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Completed

NCT Number: NCT05341700

Impact Loading Effect on Bone Biomarkers in Female Runners

This study is a randomized, cross-over intervention study that will evaluate the effect of brief, high-impact loading exercises on biomarkers of bone metabolism in energy-restricted female runners. Volunteers will complete two 5-day experimental conditions in a randomized order separated by one menstrual cycle (approximately 3 weeks). Experimental conditions will include a dietary intervention of energy intake equal to 30 kcal/kg of fat-free mass/d using controlled diets and an exercise intervention of daily treadmill running with or without an additional 50 impact loading exercises.

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Key information

Age range

18 year–35 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

Virginia Polytechnic Institute and State University

Blacksburg, Virginia, 24061, United States

About this study

Many long-distance runners struggle to consume enough calories each day to match the number of calories they are burning during exercise and as part of daily living. Undereating for long periods of time is a serious concern because it can have negative effects on general health and sports performance. One of these long-term consequences is related to bone health. With undereating, bone can start to be broken down faster than it can be rebuilt. Even though it can take months, and even years, for bone to be seriously affected, this may lead to weak and brittle bones later in life, if it is left untreated. Typically, athletes are recommended to increase the number of calories they eat to prevent negative health concerns. However, not all athletes may be willing or able to increase their calories based on their performance goals, nutrition knowledge, or concerns with food security. This means that alternative strategies need to be investigated to counteract the negative effects of undereating on bone health. This study proposes to evaluate the effect of adding short bouts of high-impact jumping exercises to typical endurance training to promote healthy bone metabolism. This will specifically involve completing two phases of a supervised treadmill run and consuming a reduced-calorie diet (provided by the research team) on 5 consecutive days. In addition, one of the phases will include performing 5 sets of 10 jumping exercises on 5 consecutive days in addition to the treadmill run. Results of the study will serve as an important first step in helping exercise and medical professionals understand more about how to protect and manage the bone health of female long-distance runners.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Females runners with regular menstrual cycles, not using contraceptives
  • Body Mass Index between 18.5-30.0 kg/m2
  • Weight stable (+/- 2 kg) for 6 months
  • VO2max of ≥35 ml/kg/min
  • Willing to consume provided meals and snacks

Exclusion criteria

  • Low Energy Availability in Females Questionnaire (LEAF-Q) score ≥8
  • Menstrual disturbances measured by progesterone and self-report
  • Using contraceptives (oral contraceptives, injections, intrauterine device, etc.)
  • Low Bone Mineral Density (z-score < -1)
  • Routine engagement in mechanical loading exercises
  • History of fracture in the previous 6 months
  • Recent recovery (within the last 12 months) or still in recovery after eating disorder diagnosis
  • Medication use that could affect bone metabolism (e.g., corticosteroids, anticonvulsants, heparin, gonadotropin-releasing hormone agonists)
  • Pregnancy or lactation
  • Abnormal thyroid-stimulating hormone levels

Treatment and study plan

Impact Load Exercises

Behavioral

Participants will complete 50-65 min running protocol on treadmill and 5 sets of 10 jumping exercises for 5 consecutive days. Participants will also be provided all meals and snacks to induce a energy-restricted state for the 5-day period.

No Impact Load Exercises

Behavioral

Participants will complete only a 50-65 min running protocol on treadmill for 5 consecutive days. Participants will also be provided all meals and snacks to induce a energy-restricted state for the 5-day period.

Primary outcomes

  1. Change in Bone Remodeling Biomarker - N-terminal Propeptide of Type 1 Procollagen

    Time frame: 10-minute blood draw in laboratory; samples assessed on intervention day 0 and day 6

    Plasma N-terminal propeptide of type 1 procollagen (PINP) was collected from fasted blood samples drawn before and after each 5-day intervention. The enzyme-linked immunosorbent assays (ELISA) were performed on all samples upon study completion.

  2. Change in Bone Remodeling Biomarker - C-terminal Telopeptide of Type 1 Collagen (CTX)

    Time frame: 10-minute blood draw in laboratory; samples assessed on intervention day 0 and day 6

    Serum C-terminal telopeptide of type 1 collagen (CTX) was collected from fasted blood samples drawn before and after each 5-day intervention. The enzyme-linked immunosorbent assays (ELISA) were performed on all samples upon study completion.

  3. Change in Blood Metabolic Marker - Parathyroid Hormone

    Time frame: 10-minute blood draw in laboratory; samples assessed on intervention day 0 and day 6

    Parathyroid hormone levels were measured from fasted blood samples collected before and after each 5-day intervention. The enzyme-linked immunosorbent assays (ELISA) were performed on all samples upon study completion.

  4. Change in Blood Metabolic Marker - Insulin-like Growth Factor-1

    Time frame: 10-minute blood draw in laboratory; samples assessed on intervention day 0 and day 6

    Insulin-like growth factor-1 (IGF1) concentration was measured from fasted blood samples collected before and after each 5-day intervention. The enzyme-linked immunosorbent assays (ELISA) were performed on all samples upon study completion.

Secondary outcomes

  1. Change in Ferritin

    Time frame: 10-minute blood draw in laboratory; samples assessed on intervention day 0 and day 6

    Fasted serum ferritin was measured before and after each 5-day intervention period.

Sponsors and collaborators

Lead sponsor

Virginia Polytechnic Institute and State University

Other

Registry information

Official study title

The Effect of Impact Loading on Bone Biomarkers in Energy-Restricted Female Runners

Important dates

Study start
2022
Primary completion
2024
Study completion
2024
First posted
Apr 22, 2022
Registry last updated
Aug 19, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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