EFFECT OF RELATIVE ENERGY DEFICIENCY IN SPORT (RED-S) SYNDROME ON BONE MINERAL DENSITY, BONE IMAGING OUTCOME AND ASSOCIATED CLINICAL BIOMARKERS IN ATHLETIC MEN: A SYSTEMATIC REVIEW
Adinnu D. C., 2Iwuamadi C. E., Carroll S., *Nwozor C. M., Enwelum H. O. and Azuoma K. E.
ABSTRACT
Objectives: To systematically investigate the effect of RED-S syndrome on bone health with regards to the BMD, bone imaging and relevant biomarkers in adult male athletes. Design: Systematic Review. Data sources: Five databases (MEDLINE, Academic Search Premier, CINAHL plus, Sport Discus, Scopus) were searched for papers. Eligibility criteria for selecting studies: Eligible studies were those academic papers that measured at least one variable of interest, included adult male athletes, and were written in English. Results: Twenty-one studies of fair to good quality were identified and reviewed. There were variations in the methods of measuring energy intake and EEE among the study participants ranging from questionnaires to dietary and training logs. Twelve studies reported some level of LEA among the athletes ranging from 18.9 ± 6.9 to 27.6 ± 12.2 kcal/kg FFM/day. Sixteen studies measured and reported the DEXA BMD with mixed outcomes of low values in some and normal values in others. Regional BMD measurement revealed that the lumbar spine was the most susceptible bone site to stress injuries. Six studies investigated the biomarkers of bone turnover with results varying in relation to LEA. Conclusion: LEA negatively affects BMD and overall bone health of male athletes putting them at risk of injury and under performance however, biomarkers of bone turnover (formation and resorption) in certain conditions could possibly remain within physiological levels despite a low BMD.
Keywords: Athletic men, BMD, biomarkers, LEA, RED-S syndrome, sports physiology.
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