Greater subchondral vBMD at the tibia is observed between 1 and 5 years of anterior cruciate ligament injury.

OBJECTIVES: This study aimed to determine if differences exist in tibial subchondral bone and muscle imbalances between individuals with and without an Anterior Cruciate Ligament (ACL) repair within the past 1 to 5 years (median 3 years). METHODS: Fifteen individuals (ages 18-23 years) that had a unilateral ACL repair with no contralateral knee injuries and 15 age- and sex-matched controls (no prior knee injuries) were recruited to participate. Subchondral bone was measured using peripheral quantitative computed tomography (pQCT) distal to the tibial plateau. Muscle force, power, and force efficiency were measured using single leg jumps performed on a force platform. RESULTS: Within subject analysis showed a greater subchondral vBMD in the injured versus uninjured legs of cases (278±11 mg/cm3 and 258±6 mg/cm3, respectively, mean±SD, p=0.01). Subchondral vBMD was greater on the injured leg of cases than controls (267±8 mg/cm3 and 237±8 mg/cm3, respectively, marginal mean±SE, p=0.01). No differences were observed between cases and controls for muscle force, power, or force efficiency. CONCLUSIONS: Greater subchondral bone mineral density was observed in participants between 1- and 5-years post-op. Given the results of this study and the known long-term effects of ACL injuries, future research must continue to focus on the prevention of these injuries.

Changes in Body Composition in Division I Football Players Over a Competitive Season and Recovery in Off-Season.

This study investigated changes in body composition over 1 competitive football season in D-I collegiate football players (N = 53; by position, 21 linemen vs. 32 nonline; or by seniority, 30 upperclassmen vs. 23 underclassmen) and additional changes by the following spring season (N = 46; 20 linemen vs. 26 nonline; 27 upperclassmen vs. 19 underclassmen). Body composition by dual-energy x-ray absorptiometry (DXA) was completed pre- and post-season and the following spring. For the team as a whole, player weight decreased 1.3 kg (1.2%) and lean mass decreased 1.4 kg (1.6%) over the season. Absolute fat mass showed no change; however, percent body fat showed a 0.5% increase. There was an interaction between player position and seniority for changes in lean mass (p < 0.01). In nonline positions upperclassmen lost more lean mass than underclassmen, whereas in line positions underclassmen lost more lean mass than upperclassmen. Spring measures indicate that weight did not increase during the off-season, but improvement in body composition was noted. Lean mass increased by 2.2 kg (2.6%), whereas absolute fat mass decreased by 1.4 kg (6.7%). Although weight and lean mass losses during the competitive season were recovered in the off-season, changes in collegiate football programs that include nutrition counseling, dietary recommendations, monitoring of weight, and skin-fold testing as an estimate of body fat change would be beneficial to players. Strength and conditioning coaches and staff need to consider strategies to incorporate these practices into their programs.

Resistant starch type 4-enriched diet lowered blood cholesterols and improved body composition in a double blind controlled cross-over intervention.

A metabolic health crisis is evident as cardiovascular diseases (CVD) remain the leading cause of mortality in the United States. Effects of resistant starch type 4 (RS4), a prebiotic fiber, in comprehensive management of metabolic syndrome (MetS) remain unknown. This study examined the effects of a blinded exchange of RS4-enriched flour (30% v/v) with regular/control flour (CF) diet on multiple MetS comorbidities. In a double blind (participants-investigators), placebo-controlled, cluster cross-over intervention (n = 86, age≥18, 2-12 week interventions, 2-week washout) in the United States, individuals were classified as having MetS (With-MetS) or not (No-MetS) following International Diabetes Federation (IDF)-criteria. RS4 consumption compared with CF resulted in 7.2% (p = 0.002) lower mean total cholesterol, 5.5% (p = 0.04) lower non-HDL, and a 12.8% (p < 0.001) lower HDL cholesterol in the With-MetS group. No-MetS individuals had a 2.6% (p = 0.02) smaller waist circumference and 1.5% (p = 0.03) lower percent body fat following RS4 intervention compared to CF. A small but significant 1% increase in fat-free mass was observed in all participants combined (p = 0.02). No significant effect of RS4 was observed for glycemic variables and blood pressures. RS4 consumption improved dyslipidemia and body composition. Incorporation of RS4 in routine diets could offer an effective strategy for public cardio-metabolic health promotion.

Greater Polar Moment of Inertia at the Tibia in Athletes Who Develop Stress Fractures.

BACKGROUND: Several previous investigations have determined potential risk factors for stress fractures in athletes and military personnel. PURPOSE: To determine factors associated with the development of stress fractures in female athletes. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: A total of 88 female athletes (cross-country, n = 29; soccer, n = 15; swimming, n = 9; track and field, n = 14; volleyball, n = 12; and basketball, n = 9) aged 18 to 24 years were recruited to participate in a longitudinal bone study and had their left distal tibia at the 4%, 20%, and 66% sites scanned by peripheral quantitative computed tomography (pQCT). Patients included 23 athletes who developed stress fractures during the following year (cases). Whole body, hip, and spine scans were obtained using dual-energy x-ray absorptiometry (DXA). Analysis of covariance was used to determine differences in bone parameters between cases and controls after adjusting for height, lower leg length, lean mass, fat mass, and sport. RESULTS: No differences were observed between cases and controls in any of the DXA measurements. Cases had significantly greater unadjusted trabecular bone mineral content (BMC), greater polar moment of inertia (PMI) at the 20% site, and greater cortical BMC at the 66% site; however, after adjusting for covariates, the differences became nonsignificant. When analyses were repeated using all individuals who had ever had a stress fracture as cases (n = 31) and after controlling for covariates, periosteal circumference was greater in the cases than the controls (71.1 ± 0.7 vs 69.4 ± 0.5 mm, respectively; P = .04). CONCLUSION: A history of stress fractures is associated with larger bones. These findings are important because larger bones were previously reported to be protective against fractures and stress fractures, but study findings indicate that may not always be true. One explanation could be that individuals who sustain stress fractures have greater loading that results in greater periosteal circumference but also results in the development of stress fractures.