October 1996 Bulletin

Academy urges NIH research on young women

The Academy has recommended that the National Institutes of Health (NIH) expand research efforts directed at gaining a better understanding of the needs of young women and on designing effective educational strategies to improve their health habits.

"Although there have been tremendous strides in women's health, the orthopaedic health of young women is lagging behind," Laura Tosi, MD, said on behalf of the Academy at a public hearing and scientific workshop. The Sept. 26-27 event was sponsored by the Office of Research on Women's Health of the NIH and the University of Pennsylvania School of Medicine and Allegheny University of the Health Sciences, MCP-Hahnemann School of Medicine.

"As a pediatric orthopaedic surgeon with 12 years' experience treating bone injuries and disease in children and adolescents, I am appalled by the poor calcium intake and exercise habits in the vast majority of my patients," Dr. Tosi said.

Although drug therapies have been developed to prevent osteoporosis and many women have become aware of the risk and ways to prevent the condition, "these efforts are coming 40 years too late," Dr. Tosi said. "It is far easier and cheaper to develop strong bone early than later. We must begin osteoporosis prevention in childhood by stressing the importance of a calcium-rich diet for young women."

Observing the results of some scientific studies, she said "longer, prospective trials on the effects of calcium intake and its effect on peak bone mass are sorely needed."

Concerning women and sports, she noted that far too often, competitive female athletes are led to believe that a childlike physique and extremely low body weight are essential for excellence in sports. This may lead some women to develop the "female athlete triad," an eating disorder, amenorrhea and osteoporosis. Bone mineral density in these girls may be two standard deviations below the norm.

"Effective educational programs are needed to bring the risk of the 'female athlete triad' to the attention of coaches, parents and young women," she said. "Instituting research to design and evaluate such programs is an urgent priority."

Dr. Tosi also pointed out that although injury rates are generally no higher in women than in men in sports with comparable rules, one exception is the greater prevalence of knee injuries in women, particularly injuries of the anterior cruciate ligament.

"Investigation of the causes of ACL and other knee injuries in young women is essential and steps to preclude these injuries should be identified," Dr. Tosi said.

She observed that "the Academy believes the Office of Research on Women's Health can and should play a leadership role in identifying the key cause and effect relationships, building data bases that accurately portray behaviors of young women and supporting critical research on the design of effective educational and intervention programs."

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