How to fight the scary cycling-osteoporosis connection? [ACHEY-BREAKY BIKER BONES]


How to fight the scary cycling-osteoporosis connection
By Roy M. Wallack

FIVE YEARS AGO, Bill Holland, a San Diego bike builder, thought he was in the shape of his life. Friends told the 48-year-old that, with his five-foot-ten-inch, 147-pound frame, he looked ten years younger than he really was. For the past 25 years, he ate a balanced diet and rode 150 miles a week.

Then, in May 2001, Holland was a test subject in a bone-density study at San Diego State University (SDSU). The results shocked him: He had borderline osteoporosis. “A doctor told me that I had the heart and lungs of a 17-year-old,” says Holland, “and the bones of a 70-year-old.”

Whoa. Osteoporosis?

If you thought of osteoporosis strictly as an “old lady’s disease,” get ready for a surprise: If you only use a non-impact sport like cycling and swimming to keep fit, you could be at risk, too. Despite his rigorous exercise habits and healthy diet, Holland’s bones had grown weak—and ripe for failure. In fact, just after the test, he “confirmed” his results with a 15-mph crash that left him with a fractured left hip, broken collar bone, and a bunch of cracked ribs. “At that (slow) speed, my riding buddies didn’t think anyone’s bones could break, but I couldn’t get up, ” he said.

Until now, few athletes have worried about skeletal strength, assuming a good diet and training would keep their bones robust. Then came the SDSU study (published in Osteoporosis International in 2003), which measured the bone density of Holland and 26 other male masters cyclists, who had trained an average of 12.2 hours per week for 20 years. The eye-opening results: Two-thirds of the test group had osteopenia—noticable bone thinning. Four had full-blown osteoporosis — severe thinning. All this at an average age, 51, when normal men have no bone thinning at all.

Explanation? For better or worse, the human body adapts to its environment. If you stop applying force to your frame by focusing on low-impact sports like cycling instead of load-bearing activities such as running or lifting weights, you’ll build muscle, but your bod will assume that it can slow down bone maintenance.

The osteo-cycling connection isn’t new. In 1996, a study of six Tour de France riders showed bone-density losses of up to 17 percent over the course of the race. Seven years later, the results of the SDSU testing led study author Jeanne Nichols, a Masters racer and exercise-physiology professor, to make a stunning warning:

“Anyone who rides a bike as his or her main form of fitness is risking osteoporosis.”

Making things worse for cyclists is a double-whammy Nichols hadn’t considered: calcium loss in sweat. In a 1995 study of college basketball players at the University of Memphis by Robert Klesges, PhD, bone-density scans revealed significant thinning during the six-month season. To find out why, his researchers literally wrung out the players’ sweatty jerseys after practice. “Our analysis showed huge expenditures of sodium, which we expected” says Klesges, “and surprising amounts of calcium, which we didn’t.”

Turns out that an average-sized man can sweat out up to 200 milligrams of calcium in an hour of vigorous exercise, according to Dr. Christine Snow of the Oregon State University Bone Research Laboratory. The math is frightening for cyclists, who often ride all day long. At 12.2 hours a week, Nichols’ test subjects lost over 2400 mg of calcium — two days worth of the USRDA per week for years. No wonder their bones were wasting away.


Fortunately, what comes out can be put back in. During the 1996 Memphis basketball season, Klesges supplemented each player’s daily diet with up to 2,000 milligrams of calcium, by stirring low-cost calcium lactate into their energy drinks. Lo and behold, “bone loss was virtually eliminated that season,” he says. For five years, Memphis players continued to drink extra calcium, with the same results.

Klesges’ findings, published in The Journal of the American Medical Association in 1996, exposed a common shortfall in the American diet: too little calcium. “Most people don’t even come close to the USRDA of 1,200 mg,” says Klesges, “but that amount is still not enough for an athlete exercising over an hour each day.”

Don’t count on sports drinks to fill the gap; most have no calcium at all. Gatorade’s new high-octane Endurance formula has a mere 12 mg per 16 ounces, meaning a basketball player practicing hard for 2 hours would have to drink 33 pints of the stuff a day. Nichols’ test subjects would have to drink 200 pints a week — or consume 12 to 15 cups of yogurt or milk.

But getting cyclists to alter their diets — or run or jump rope occasionally to get the impact they need (see the “How to Bone Up” tips below) — isn’t easy. Despite the test results and articles about bone loss by this writer in Bicycling and Outside magazines, Holland says few of his cohorts have changed their eating or exercise habits.

“It’s ‘Out of sight, out of mind,’” he says. “They can’t see their bones thinning, and can’t project into the future, so they don’t worry. Not me.”

Holland still rides a lot, but now downs 1,200 mg of calcium a day and rotates in thrice-weekly four-mile runs and weight-lifting sessions. The results are upbeat: since his first bone scan in 2001, he’s reversed his bone loss and seen 1 to 2 percent annual increases in density.

“Someday, if I live long enough” says Holland, “My bones might even be back to average again.”


Don’t wait until you break your hip. Get more calcium in your diet and balance in your athletic life now by adding dairy, weight lifting and running, and deleting smoking and soda. Try bone-building drugs if thinning. The details:

1. TAKE SUPPLEMENTS to reach 1200mg of calcium per day. Up intake by 200 mg for every training hour beyond one per day.

2. GET VITAMIN D ( to help absorb calcium) from sunlight and supps. Walk in the sun for 15 minutes three times a week with sleeves up, or take 400-800 IU of vitamin D daily.

3. DAIRY PRODUCTS: A serving of milk (any type), yogurt, Swiss or cheddar cheese, contains 200 to 230 mg of calcium.

4. RUN: A 1999 Hebrew University study found that a one-minute run, three times a week, can strengthen shinbones. Also good: uphill hiking with backpack, skipping rope, jumping jacks, stair-climbing, or jumping up and down. Walking is too mild to strengthen bones.

5. LIFT WEIGHTS: Heavy weights lifted to “failure” (inability to keep form) two or three times a week stress muscles and cue bone strengthening. Do three sets of 6 to 10 reps on all major muscles of chest, back, shoulders, arms, and legs.

6. WORK THE BACK: Protect the lower vertebrae, weakened by cycling’s lack of movement, by using the back-extension machine or yoga’s Cobra position.

7. CUT SMOKING, SODA, and BOOZE: Hard drinkers lose almost 70 percent more bone than nondrinkers. The phosphorus in cola leaches bone calcium; a 2006 Tufts study found that regular female cola drinkers had 4% lower bone mineral density than non.

8. BONE-BUILDING DRUGS: Fosamax slows bone-destroying cells. Forteo grows bone so fast that users often feel a teenage-like “growth spurt.”