This study used forearm bone parameters data from different types of track and field female athletes aged 40 years and over from the European and World Masters Athletics Indoor Championships. The results suggest that bone mineral density (BMD) in the forearm of female masters athletes is strongly affected by biological factors such as age at menopause, age at menarche, number of fractures, number of dairy products per day, type of dietary pattern, and especially sports competition. In the case of masters athletes women, the main parameters affecting BMC were age at menarche, age at menopause, past fractures, dairy products, type of dietary pattern, and sports competition.
Multifactorial determinants of bone mineralization have been the subject of numerous studies in the general population43,44,45. There is much less research focused on specific groups such as female athletics trainees over the age of 4046,47,48.
Long-term exercise training and bone mineralization
In this study females in the TA group had significantly greater BMD dis, BMC dis, T-score dis, BMD prox, BMC prox, and T-score prox than those in the EA and SPA. Master athletes offer a model to examine associations between long-term exercise training and bone mineralization. The bone adapts to the mechanical loading it experiences during physical activity. In many studies, positive associations between PA levels and bone strength in older adults have been reported49,50. This study suggested that exercise is an effective way to improve and maintain BMD. There is also uncertainty over the types of activities that are potentially osteogenic. The effects of different muscle-loading exercise modes and volumes on musculoskeletal health are not well-studied in older populations51.
To fully understand the effect of activity on bone mineralization, it is necessary to take into account not only the duration of activity but also the type of activity, and the type of exercise according to the osteogenic effect. In our study, the type of athletic competition was important. Athletic throws are characterized by a large proportion of weight-bearing exercises during training, and they cause considerable pressure on the bone improving its strength. This type of training has a high osteogenic index. Moreover, in the case of the masters category, such physical activity has a long-term impact. Similar results were shown in earlier studies3. The results of two distinct cohorts of masters athletes with 10 years of training experience, Olympic weightlifters and distance runners, showed that greater total and regional BMD in Olympic weightlifters than in runners may reduce the risk of developing osteoporosis52. Piasecki et al.46 in a masters study (38 master sprint runners males and females, mean age 71 ± 7 years, and 149 master endurance runners males and females, mean age 70 ± 6 years) showed that regular running is associated with greater BMD at fracture-prone hip and spine sites in master sprinters but not in runners. In our study, female masters with SPA also had better bone mineralization than the EA group.
The available research highlights the most appropriate features of exercise for increasing bone density: weight-bearing aerobic exercises, i.e., walking, stair climbing, jogging, and Tai Chi, multicomponent exercises consist of a combination of different methods (aerobics, strengthening, progressive resistance, balancing, and dancing) aimed at increasing or preserving bone mass. However, for these protocols to be effective they must always contain a proportion of strengthening and resistance exercises53.
Interactions of sport competition category and type of dietary pattern with BMD and BMC
The positive and beneficial effects of physical activity and sports training on bone mineralization may be supported or reduced by other factors. In our study, we analyzed dietary patterns more accurately than individual dietary data. This study had significant interactions of sport competition category and type of dietary pattern with BMD and BMC. In both groups of women, EA and SPA, dietary pattern with a high intake of fruit, vegetables, dairy products, whole grains, poultry, fish, nuts, and legumes had greater mean BMD and BMC. In contrast, in the TA group, dietary pattern with lactose-free and gluten-free products was associated with greater mean BMD and BMC. The latest studies have shown that adherence to the Mediterranean diet rich in olive oil, a high intake of fruit, vegetables, fish, and nuts, and a high proportion of phenols is protective against osteoporosis27. Lactose intolerance may predispose individuals to low calcium intake, but a study found no significant difference in calcium absorption from a range of dairy products differing in lactose levels in adult women54. Therefore, it can be concluded that the regular physical activity of women in the masters category also influences nutritional choices. In our study, regardless of sport discipline, more than 60% of women consumed dairy products. Compared to the data from the fourth wave (2011/2012) of the Survey of Health, Aging and Retirement in Europe55, this percentage is much greater than that of non-training women of a similar age. In our study, the number of dairy products consumed per day significantly influenced forearm BMD in connection with physical activity. Dairy products are the main food sources providing bone-beneficial nutrients, such as calcium, phosphorus and magnesium and also protein, vitamin B-12, zinc, potassium and riboflavin. These food sources provide a morphological role in bone healthy structure7. The dietary intake of nutrients, especially protein, calcium and vitamin D, is important for masters athletes because of the physiological changes that occur with aging and the unique nutritional needs associated with high levels of physical activity.
