Heikura sciclip — Transcript

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1. 0:01foreign
2. 0:02[Music]
3. 0:11and I'm with the Canadian Sport
4. 0:14Institute Pacific and University of
5. 0:16Victoria in British Columbia Canada
6. 0:19today I'll be talking about nutritional
7. 0:21considerations for female athlete bone
8. 0:24health
9. 0:26and why this topic is important we do
10. 0:31know from research female athletes are
11. 0:33at a high risk for launch availability
12. 0:36or Lea
13. 0:37and Lea in turn is one of the main
14. 0:41underlying factors for the development
15. 0:43of poor bone health outcomes
16. 0:45and what makes bone injuries such a
17. 0:48challenging topic is that they take a
18. 0:51long time to develop
19. 0:53so it's sometimes difficult to see
20. 0:54warning signs until the alphabet
21. 0:56develops the injury
22. 0:58and by this point the athlete may have
23. 1:00months or years of learning availability
24. 1:02behind them so this highlights the
25. 1:05importance of appropriate primary
26. 1:07secondary and tertiary tertiary
27. 1:09prevention measures to protect female
28. 1:12athlete bone health
29. 1:14so launch of our ability and its
30. 1:17outcomes can be seen as an iceberg we
31. 1:20want to be able to detect what can be
32. 1:22seen above the surface uh all those
33. 1:25signs and symptoms that are visible to
34. 1:26us are easy to measure to be able to
35. 1:28prevent whatever is going on behind or
36. 1:32below the surface
37. 1:34and Bone outcomes are something that are
38. 1:37often invisible to us
39. 1:41some of the definitions that I'll be
40. 1:43using throughout this webinar when I
41. 1:45talk about poor bone health here I refer
42. 1:48to low bmd or bone density
43. 1:51so agency specific Z score of less than
44. 1:54minus 1.0 or bone stress injuries with
45. 2:00bone stress injuries we refer to
46. 2:02anything from stress reactions to
47. 2:04complete stress fractures and although
48. 2:08this webinar is directed to nutrition
49. 2:10only it's important to highlight that
50. 2:13bone stress injuries are multifactorial
51. 2:15and complex in nature so there are many
52. 2:18other non-nutritional factors that can
53. 2:21increase the risk of bone outcomes and
54. 2:24can also be used to treat bone health
55. 2:27impairments so things like training
56. 2:30characteristics impact loading and so on
57. 2:34so possibly the most important
58. 2:38nutritional consideration in terms of
59. 2:39bone health is energy availability
60. 2:42and when we talk about energy
61. 2:43availability we refer to the balance
62. 2:46between dietary energy intake and
63. 2:48exercise energy expenditure and whatever
64. 2:51is left from this equation
65. 2:54um is factors of a free mass and this is
66. 2:57what we call initiable ability
67. 2:59and when this amount of energy left is
68. 3:02not enough to cover all the
69. 3:06requirements of other body systems we
70. 3:09talk about launch availability or Lea
71. 3:12and it's important to highlight that Lea
72. 3:14can be intentional or unintentional
73. 3:18intentional can be something like
74. 3:20attempts to lose body weight or eating
75. 3:23disorders but many athletes develop Lea
76. 3:26without aiming to do so so thinking of
77. 3:29athletes in high energy expenditure
78. 3:32Sports rowing Triathlon team sports but
79. 3:35also athletes who are maybe uneducated
80. 3:38or unaware of the energy energetic
81. 3:41demands of daily training and living
82. 3:45and when a launch availability is long
83. 3:49enough or severe enough we talk about
84. 3:51problematic and Lea and this is the type
85. 3:55of Lea that will cause impairments to
86. 3:57health and performance
87. 4:00these impairments have been collectively
88. 4:03defined as relative energy deficiencies
89. 4:05board Reds
90. 4:07this concept was first introduced nine
91. 4:11years ago in 2014 and this definition
92. 4:14here is an updated definition from the
93. 4:172023 consensus statement
94. 4:19so here we Define Reds as a syndrome of
95. 4:23inter-physiological or psychological
96. 4:25functioning experienced by both female
97. 4:28and male athletes that caused by
98. 4:30exposure to problematic Lea and there
99. 4:34are lots of different detrimental
100. 4:36outcomes as a result of Reds some of
101. 4:39them include indeed poor broad Health
102. 4:41outcomes but lots of the other outcomes
103. 4:43precede poor boy Health outcomes and are
104. 4:46important to consider
105. 4:49so female athletes in general regardless
106. 4:51of energy available Studies have a high
107. 4:54risk of bone stress injuries it's been
108. 4:57estimated that up to 20 percent of
109. 4:59female athletes every year suffer a bond
110. 5:02stress injury and this risk is further
111. 5:06increased by the presence of Lea so two
112. 5:09to four times higher risk of
113. 5:11bone stress entries has been reported in
114. 5:14famous with Lea
115. 5:16one of the outcomes of Lea prolonged Lea
116. 5:19is a decreased bone mineral density and
117. 5:23this in turn has been linked to up to
118. 5:26three times higher prevalence of high
119. 5:29risk bone stress injuries so trabecular
120. 5:33rich bone
121. 5:35type
122. 5:37and while boisterous injuries are a new
123. 5:39an important consideration for the
124. 5:41athlete is that they often take a
125. 5:43prolonged time to to recolores or one to
126. 5:47up to six months of absence from primary
127. 5:50sport
128. 5:52and while energy availability is the
129. 5:55domain Focus here there are other
130. 5:58nutritional considerations that need to
131. 6:00be considered for the female athlete
132. 6:03recently a handful of Studies have
