{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:57:32Z","timestamp":1790420252312,"version":"4.1.0"},"reference-count":32,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2016,11,28]]},"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Limited research has evaluated risk factors for low bone mineral density (BMD) in male adolescent athletes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims\/objectives<\/jats:title>\n                    <jats:p>To evaluate predictors of low BMD (defined as BMD Z-score &lt;\u22121.0) in a sample of male adolescent distance runner and non-runner athletes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Male adolescent athletes completed a survey characterising sports participation, nutrition, stress fracture history, dual energy X-ray absorptiometry (DXA)-measured BMD and body composition. Independent t-tests and analysis of covariance (ANCOVA) evaluated group differences; logistic regression evaluated low BMD risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Runners (n=51) exhibited a lower body weight (p=0.02), body mass index (BMI) (kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) (p=0.02), per cent expected weight (p=0.02) and spine BMD Z-score (p=0.002) compared with non-runners (n=18). Single risk factors of low BMD included &lt;85% expected weight (OR=5.6, 95% CI 1.4 to 22.5) and average weekly mileage &gt;30 in the past year (OR=6.4, 95% CI 1.5 to 27.1). The strongest two-variable and three-variable risk factors included weekly mileage &gt;30+ stress fracture history (OR=17.3, 95% CI 1.6 to 185.6) and weekly mileage &gt;30+&lt;85% expected weight + stress fracture history (OR=17.3, 95% CI 1.6 to 185.6), respectively. Risk factors were cumulative when predicting low BMD (including &lt;85% expected weight, weekly mileage &gt;30, stress fracture history and &lt;1 serving of calcium-rich food\/day): 0\u20131 risk factors (11.1%), 2 risk factors (42.9%), or 3\u20134 risk factors (80.0%), p&lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Male adolescent runners exhibited lower body weight, BMI and spine BMD Z-score values. The risk of low BMD displayed a graded relationship with increasing risk factors, highlighting the importance of using methods to optimise bone mass in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjsports-2016-096698","type":"journal-article","created":{"date-parts":[[2018,2,23]],"date-time":"2018-02-23T08:05:15Z","timestamp":1519373115000},"page":"200-205","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":88,"title":["Evidence of a cumulative effect for risk factors predicting low bone mass among male adolescent athletes"],"prefix":"10.1136","volume":"51","author":[{"given":"Michelle T","family":"Barrack","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Fredericson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam S","family":"Tenforde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurelia","family":"Nattiv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,1,18]]},"reference":[{"key":"2024051411335260000_51.3.200.1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1123\/ijsnem.16.1.1","article-title":"The prevalence of disordered eating, menstrual dysfunction, and low bone mineral density among US collegiate athletes","volume":"16","author":"Beals","year":"2006","journal-title":"Int J Sport Nutr Exerc Metab"},{"key":"2024051411335260000_51.3.200.2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2004.012781"},{"key":"2024051411335260000_51.3.200.3","doi-asserted-by":"publisher","DOI":"10.1249\/01.MSS.0000064935.68277.E7"},{"key":"2024051411335260000_51.3.200.4","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e3181822ea0"},{"key":"2024051411335260000_51.3.200.5","doi-asserted-by":"publisher","DOI":"10.1249\/mss.0b013e318149f111"},{"key":"2024051411335260000_51.3.200.6","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/j.jand.2015.10.022","article-title":"Diets high in fiber and vegetable protein are associated with low lumbar bone mineral density in young athletes with oligoamenorrhea","volume":"116","author":"Barron","year":"2016","journal-title":"J Acad Nutr Diet"},{"key":"2024051411335260000_51.3.200.7","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515572142"},{"key":"2024051411335260000_51.3.200.8","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e3182a03b8b"},{"key":"2024051411335260000_51.3.200.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2006.03.012"},{"key":"2024051411335260000_51.3.200.10","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2006.030783"},{"key":"2024051411335260000_51.3.200.11","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.2000.15.11.2245"},{"key":"2024051411335260000_51.3.200.12","doi-asserted-by":"publisher","DOI":"10.1249\/01.MSS.0000152677.60545.3A"},{"key":"2024051411335260000_51.3.200.13","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e3182963d75"},{"key":"2024051411335260000_51.3.200.14","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1093\/oxfordjournals.aje.a115149","article-title":"A dietary and risk factor questionnaire and analysis system for personal computers","volume":"129","author":"Smucker","year":"1989","journal-title":"Am J Epidemiol"},{"key":"2024051411335260000_51.3.200.15","first-page":"1","article-title":"CDC growth charts: United States","volume":"314","author":"Kuczmarski","year":"2000","journal-title":"Adv Data"},{"key":"2024051411335260000_51.3.200.16","unstructured":"Hamwi GJ . 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