Nutritional Factors that Influence Change in Bone Density and Stress Fracture Risk Among Young Female Cross-County Runners

Stress fractures are common among young female competitive athletes, especially among those participating in track and field. There are limited data that suggest that disordered eating, low calcium and dairy product intake, and low dietary fat intake may be related to stress fracture incidence.1–10 Numerous dietary factors have been hypothesized to relate to BMD including calcium, vitamin D, phosphorous, potassium, vitamin C, fiber, protein, fat, and iron. However, few longitudinal studies have examined the role of diet on skeletal health in female endurance athletes, although this population may have unique nutritional requirements because of their intense physical activity. Potential interactions among foods in the diet may limit the evaluation of single nutrients and bone health. Therefore, it is important to consider the impact of food groups and dietary patterns of the whole diet on bone health. The goal of this study was to identify potential nutritional factors and dietary patterns that predict stress fractures and change in BMD in young female long-distance runners.