Nutrition, Bone Health, and the Young Dancer

Chapter
Part of the Contemporary Pediatric and Adolescent Sports Medicine book series (PASM)

Abstract

Optimized bone health is a dynamic process that utilizes hormonal, nutritional, and biomechanical balance. For those who dance recreationally and in particular as young professionals, healthy bones become especially important given the demands of dance training. An imbalance in one of the areas noted above creates a progression of health challenges that ultimately affect dance performance. A well-balanced diet is a key modifiable factor available to young dancers to aid in their physical and artistic maturation. Diets rich in calcium and adequate amounts of vitamin D from the diet and controlled exposure to the sun enhance the positive effect dancing has on bone development. Thus, choosing to eat healthily while balancing dancing with normal childhood activities provides an opportunity for young dancers to grow into strong mature dancers of the future.

Keywords

Bone health Hormones Nutritional physiological phenomena Skeletal maturation 

References

  1. 1.
    Weeks BK, Young CM, Beck BR. Eight months of regular in-school jumping improves indices of bone strength in adolescent boys and girls: the power PE study. J Bone Miner Res. 2008;23(7):1002–11.CrossRefPubMedGoogle Scholar
  2. 2.
    Bowerman EA, Whatman C, Harris N, Bradshaw E. A review of the risk factors for lower extremity overuse injuries in young elite female ballet dancers. J Dance Med Sci. 2015;19(2):51–6.CrossRefPubMedGoogle Scholar
  3. 3.
    Allen N, Nevill A, Brooks J, Koutedakis Y, Wyon M. Ballet injuries: injury incidence and severity over 1 year. J Orthop Sports Phys Ther. 2012;42(9):781-A1.CrossRefGoogle Scholar
  4. 4.
    Leanderson C, Leanderson J, Wykman A, Strender L-E, Johansson S-E, Sundquist K. Musculoskeletal injuries in young ballet dancers. Knee Surg Sports Traumatol Arthrosc. 2011;19(9):1531–5.CrossRefPubMedGoogle Scholar
  5. 5.
    Steinberg N, Aujla I, Zeev A, Redding E. Injuries among talented young dancers: findings from the UK Centres for Advanced Training. Int J Sports Med. 2014;35(3):238–44.PubMedGoogle Scholar
  6. 6.
    Georgopoulos NA, Markou KB, Theodoropoulou A, Vagenakis GA, Mylonas P, Vagenakis AG. Growth, pubertal development, skeletal maturation and bone mass acquisition in athletes. Hormones (Athens). 2004;3(4):233–43.CrossRefGoogle Scholar
  7. 7.
    Davies JH, Evans BAJ, Gregory JW. Bone mass acquisition in healthy children. Arch Dis Child. 2005;90(4):373–8.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Prentice A, Schoenmakers I, Laskey MA, de Bono S, Ginty F, Goldberg GR. Nutrition and bone growth and development. Proc Nutr Soc. 2006;65(4):348–60.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Karlberg J, Jalil F, Lindblad BS. Longitudinal analysis of infantile growth in an urban area of Lahore, Pakistan. Acta Paediatr Scand. 1988;77(3):392–401.CrossRefPubMedGoogle Scholar
  10. 10.
    Ekstrand J, Hagglund M, Walden M. Injury incidence and injury patterns in professional football: the UEFA injury study. Br J Sports Med. 2011;45(7):553–8.CrossRefPubMedGoogle Scholar
  11. 11.
    Shields BJ. Cheerleading-related injuries to children 5 to 18 years of age: United States, 1990–2002. Pediatrics. 2006;117(1):122–9.CrossRefPubMedGoogle Scholar
