Mapping Bone Mineral Density Across Sport Modalities in Young Adults: A Scoping Review

Abstract

Bone mineral density (BMD) is a key indicator of bone health, influenced by factors like exercise or energy availability. While exercise generally benefits BMD, sports with varied, dynamic movements (team/power-based sports) seem more effective than endurance modalities, characterized by repetitive, cyclic movements with low intensity. Thus, this scoping review aimed to examine and reflect on whole-body, spine, and femoral neck BMD values reported in the literature, categorized by specific sport modalities. Following PRISMA 2020 and PRISMA-ScR guidelines, a systematic searchwas conducted in January 2024 using PubMed, Scopus, and Web of Science, yielding 4711 studies. After screening, 111 studies were included, encompassing a total of 6058 participants across 60 distinct sport modalities in the final review. Studies were selected based on specific inclusion criteria, including healthy females and males aged 18–35 years and playing any sport classified from Tier 2–5 according to the Participation Classification Framework. Of the groups above the weighted mean for whole-body BMD, 83.7% of males and 76.3% of females were involved in team/power-based sports. For spine BMD, 9.1% of males and 12.9% of females engaged in team/power-based sports were below the weighted mean. For the femoral neck, 95.8% of males and 86.7% of females’ groups below the weighted mean were involved in individual sports. Overall, team/power-based sports characterized by dynamic, multidirectional loading are associated with higher bone mineral density, whereas exclusive participation in individual/endurance-based sports—often involving lower mechanical stimuli—may be linked to lower bone mineral density, highlighting the importance of sport-specific loading characteristics for bone health.