Low Calcium and Vitamin D Intake

Low calcium intake is associated with low BMD [83] and therefore may contribute to the development of stress fractures. Myburgh and colleagues [57] observed an association between decreased calcium intake and increased stress fracture risk. However, other studies found no association between calcium intake and stress fracture risk, with both stress fracture and nonstress fracture groups having normal calcium intake [13,84,85]. Athletes whose calcium intake is below the daily recommended value are likely to be at risk for stress fractures, but for those with normal dietary calcium intake, other factors play a larger role.

Vitamin D is also essential to bone health, and its functions include stimulating calcium transport, osteoblastic stimulation, and decreasing parathyroid hormone. Recent studies have focused on the role of the vitamin D receptor allele in predicting bone density. More research is necessary to determine the clinical applications of its use in screening [86-88].

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