractures in women","author":"Lopez","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"10.1016\/j.jocd.2021.01.013_bib0020","doi-asserted-by":"crossref","first-page":"28","DOI":"10.70252\/IHLJ2416","article-title":"Influence of body composition, oral contraceptive use, and physical activity on bone mineral density in premenopausal women","volume":"2","author":"Sherk","year":"2009","journal-title":"Int J Exerc Sci"},{"issue":"12","key":"10.1016\/j.jocd.2021.01.013_bib0021","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.1007\/s00198-005-1868-6","article-title":"Oral contraceptive use in young women is associated with lower bone mineral density than that of controls","volume":"16","author":"Almstedt Shoepe","year":"2005","journal-title":"Osteoporos Int"},{"issue":"4","key":"10.1016\/j.jocd.2021.01.013_bib0022","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1123\/ijsnem.2018-0136","article-title":"International Olympic Committee (IOC) consensus statement on relative energy deficiency in sport (red-s): 2018 update","volume":"28","author":"Mountjoy","year":"2018","journal-title":"Int J Sport Nutr Exerc Metab"},{"key":"10.1016\/j.jocd.2021.01.013_bib0023","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.cophys.2019.04.001","article-title":"Rethinking the concept of an energy availability threshold and its role in the Female Athlete Triad","volume":"10","author":"De Souza","year":"2019","journal-title":"Current Opinion in Physiology"},{"key":"10.1016\/j.jocd.2021.01.013_bib0024","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.bone.2018.06.016","article-title":"Bone metabolic responses to low energy availability achieved by diet or exercise in active eumenorrheic women","volume":"114","author":"Papageorgiou","year":"2018","journal-title":"Bone"},{"issue":"22","key":"10.1016\/j.jocd.2021.01.013_bib0025","first-page":"610","article-title":"Profile of the female athlete triad among elite Kenyan enduranceathletes and non-athletes","volume":"20","author":"Goodwin","year":"2014","journal-title":"Afr J Physl Health Educ Recr Dance"},{"issue":"5","key":"10.1016\/j.jocd.2021.01.013_bib0026","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1097\/JSM.0b013e3181b8c136","article-title":"Prevalence of the female athlete triad in high school athletes and sedentary students","volume":"19","author":"Hoch","year":"2009","journal-title":"Clin J Sport Med"},{"issue":"5","key":"10.1016\/j.jocd.2021.01.013_bib0027","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1111\/sms.12261","article-title":"Energy availability and the female athlete triad in elite endurance athletes","volume":"25","author":"Melin","year":"2015","journal-title":"Scand J Med Sci Sports"},{"issue":"3","key":"10.1016\/j.jocd.2021.01.013_bib0028","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1007\/s00394-017-1498-8","article-title":"Reduced energy availability: implications for bone health in physically active populations","volume":"57","author":"Papageorgiou","year":"2018","journal-title":"Eur J Nutr"},{"issue":"1","key":"10.1016\/j.jocd.2021.01.013_bib0029","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.bone.2008.03.013","article-title":"The presence of both an energy deficiency and estrogen deficiency exacerbate alterations of bone metabolism in exercising women","volume":"43","author":"De Souza","year":"2008","journal-title":"Bone"},{"issue":"8","key":"10.1016\/j.jocd.2021.01.013_bib0030","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1359\/JBMR.040410","article-title":"Dose-response relationships between energy availability and bone turnover in young exercising women","volume":"19","author":"Ihle","year":"2004","journal-title":"J Bone Miner Res"},{"issue":"2","key":"10.1016\/j.jocd.2021.01.013_bib0031","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1123\/ijsnem.2018-0201","article-title":"Energy availability in athletics: health, performance, and physique","volume":"29","author":"Melin","year":"2019","journal-title":"Int J Sport Nutr Exerc Metab"},{"issue":"5","key":"10.1016\/j.jocd.2021.01.013_bib0032","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1111\/sms.13385","article-title":"Low energy availability, menstrual dysfunction, and impaired bone health: a survey of elite para athletes","volume":"29","author":"Brook","year":"2019","journal-title":"Scand J Med Sci Sports"},{"issue":"4","key":"10.1016\/j.jocd.2021.01.013_bib0033","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1016\/j.bone.2012.07.019","article-title":"Cortical microstructure and estimated bone strength in young amenorrheic athletes, eumenorrheic athletes and non-athletes","volume":"51","author":"Ackerman","year":"2012","journal-title":"Bone"},{"issue":"4","key":"10.1016\/j.jocd.2021.01.013_bib0034","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1007\/s00198-016-3887-x","article-title":"Unique effects of energy versus estrogen deficiency on multiple components of bone strength in exercising women","volume":"28","author":"Southmayd","year":"2017","journal-title":"Osteoporos Int"},{"issue":"12","key":"10.1016\/j.jocd.2021.01.013_bib0035","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.3390\/nu9121313","article-title":"Validity of dietary assessment in athletes: a systematic review","volume":"9","author":"Capling","year":"2017","journal-title":"Nutrients"}],"container-title":["Journal of Clinical Densitometry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1094695021000147?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1094695021000147?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T21:43:54Z","timestamp":1761083034000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1094695021000147"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":35,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["S1094695021000147"],"URL":"https:\/\/doi.org\/10.1016\/j.jocd.2021.01.013","relation":{},"ISSN":["1094-6950"],"issn-type":[{"value":"1094-6950","type":"print"}],"subject":[],"published":{"date-parts":[[2022,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Low Energy Availability Interferes With Exercise-Associated Bone Effects in Female Long-Distance Triathletes as Detected by HR-pQCT","name":"articletitle","label":"Article Title"},{"value":"Journal of Clinical Densitometry","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jocd.2021.01.013","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 The International Society for Clinical Densitometry. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}