Healthy Runner Project: a 7-year, multisite nutrition education intervention to reduce bone stress injury incidence in collegiate distance runners
Objectives We evaluated the effect of a nutrition education intervention on bone stress injury (BSI) incidence among female distance runners at two NCAA Division I institutions.Methods Historical BSI rates were measured retrospectively (2010–2013); runners were then followed prospectively in pilot (...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-05-01
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| Series: | BMJ Open Sport & Exercise Medicine |
| Online Access: | https://bmjopensem.bmj.com/content/9/2/e001545.full |
| _version_ | 1827323366517768192 |
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| author | Emily Kraus Aurelia Nattiv Andrea Kussman Sonal Singh Brian Young Kim Michelle T Barrack Michael Fredericson Adam Tenforde Emily Miller Katherine Fahy Megan Roche Kristin Sainani Emily Miller Olson Ellie Diamond Sonya Meraz |
| author_facet | Emily Kraus Aurelia Nattiv Andrea Kussman Sonal Singh Brian Young Kim Michelle T Barrack Michael Fredericson Adam Tenforde Emily Miller Katherine Fahy Megan Roche Kristin Sainani Emily Miller Olson Ellie Diamond Sonya Meraz |
| author_sort | Emily Kraus |
| collection | DOAJ |
| description | Objectives We evaluated the effect of a nutrition education intervention on bone stress injury (BSI) incidence among female distance runners at two NCAA Division I institutions.Methods Historical BSI rates were measured retrospectively (2010–2013); runners were then followed prospectively in pilot (2013–2016) and intervention (2016–2020) phases. The primary aim was to compare BSI rates in the historical and intervention phases. Pilot phase data are included only for descriptive purposes. The intervention comprised team nutrition presentations focused on optimising energy availability plus individualised nutrition sessions for runners with elevated Female Athlete Triad risk. Annual BSI rates were calculated using a generalised estimating equation Poisson regression model adjusted for age and institution. Post hoc analyses were stratified by institution and BSI type (trabecular-rich or cortical-rich).Results The historical phase included 56 runners and 90.2 person-years; the intervention phase included 78 runners and 137.3 person-years. Overall BSI rates were not reduced from the historical (0.52 events per person-year) to the intervention (0.43 events per person-year) phase. Post hoc analyses demonstrated trabecular-rich BSI rates dropped significantly from 0.18 to 0.10 events per person-year from the historical to intervention phase (p=0.047). There was a significant interaction between phase and institution (p=0.009). At Institution 1, the overall BSI rate dropped from 0.63 to 0.27 events per person-year from the historical to intervention phase (p=0.041), whereas no decline was observed at Institution 2.Conclusion Our findings suggest that a nutrition intervention emphasising energy availability may preferentially impact trabecular-rich BSI and depend on team environment, culture and resources. |
| first_indexed | 2024-03-12T21:46:50Z |
| format | Article |
| id | doaj.art-fc200a119bfa4df2ab914a9659613721 |
| institution | Directory Open Access Journal |
| issn | 2055-7647 |
| language | English |
| last_indexed | 2024-04-25T01:43:50Z |
| publishDate | 2023-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Sport & Exercise Medicine |
| spelling | doaj.art-fc200a119bfa4df2ab914a96596137212024-03-08T01:25:07ZengBMJ Publishing GroupBMJ Open Sport & Exercise Medicine2055-76472023-05-019210.1136/bmjsem-2023-001545Healthy Runner Project: a 7-year, multisite nutrition education intervention to reduce bone stress injury incidence in collegiate distance runnersEmily Kraus0Aurelia Nattiv1Andrea Kussman2Sonal Singh3Brian Young Kim4Michelle T Barrack5Michael Fredericson6Adam Tenforde7Emily Miller8Katherine Fahy9Megan Roche10Kristin Sainani11Emily Miller Olson12Ellie Diamond13Sonya Meraz14Department of Orthopaedic Surgery, Stanford Hospital and Clinics, Stanford, California, USADivision of Sports Medicine, Departments of Family Medicine and Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, California, USADepartment of Orthopaedic Surgery, Stanford Hospital and Clinics, Stanford, California, USASchool of Medicine, St