The Effects of a 1-year Recreational Football Protocol on Bone Health Parameters in a Group of Healthy Inactive 50-year-Old Men

Osteoporosis is "the most common bone disease in humans and it is characterized by low bone mineral density (BMD) and deterioration of bone microarchitecture leading to increased risk of fracture"1. In 2001, a group of experts defined osteoporosis as "a skeletal disorder characterized by low bone strength which increases the risk of fractures"2. According to these experts, bone strength is influenced by three major factors which are the total bone mass, the geometric distribution of the mass, and the material properties2. BMD measurements by DXA reflect some of the components of bone strength, including bone mass. BMD, which is influenced by several factors such as genetic factors, ethnicity, gender, nutrition and mechanical factors (such as body weight and physical activity), is still considered as one of the best determinants of fracture risk3, 4, 5, 6. However, other densitometric variables also predict osteoporotic fracture such as Beck's geometric indices and femoral neck bone resistance indices established by Karlamangla7, 8, 9. Bone loss will occur with aging in both sexes10,11, and one out of 5 men above the age of 50 will encounter fractures related to osteoporosis in his lifetime12. Hip fractures are considered to be the most serious of fractures because they are correlated to a high rate of morbidity and mortality13. An increased risk of death during the first year after a hip fracture is found in both sexes but at a higher rate in men compared to women12,14,15. It is never too late to start practicing a physical activity even at the age of 50 years16. On the contrary, it is a good time to prevent the normal loss of bone associated with aging16. Lebanese middle-aged men are not used to doing physical activities due to the lack of school physical education programs in that period of time characterised by conflicts and economic collapse related to civil wars; the importance of physical activities on health was neglected. This showed lower BMD values in the Lebanese population compared to US and European values17,18. The lower BMD values may also be due to the deficiency in vitamin D levels and low calcium consumption that is commonly found in this population19, 20, 21, 22. Moreover, the majority of Lebanese children and youth are inactive and do not follow the physical activity guideline recommendations23,24. Therefore, it is important to incorporate strategies that help to prevent this type of fracture in the Lebanese population especially in middle-aged men. Physical activity could be beneficial to increase bone mass and to prevent its loss. The choice of physical activity is very important because some types of physical activities (high impact: football, gymnastics and volleyball) are superior to others (swimming and cycling) in positively affecting bone formation25. Football is considered a high impact weight-bearing sport25. In addition, football played as small sided games also has a high impact on the cardio vascular system, irrespective of age, fitness status and previous experience of football training26. There is compelling data which shows that a consistent physical activity practice, especially weight-bearing and impact activities, helps to prevent bone loss that is associated with aging27. Football shows a high rate of attendance and consistency in its training since playing football is enjoyable and fun with a moderate feeling of physical fatigue after its practice28. It helps to build new friends with different socio-economic backgrounds and creates social relationships. Furthermore, football is dispersed everywhere in the world, and it is considered as being one of the sports with the highest number of enrolment in participants and players29. However, all football related studies that we know about30, 31, 32, 33 had a training time ranged between 45 and 60 minutes, 2 to 3 times per week. Middle-aged men usually have many responsibilities and lack the sufficient time to practice sports. Therefore, creating a time efficient football training intervention should be investigated. It is also shown that practicing football during adolescence and young adulthood has a positive osteogenic effect on bone health parameters34, 35, 36, 37. However, longitudinal studies that aim to investigate the effects of football practice on bone health parameters in middle-aged men are rare. Moreover, the best frequency of training to stimulate osteogenic adaptation needs to be defined in this age group. Thus, the aim of this present study was to compare the effects of two recreational football protocols (RF30: 2 × 30min vs. RF60: 2 × 60min per week) for a 1-year period on bone health parameters in a group of healthy inactive middle-aged men.

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