{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:43:33Z","timestamp":1769561013858,"version":"3.49.0"},"reference-count":44,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T00:00:00Z","timestamp":1769472000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfeicoamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["88881.846590\/2023-01"],"award-info":[{"award-number":["88881.846590\/2023-01"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["305262\/2023-8"],"award-info":[{"award-number":["305262\/2023-8"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","doi-asserted-by":"publisher","award":["FCT UID\/00617\/2025"],"award-info":[{"award-number":["FCT UID\/00617\/2025"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Peak bone mass gained in youth is crucial for preventing osteoporosis. Artistic gymnastics (AG) is highly osteogenic, yet its long-term effects on adults \u2265 45 years are not well documented. This case\u2013control study compared bone mineral density (BMD) and the prevalence of osteopenia\/osteoporosis in former gymnasts, age-matched controls, and reference populations from Brazil and Portugal. Participants included 65 former gymnasts (32 males, 33 females; 45\u201384 years), who trained for 12.6 \u00b1 4.3 years and included 41 international competitors, and 91 controls (37 males; 45\u201387 years). Whole-body and femoral BMD were assessed by DXA. Physical activity during youth (10\u201320 years) (PA-Youth) and the past decade (PA-10) was recorded. Reference data were drawn from large cohorts in Brazil (FIBRA, n = 828) and Portugal (CIAFEL, n = 1089). Former gymnasts had substantially higher PA-Youth than controls, while PA-10 was similar. Gymnasts displayed 4\u20136 times higher femoral Z-scores (neck and total) and a markedly lower prevalence of osteopenia\/osteoporosis (males: 3% vs. 16%; females: 36% vs. 52%, p &lt; 0.05). These benefits remained after adjustment for age, PA-10, and hormonal\/calcium therapy. Relative to reference populations, gymnasts showed greater whole-body and femoral mineralization, with no osteoporosis cases (vs. 6\u201312% overall; 9\u201313% among those \u226560 years). Age-stratified analysis (45\u201359 and \u226560 years) revealed a consistently lower osteopenia prevalence across age groups, except in females \u2265 60 years. In conclusion, early-life AG participation is associated with enduring skeletal benefits, including higher bone mineralization and reduced osteopenia\/osteoporosis in adults \u2265 45 years. The protective effect appears diminished in older females, likely reflecting prolonged postmenopausal bone loss.<\/jats:p>","DOI":"10.3390\/ijerph23020159","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T11:35:42Z","timestamp":1769513742000},"page":"159","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bone Health in Former Artistic Gymnasts Aged 45 Years and Over: Case\u2013Control Comparison with Controls and Reference Populations"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0301-8973","authenticated-orcid":false,"given":"Patr\u00edcia Arruda de Albuquerque","family":"Farinatti","sequence":"first","affiliation":[{"name":"Graduate Program in Exercise and Sport Sciences, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil"}]},{"given":"Cinthia","family":"Sousa","sequence":"additional","affiliation":[{"name":"Graduate Program in Exercise and Sport Sciences, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0494-0000","authenticated-orcid":false,"given":"Rodrigo","family":"Zacca","sequence":"additional","affiliation":[{"name":"Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports, University of Porto, 4200-450 Porto, Portugal"},{"name":"Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal"},{"name":"Laboratory of Sport Physiology, Faculty of Sports, University of Porto, 4200-450 Porto, Portugal"},{"name":"Nucleus of Research in Human Motricity Sciences, Universidad Adventista de Chile, Chill\u00e1n 3780000, Chile"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0289-4613","authenticated-orcid":false,"given":"Lurdes \u00c1vila","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia-UMAIA, 4475-690 Maia, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7571-9181","authenticated-orcid":false,"given":"Jorge","family":"Mota","sequence":"additional","affiliation":[{"name":"Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports, University of Porto, 4200-450 Porto, Portugal"},{"name":"Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2028-5792","authenticated-orcid":false,"given":"Igor","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Graduate Program in Exercise and Sport Sciences, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6500-7543","authenticated-orcid":false,"given":"Joana","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports, University of Porto, 4200-450 Porto, Portugal"},{"name":"Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0617-0521","authenticated-orcid":false,"given":"N\u00e1dia Souza Lima","family":"da Silva","sequence":"additional","affiliation":[{"name":"Graduate Program in Exercise and Sport Sciences, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2463-1280","authenticated-orcid":false,"given":"Paulo","family":"Farinatti","sequence":"additional","affiliation":[{"name":"Graduate Program in Exercise and Sport Sciences, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.rbr.2017.06.001","article-title":"Brazilian guidelines for the diagnosis and treatment of postmenopausal osteoporosis","volume":"57","author":"Radominski","year":"2017","journal-title":"Rev. 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