George’s University, St George’s, GrenadaFamily Medicine, University of California, Los Angeles, Santa Monica, California, USADepartment of Family and Consumer Sciences, California State University Long Beach, Long Beach, California, USADepartment of Orthopaedic Surgery, Division of Physical Medicine & Rehabilitation, Stanford University, Stanford, California, USADepartment of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA2 Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USADepartment of Family Medicine, University of Washington Medical Center, Seattle, Washington, USADepartment of Epidemiology, Stanford Hospital and Clinics, Stanford, California, USADepartment of Epidemiology and Population Health, Stanford University, Stanford, California, USABodor Clinic, Napa, California, USADepartment of Orthopaedic Surgery, Stanford University, Stanford, California, USASchool of Nursing, University of Massachusetts System, Boston, Massachusetts, USAObjectives We evaluated the effect of a nutrition education intervention on bone stress injury (BSI) incidence among female distance runners at two NCAA Division I institutions.Methods Historical BSI rates were measured retrospectively (2010–2013); runners were then followed prospectively in pilot (2013–2016) and intervention (2016–2020) phases. The primary aim was to compare BSI rates in the historical and intervention phases. Pilot phase data are included only for descriptive purposes. The intervention comprised team nutrition presentations focused on optimising energy availability plus individualised nutrition sessions for runners with elevated Female Athlete Triad risk. Annual BSI rates were calculated using a generalised estimating equation Poisson regression model adjusted for age and institution. Post hoc analyses were stratified by institution and BSI type (trabecular-rich or cortical-rich).Results The historical phase included 56 runners and 90.2 person-years; the intervention phase included 78 runners and 137.3 person-years. Overall BSI rates were not reduced from the historical (0.52 events per person-year) to the intervention (0.43 events per person-year) phase. Post hoc analyses demonstrated trabecular-rich BSI rates dropped significantly from 0.18 to 0.10 events per person-year from the historical to intervention phase (p=0.047). There was a significant interaction between phase and institution (p=0.009). At Institution 1, the overall BSI rate dropped from 0.63 to 0.27 events per person-year from the historical to intervention phase (p=0.041), whereas no decline was observed at Institution 2.Conclusion Our findings suggest that a nutrition intervention emphasising energy availability may preferentially impact trabecular-rich BSI and depend on team environment, culture and resources.https://bmjopensem.bmj.com/content/9/2/e001545.full |
| spellingShingle | Emily Kraus Aurelia Nattiv Andrea Kussman Sonal Singh Brian Young Kim Michelle T Barrack Michael Fredericson Adam Tenforde Emily Miller Katherine Fahy Megan Roche Kristin Sainani Emily Miller Olson Ellie Diamond Sonya Meraz Healthy Runner Project: a 7-year, multisite nutrition education intervention to reduce bone stress injury incidence in collegiate distance runners BMJ Open Sport & Exercise Medicine |
| title | Healthy Runner Project: a 7-year, multisite nutrition education intervention to reduce bone stress injury incidence in collegiate distance runners |
| title_full | Healthy Runner Project: a 7-year, multisite nutrition education intervention to reduce bone stress injury incidence in collegiate distance runners |
| title_fullStr | Healthy Runner Project: a 7-year, multisite nutrition education intervention to reduce bone stress injury incidence in collegiate distance runners |
| title_full_unstemmed | Healthy Runner Project: a 7-year, multisite nutrition education intervention to reduce bone stress injury incidence in collegiate distance runners |
| title_short | Healthy Runner Project: a 7-year, multisite nutrition education intervention to reduce bone stress injury incidence in collegiate distance runners |
| title_sort | healthy runner project a 7 year multisite nutrition education intervention to reduce bone stress injury incidence in collegiate distance runners |
| url | https://bmjopensem.bmj.com/content/9/2/e001545.full |
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