  12. 12.
    Roberts KJ, Nelson NG, McKenzie L. Dance-related injuries in children and adolescents treated in US emergency departments in 1991–2007. J Phys Act Health. 2013;10(2):143–50.CrossRefPubMedGoogle Scholar
  13. 13.
    Jacobs CL, Hincapié CA, Cassidy JD. Musculoskeletal injuries and pain in dancers: a systematic review update. J Dance Med Sci. 2012;16(2):74–84.Google Scholar
  14. 14.
    Russell JA. Preventing dance injuries: current perspectives. Open Access J Sports Med. 2013;4:199–210.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Hind K, Burrows M. Weight-bearing exercise and bone mineral accrual in children and adolescents: a review of controlled trials. Bone. 2007;40(1):14–27.CrossRefPubMedGoogle Scholar
  16. 16.
    Munoz MT, la Piedra de C, Barrios V, Garrido G, Argente J. Changes in bone density and bone markers in rhythmic gymnasts and ballet dancers: implications for puberty and leptin levels. Eur J Endocrinol. 2004;151(4):491–6.Google Scholar
  17. 17.
    Finkelstein JS, Neer RM, Biller BM, Crawford JD, Klibanski A. Osteopenia in men with a history of delayed puberty. N Engl J Med. 1992;326(9):600–4.CrossRefPubMedGoogle Scholar
  18. 18.
    Pigeon P, Oliver I, Charlet JP, Rochiccioli P. Intensive dance practice: repercussions on growth and puberty. Am J Sports Med. 1997;25(2):243–7.CrossRefPubMedGoogle Scholar
  19. 19.
    Steinberg N, Siev-Ner I, Peleg S, Dar G, Masharawi Y, Hershkovitz I. Growth and development of female dancers aged 8–16 years. Am J Hum Biol. 2008;20(3):299–307.CrossRefPubMedGoogle Scholar
  20. 20.
    Bailey DA, Faulkner RA, McKay HA. Growth, physical activity, and bone mineral acquisition. Exerc Sport Sci Rev. 1996;24:233–66.CrossRefPubMedGoogle Scholar
  21. 21.
    Burckhardt P, Wynn E, Krieg M-A, Bagutti C, Faouzi M. The effects of nutrition, puberty and dancing on bone density in adolescent ballet dancers. J Dance Med Sci. 2011;15(2):51–60.PubMedGoogle Scholar
  22. 22.
    Brown D, Wyon M. The effect of moderate glycemic energy bar consumption on blood glucose and mood in dancers. Med Probl Perform Art. 2014;29(1):27–31.PubMedGoogle Scholar
  23. 23.
    Seeman E. Pathogenesis of bone fragility in women and men. Lancet. 2002;359(9320):1841–50.CrossRefPubMedGoogle Scholar
  24. 24.
    Mølgaard C, Thomsen BL, Prentice A, Cole TJ, Michaelsen KF. Whole body bone mineral content in healthy children and adolescents. Arch Dis Child. 1997;76(1):9–15.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Amorim T, Wyon M, Maia J, Machado JC, Marques F, Metsios GS, et al. Prevalence of low bone mineral density in female dancers. Sports Med. 2015;45(2):257–68.CrossRefPubMedGoogle Scholar
  26. 26.
    Chang G, Rajapakse CS, Diamond M, Honig S, Recht MP, Weiss DS, et al. Micro-finite element analysis applied to high-resolution MRI reveals improved bone mechanical competence in the distal femur of female pre-professional dancers. Osteoporos Int. 2012;24(4):1407–17.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Parfitt AM, Travers R, Rauch F, Glorieux FH. Structural and cellular changes during bone growth in healthy children. Bone. 2000;27(4):487–94.CrossRefPubMedGoogle Scholar
  28. 28.
