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Bone mineral density in elite masters athletes: the effect of body composition and long-term exercise
Open accessAbstract
Background: The purpose of the study was to examine how bone mineral density (BMD) is related to body composition depending on the practiced sport (endurance, speed-power, throwing sports) in participants of the World Masters Athletics Championship. Methods: Dual-energy X-ray absorptiometry (DXA) was used to determine BMD and bone mass (BMC). Body composition was analyzed by means of the JAWON Medical X-scan analyzer using bioelectrical impedance methods. Percentage body fat (%BF), body fat mass (BFM), lean body mass (LBM), total body water (TBW), soft lean mass (SLM), intracellular water (ICW), and extracellular water (ECW) were evaluated. Results: Among men, the most important variables affecting the BMD norm were LBM (OR = 32.578; p = 0.023), ECW (OR = 0.003; p = 0.016) and ICW (OR = 0.011; p = 0.031), in the distal part and SLM (OR = 5.008; p = 0.020) and ICW (0.354, p = 0.008) in the proximal part. In women, the most important predictors of normal BMD were ICW (OR = 10.174; p = 0.003) and LBM (OR = 0.470; p = 0.020) in the distal part and ICW (OR = 5.254; p = 0.038) in the proximal part. Conclusion: The representatives of strength based events had the most advantageous BMD levels. The condition of bone tissue evaluated by BMC and BMD of the forearm in masters athletes was strongly determined by the level of lean body components and the type of sports training associated with the track and field event. In the most important predictors of the BMD norm were also hydration components ECW and ICW. However, this relationship requires more research on the nature and mechanisms of these interactions.
Overview
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TL;DR
In 244 World Masters Athletics Championship participants, throwing athletes had the most favorable forearm bone mineral density (BMD)/bone mass and the lowest osteoporosis prevalence, while lean and hydration body-composition components predicted normal BMD. The authors conclude that strength-based track-and-field events are associated with better bone status, but the ICW/ECW relationships need further research.
Key findings
Throwing athletes (TA) had the highest BMD/BMC: men’s distal R+U BMD was 0.488 g/cm² in TA vs 0.420 in endurance (EA) and 0.446 in speed-power (SPA); women’s proximal R+U BMD was 0.783 g/cm² in TA vs 0.649 in EA and 0.713 in SPA. No osteoporosis cases were observed in male TA; women TA had 10.5% osteoporosis in proximal R+U, compared with 50.0% in EA and 37.5% in SPA. Low bone status was common: 87.5% of women EA and 60% of women SPA had underestimated BMD in proximal R+U; in men, >50% of EA and SPA had underestimated BMD in the proximal part. Logistic regression predictors of normal BMD included, in men, distal LBM (OR = 32.578; p = 0.023), ECW (OR = 0.003; p = 0.016), ICW (OR = 0.011; p = 0.031), proximal SLM (OR = 5.008; p = 0.020), and ICW (OR = 0.354; p = 0.008); in women, distal ICW (OR = 10.174; p = 0.003), LBM (OR = 0.470; p = 0.020), and proximal ICW (OR = 5.254; p = 0.038).
Methods
Cross-sectional study of 244 masters athletes at the March 2019 World Masters Athletics Championship in Poland: 107 women aged 56.6 ± 11.3 years and 137 men aged 57.0 ± 11.9 years, grouped as endurance, speed-power, or throwing athletes. Bone parameters of the non-dominant forearm (distal and proximal; radiale plus ulna and radiale only) were measured by DXA for BMC, BMD, and T-scores; body composition was assessed by bioelectrical impedance (JAWON Medical X-scan) for %BF, BFM, LBM, TBW, SLM, ICW, and ECW. Analysis used ANOVA with Bonferroni post hoc and eta-squared, chi-squared with phi, and backward stepwise logistic regression with odds ratios, 95% CI, Nagelkerke R², and p < 0.05.
Limitations
Stated by the paper: the number of athletes was relatively small after accounting for gender and track-and-field event type, and bone scans in other skeletal locations are needed in older athletes. Evident from the text: the cross-sectional design cannot establish causality or temporal ordering; DXA was limited to the forearm, so findings may not generalize to other skeletal sites such as hip or spine; and the sample consisted of elite, healthy masters athletes/medallists, with no non-athlete control group in this study.
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In the paper
“There were no cases of osteoporosis in the TA group.”
§ Bone mineral density in elite masters athletes: the effect of body composition and long-term exercise > Results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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- Rests on 2 assumptions not shown here.
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In the paper
“ICW (OR = 10.174; p = 0.003)”
§ Bone mineral density in elite masters athletes: the effect of body composition and long-term exercise > Abstract > Results
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“BMC in the distal part (by 18.3 and 14.6%, respectively)”
§ Bone mineral density in elite masters athletes: the effect of body composition and long-term exercise > Results
plainstates an association- Asserted: passes — The authors put it forward as true.