133. 6:06linked low carbohydrate availability to
134. 6:08impaired endocrine and Bone outcomes
135. 6:11independent of energy availability
136. 6:12status
137. 6:14in terms of proteins there might be a
138. 6:16small potentially positive effect
139. 6:19um on bone by anabolic anabolic Pathways
140. 6:23and calcium homeostasis however it's
141. 6:25important to highlight that this
142. 6:27potentially beneficial effect is only
143. 6:30present in the context of optimal energy
144. 6:34availability so higher protein intake
145. 6:36cannot
146. 6:38rescue the detrimental outcomes caused
147. 6:42by poorer or low initial probability
148. 6:45obviously vitamin D and calcium are
149. 6:48important considerations and work
150. 6:49together to support bone health and
151. 6:53especially from vitamin D female
152. 6:55athletes who train indoors most of the
153. 7:00year are an increased risk of low
154. 7:02vitamin D and thus this poor bone health
155. 7:05outcomes
156. 7:07so some opportunities here to to utilize
157. 7:11these nutrients to support bone health
158. 7:13and female athletes these are very
159. 7:16general
160. 7:17recommendations every female athlete
161. 7:19will need to consult a dietitian to
162. 7:22determine what their carbohydrate
163. 7:24requirements are that's determined by
164. 7:26training and competition requirements
165. 7:29daily
166. 7:30the same goes with protein as well as
167. 7:33vitamin D and calcium but some general
168. 7:35numbers have been given here
169. 7:40and then moving on to prevention of poor
170. 7:43Ben poor bone health outcomes and some
171. 7:45of these nutritional
172. 7:48um considerations that we'll be
173. 7:50discussing
174. 7:51um are included in the the first step of
175. 7:54the primary prevention here so I'll be
176. 7:57going through primary secondary and
177. 7:59tertiary prevention briefly
178. 8:02so with primary prevention we want to
179. 8:04minimize the exposure to Lea or poor
180. 8:07dietary
181. 8:09habits that might increase the risk of
182. 8:12large availability or bone health
183. 8:15impairments so this highlights the
184. 8:17importance of educational athletes and
185. 8:20people around them we also need to make
186. 8:23sure that the knowledge is actually
187. 8:25translated into behavioral knowledge in
188. 8:27itself doesn't do anything if Behavior
189. 8:29doesn't follow the behavior
190. 8:32requires the appropriate skills and
191. 8:35capacity to to act
192. 8:38and this can be done in in a number of
193. 8:40different ways depending on what
194. 8:42resources are available
195. 8:45secondary prevention highlights frequent
196. 8:49screening of athletes highlight to to
197. 8:53discover a really signs and symptoms of
198. 8:56Lea or Reds or poor dietary behaviors so
199. 9:00here we look at symptoms and signs
200. 9:02symptoms are something that we can see
201. 9:04without measurements
202. 9:06um and signs are something that we can
203. 9:08only see
204. 9:10by measuring a physiological
205. 9:13outcome
206. 9:15so lots of these signs and symptoms are
207. 9:17things that we are able to detect early
208. 9:19on when Lea hasn't been going on for too
209. 9:25long for bone specific outcomes bone
210. 9:29stress injuries and decreased bmd these
211. 9:32are something that usually develop over
212. 9:34months or years of
213. 9:36um Lea so it's important to look at the
214. 9:39the other list of symptoms and signs
215. 9:42here and focus on those for early
216. 9:44screening and detection and the
217. 9:47intervention to improve these outcomes
218. 9:49before the app that develops the bone
219. 9:51specific impairments
220. 9:54and finally unfortunately some athletes
221. 9:57do develop poor bone density or bone
222. 9:59stress injury so we need to know how to
223. 10:01trade these athletes appropriately in
224. 10:04general we need to first and foremost
225. 10:06restore optimal energy availability
226. 10:09but then if the female athlete doesn't
227. 10:12improve their signs and symptoms of rats
228. 10:14if amenorrhea or lack of menstrual
229. 10:18function persists and no bond density
230. 10:21improvements are seen we can consider
231. 10:23pharmacological options but this is
232. 10:26something that always needs to be
233. 10:27discussed with
234. 10:28um in consultation with a medical
235. 10:30professional
236. 10:33so to summarize uh there are lots of
237. 10:38different options for the athlete and
238. 10:40the support team moving from primary to
239. 10:43secondary to tertiary prevention in in
240. 10:46support of optimal bone health so for
241. 10:50primary prevention for athletes the main
242. 10:52thing is to to maintain optimal data
243. 10:54habits for the support team
244. 10:57this requires support So education
245. 11:01of athletes support to for the athletes
246. 11:05to access the food sources and so on
247. 11:09for the secondary prevention we need to
248. 11:11implement screening of athletes for
249. 11:14early signs and symptoms of Reds
250. 11:17um using different tools ioc reads Cat 2
251. 11:20um Detroit
252. 11:21tool at least keyed and so on and
253. 11:24potentially other physiological testing
254. 11:27mirror maybe warranted and then for
255. 11:30tertiary prevention for the athlete they
256. 11:33need to be trusting the the
257. 11:35professionals and follow the treatment
258. 11:36plans
259. 11:38um and be confident that increasing
260. 11:41energy availability is the the first
261. 11:44goal and the best treatment to restore
262. 11:46health and performance
263. 11:49um
264. 11:50outcomes
265. 11:52and I would like to thank you so much
266. 11:58[Music]