    Jahreis G, Kauf E, Fröhner G, Schmidt HE. Influence of intensive exercise on insulin-like growth factor I, thyroid and steroid hormones in female gymnasts. Growth Regul. 1991;1(3):95–9.PubMedGoogle Scholar
  29. 29.
    Turner CH. Three rules for bone adaptation to mechanical stimuli. Bone. 1998;23(5):399–407.CrossRefPubMedGoogle Scholar
  30. 30.
    Hoch AZ, Papanek P, Szabo A, Widlansky ME, Schimke JE, Gutterman DD. Association between the female athlete triad and endothelial dysfunction in dancers. Clin J Sport Med. 2011;21(2):119–25.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Khan KM, Bennell KL, Hopper JL, Flicker L, Nowson CA, Sherwin AJ, et al. Self-reported ballet classes undertaken at age 10–12 years and hip bone mineral density in later life. Osteoporos Int. 1998;8(2):165–73.CrossRefPubMedGoogle Scholar
  32. 32.
    Dhillon PS, Currall V, Shannon MN. Traumatic plastic deformation of the tibia: case report and literature review. Ann R Coll Surg Engl. 2012;94(1):e30–2.CrossRefPubMedGoogle Scholar
  33. 33.
    Weiss DS, Rist RA, Grossman G. When can I start pointe work? Guidelines for initiating pointe training. J Dance Med Sci. 2009;13(3):90–2.PubMedGoogle Scholar
  34. 34.
    Gerrard DF. Overuse injury and growing bones: the young athlete at risk. Br J Sports Med. 1993;27(1):14–8.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Stracciolini A, Casciano R, Levey Friedman H, Stein CJ, Meehan WP, Micheli LJ. Pediatric sports injuries: a comparison of males versus females. Am J Sports Med. 2014;42(4):965–72.CrossRefPubMedGoogle Scholar
  36. 36.
    Tanner JM. Growth and maturation during adolescence. Nutr Rev. 1981;39(2):43–55.CrossRefPubMedGoogle Scholar
  37. 37.
    Bianchi ML. Osteoporosis in children and adolescents. Bone. 2007;41(4):486–95.CrossRefPubMedGoogle Scholar
  38. 38.
    Cromer B, Harel Z. Adolescents: at increased risk for osteoporosis? Clin Pediatr (Phila). 2000;39(10):565–74.CrossRefGoogle Scholar
  39. 39.
    Brown DD, Challis J. Optimal nutrition for dancers. In: Krasnow D, Wilmerding V, editors. Dancer wellness. Champaign, IL: Human Kinetics Books; 2016. p. 1–20.Google Scholar
  40. 40.
    Rogol AD, Clark PA, Roemmich JN. Growth and pubertal development in children and adolescents: effects of diet and physical activity. Am J Clin Nutr. 2000;72(2 Suppl):521S–8S.PubMedGoogle Scholar
  41. 41.
    Kurz S, van Dyck Z, Dremmel D, Munsch S, Hilbert A. Variants of early-onset restrictive eating disturbances in middle childhood. Int J Eat Disord. 2016;49(1):102–6.CrossRefPubMedGoogle Scholar
  42. 42.
    Kerstetter JE, O’Brien KO, Caseria DM, Wall DE, Insogna KL. The impact of dietary protein on calcium absorption and kinetic measures of bone turnover in women. J Clin Endocrinol Metab. 2005;90(1):26–31.CrossRefPubMedGoogle Scholar
  43. 43.
    U.S. Department of Agriculture, U.S. Department of Health and Human Services. Dietary Guidelines for Americans. 7th ed. Washington DC: U.S. Government Printing Office; 2010.Google Scholar
  44. 44.
    Weaver CM, Martin BR, Plawecki KL, Peacock M, Wood OB, Smith DL, et al. Differences in calcium metabolism between adolescent and adult females. Am J Clin Nutr. 1995;61(3):577–81.PubMedGoogle Scholar
  45. 45.