When analyzing the nutritional patterns of physically active women and their impact on BMD, it is necessary to mention potential confounding variables such as impaired absorption of dietary components, general health condition, heat treatment of food, and quality of food products.
Interactions between mean BMD and BMC and biological factors
In the masters population, progressive aging processes and age-related diseases may also be obstacles to accurate analysis. In this study, there were clear significant interactions between mean BMD and BMC and biological factors such as age at menarche and age at menopause. In all groups of women TA, EA and SPA late menarche determined higher mean BMD, especially in TA. Studies of the interaction of biological status and bone mineralization show divergent results, and most often involve women from the general, non-training population. In addition, studies show different relationships between the age of menarche and menopausal status on BMD at different skeletal locations3,31,32,33. One study found that postmenopausal women with a menarche age of ≥ 16 years had significantly lower lumbar spine BMD than that had by those with a menarche age of ≤ 12 years31. In the other research age at menopause did not influence the BMD of the lumbar spine or femoral neck. In this study age at menarche or menopause seems to be of limited or no importance as a risk factor for osteoporosis33. Our study of women training after the age of 40 showed that biological status significantly influenced forearm bone parameters. The surveyed women were physically active in the past, at the age of puberty and peak bone mass building, and now at the peri, pre-, and menopausal age, so this is also a specific group for analysis. Physical activity affects the menstrual cycle, and after the age of 40, it may improve the health and hormonal status of women. In a Polish study with middle-aged women (aged 40–65), high and moderate PA levels have less severe menopausal symptoms compared to inactive women56. Interactions of biological factors and bone mineral status in physically active women require further in-depth research.
Athletes in the masters category are excellent materials for testing the long-term effect of training on the mineral state of bones. As research and data collected from their life histories indicate, most of them were competitive athletes both in their youth and now. This study suggested that high-altitude osteogenic exercises, such as throwing, and weight-bearing exercises at a young age and training continuation later in life may be important contributors to BMD and BMC in middle-aged and elderly individuals. Physical activity in women over 40 years of age may also influence better eating patterns and more frequent consumption of healthier foods such as fruit, vegetables, dairy products, whole grains, poultry, fish, nuts, and legumes.
Strengths and limitations
Athletes in the masters category are excellent materials for testing the long-term effect of training on the mineral state of bones, in the general population it is very hard to find individuals with physical activity and sports almost in all life. The strength of the work is that the study was performed at a single point in time, with all participants tested and measured by a single specialist. This eliminated the subjective error of the measurements. Determinants of BMD were analyzed multivariate and in two ROIs. A thorough statistical analysis of the data was carried out. ANOVA helps identify the sources of variation in the data and provides a measure of the variability between groups. We used in analysis the degree of correlation of the predictors was assessed using the variance inflation factor (VIF) collinearity test, taking a not-to-exceed value of 10. Residual analysis was also performed, testing for homoscedasticity using the White test and the degree of correlation of the residuals using the Durbin-Watson test. Our study, although it includes the results of an elite group of women in the masters category, has some limitations. One limitation of the full interpretation of the results of the study is the relatively small number of female athletes studied after participating in the sports competition. BMD accounts for almost 70% of bone strength and bone quality accounts for the remaining 30%, therefore, it is worth extending this research to include bone quality characteristics. The one of the limitations of this study can be the study’s homogeneity (Caucasian, European origin) limits the applicability of findings to broader populations, and exclusion criteria may restrict results to specific athlete groups.
Summary and conclusions
Physical activity at the masters age helps maintain bone mineralization and may influence dietary choices. The long-term effects of athletic training, especially exercises such as throwing, have been confirmed in these studies. It is therefore worth considering popularizing these exercises at every stage of ontogenesis as a supplement to any other physical activity. Athletic training after the age of 40 can help eliminate the risk of developing osteoporosis. Dietary patterns, particularly those based on the consumption of dairy products, vegetables, fish, poultry, nuts and legumes, are important determinants of BMD and BMC among female masters trainers. Interactions of biological factors and bone mineral status in physically active women require further in-depth research. The findings underscore the need for personalized training and nutritional approaches for elite female athletes to support bone health, with a call for further longitudinal studies to assess long-term impacts.
The results and conclusions of this study have practical, applied uses for both coaches and Masters athletes. They can serve as practical guidance as to what factors particularly related to diet are important for the bone health of athletes.
Future Research Directions: a further investigation into biological factors to BMD in Masters athletes women, extending the scope of the study to include other sports disciplines with different OI in the masters category, including analyses of bone turnover markers and other biochemical tests to assess bone metabolism.