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In the paper
“R + U (by 12.4 and 10.8%, respectively)”
§ Bone mineral density in elite masters athletes: the effect of body composition and long-term exercise > Results
plainstates an association- Asserted: passes — The authors put it forward as true.
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In the paper
“LBM (OR = 0.470; p = 0.020)”
§ Bone mineral density in elite masters athletes: the effect of body composition and long-term exercise > Abstract > Results
plainstates an association- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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- Rests on 2 assumptions not shown here.
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Percentages, sums and reported differences re-computed from the paper’s own numbers.
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Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ Bone mineral density in elite masters athletes: the effect of body composition and long-term exercise > Conclusions
“Intracellular and extracellular water levels increased the odds ratio of normal bone mineralization by several times.”
§ Bone mineral density in elite masters athletes: the effect of body composition and long-term exercise > Abstract > Results
“ECW (OR = 0.003; p = 0.016) and ICW (OR = 0.011; p = 0.031)”
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
“| TBW [kg] | 30.5 ± 3.2 | 33.0 ± 3.3 | 56.4 ± 7.5 | 1v2v3 | 50.5 (< 0.001) | 0.49 |”
§ Bone mineral density in elite masters athletes: the effect of body composition and long-term exercise > Results
Reported 56.4 · recomputed 40.5
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Bone mineral density in elite masters athletes: the effect of body composition and long-term exercise > Results
“There was a lower than women prevalence of osteopenia and osteoporosis regardless of athletic event.”
§ Bone mineral density in elite masters athletes: the effect of body composition and long-term exercise > Results
“| Proximal R + U | Osteopenic (T-score − 1 to −2.49) | 40.3 | 44.4 | 38.1 | 3.8 (0.431) 0.2 | 37.5 | 22.5 | 26.3 | 19.7 (< 0.001) 0.4 |”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Bone mineral density in elite masters athletes: the effect of body composition and long-term exercise > Discussion
“the lowest number of cases of osteoporosis in femoral neck and lumbar spine was observed among women in throwing sports (10.5%).”
§ Bone mineral density in elite masters athletes: the effect of body composition and long-term exercise > Methodology > Dual-energy X-ray absorptiometry
“Bone parameters of the non-dominant forearm were measured by the densitometric method for measuring the peripheral skeleton.”
Citations
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“The differentiation of TBW into intracellular water (ICW) and extracellular water (ECW) compartments is useful to describe fluid shifts and fluid balance and to explore variations in levels of hydration [37].”
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Cited by
Muscle-derived factors influencing bone metabolism
Gries, K. J., Zysik, V. S., Jobe, T. K., Griffin, N., Leeds, B. P., & Lowery, J. W. (2021) · Seminars in Cell and Developmental Biology · doi:10.1016/j.semcdb.2021.10.009 · Cited by 38
Li, Y., Huang, Z., Gong, Y., Zheng, Y., & Zeng, Q. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.965758 · Cited by 11
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Gowers, C. R., McManus, C., Chung, H. C., Jones, B., Tallent, J., & Waterworth, S. (2025) · Journal of the International Society of Sports Nutrition · doi:10.1080/15502783.2025.2496448 · Cited by 8
Cvijetić, S., Boschiero, D., Shin, H., Reilly, A. S., Noorani, S. T., Vasiljević, N., & Ilich, J. Z. (2026) · Metabolites · doi:10.3390/metabo16010040 · Cited by 7
Metadata
- Authors
- Kopiczko, A., Adamczyk, J. G., Gryko, K., & Popowczak, M.
- Affiliations
- Józef Piłsudski University of Physical Education in Warsaw (PL)
- University of Wrocław (PL)
- Corresponding author
- Gryko, Karol
- Venue
- European Review of Aging and Physical Activity
- Published
- 2021-05-31
- Volume
- 18
- Issue
- 1
- Pages
- 7-7
- ISSN
- 1813-7253 (ISSN-L)
- 1861-6909
- PMC
- PMC8166030
- OpenAlex
- W3163973844
- Semantic Scholar
- 34b60fc387967f38ae291eefa1962a8c6fcbba94
- Cited by
- 24
- References
- 46
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 3 · 2023: 4 · 2022: 3 · 2021: 2
- FWCI
- 2.80
- Type
- journal article
- Language
- en
- Update notices
- correction (2021-07-03)
- Open access
- gold
- doi.org
- Licence
- cc-by
- creativecommons.org/licenses/by/4.0 (tdm)
- creativecommons.org/licenses/by/4.0 (vor)
- Locations
- European Review of Aging and Physical Activity (publishedVersion, cc-by)
- PubMed (publishedVersion)
- PubMed Central (publishedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Physiology (medical) › Body Composition Measurement Techniques
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Keywords
- bone mineral density, masters athletes, body composition, lean body mass, intracellular water, extracellular water, total body water, endurance sports, throwing sports, track and field, bone mass, hydration, older athletes
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