    Moyer-Mileur LJ, Xie B, Ball SD, Pratt T. Bone mass and density response to a 12-month trial of calcium and vitamin D supplement in preadolescent girls. J Musculoskelet Neuronal Interact. 2003;3(1):63–70.PubMedGoogle Scholar
  46. 46.
    Matkovic V, Heaney RP. Calcium balance during human growth: evidence for threshold behavior. Am J Clin Nutr. 1992;55(5):992–6.PubMedGoogle Scholar
  47. 47.
    Todd JJ, Pourshahidi LK, McSorley EM, Madigan SM, Magee PJ. Vitamin D: recent advances and implications for athletes. Sports Med. 2015;45(2):213–29.CrossRefPubMedGoogle Scholar
  48. 48.
    Wolman R, Wyon MA, Koutedakis Y, Nevill AM, Eastell R, Allen N. Vitamin D status in professional ballet dancers: winter vs. summer. J Sci Med Sport. 2013;16(5):388–91.CrossRefPubMedGoogle Scholar
  49. 49.
    Ducher G, Kukuljan S, Hill B, Garnham AP, Nowson CA, Kimlin MG, et al. Vitamin D status and musculoskeletal health in adolescent male ballet dancers a pilot study. J Dance Med Sci. 2011;15(3):99–107.PubMedGoogle Scholar
  50. 50.
    Craig WJ. Health effects of vegan diets. Am J Clin Nutr. 2009;89(5):1627S–33S.CrossRefPubMedGoogle Scholar
  51. 51.
    Appleby P, Roddam A, Allen N, Key T. Comparative fracture risk in vegetarians and nonvegetarians in EPIC-Oxford. Eur J Clin Nutr. 2007;61(12):1400–6.CrossRefPubMedGoogle Scholar
  52. 52.
    Lanou AJ, Berkow SE, Barnard ND. Calcium, dairy products, and bone health in children and young adults: a reevaluation of the evidence. Pediatrics. 2005;115(3):736–43.CrossRefPubMedGoogle Scholar
  53. 53.
    Weaver CM. Should dairy be recommended as part of a healthy vegetarian diet? Point. Am J Clin Nutr. 2009;89(5):1634S–7S.CrossRefPubMedGoogle Scholar
  54. 54.
    Nkansah N, Nguyen T, Iraninezhad H, Bero L. Randomized trials assessing calcium supplementation in healthy children: relationship between industry sponsorship and study outcomes. Public Health Nutr. 2009;12(10):1931–7.CrossRefPubMedGoogle Scholar
  55. 55.
    Venkatraman JT, Pendergast DR. Effect of dietary intake on immune function in athletes. Sports Med. 2002;32(5):323–37.CrossRefPubMedGoogle Scholar
  56. 56.
    Ducher DG, Turner AI, Kukuljan S, Pantano KJ, Carlson JL, Williams NI, et al. Obstacles in the optimization of bone health outcomes in the female athlete triad. Sports Med. 2011;41(7):587–607.CrossRefPubMedGoogle Scholar
  57. 57.
    de Vries ALC, McGuire JK, Steensma TD, Wagenaar ECF, Doreleijers TAH, Cohen-Kettenis PT. Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics. 2014;134(4):696–704.CrossRefPubMedGoogle Scholar
  58. 58.
    Klink D, Caris M, Heijboer A, van Trotsenburg M, Rotteveel J. Bone mass in young adulthood following gonadotropin-releasing hormone analog treatment and cross-sex hormone treatment in adolescents with gender dysphoria. J Clin Endocrinol Metab. 2015;100(2):E270–5.CrossRefPubMedGoogle Scholar
  59. 59.
    Couturier J, Pindiprolu B, Findlay S, Johnson N. Anorexia nervosa and gender dysphoria in two adolescents. Int J Eat Disord. 2014;48(1):151–5.CrossRefPubMedGoogle Scholar
  60. 60.
    Ewan LA, Middleman AB, Feldmann J. Treatment of anorexia nervosa in the context of transsexuality: a case report. Int J Eat Disord. 2014;47(1):112–5.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Institute of Sport Science/Dance ScienceUniversity BernBernSwitzerland
  2. 2.ArnhemThe Netherlands

Personalised recommendations