title: Reduced Bone Strength and Muscle Force in Women 27 Years After Anorexia Nervosa.
abstract: BACKGROUND
  A substantial body of research findings indicate that muscle mass and bone mass are reduced in populations of anorexic females, even in such populations whose anorexia nervosa had been in remission for longer periods.
  
  
  OBJECTIVE
  This study aimed to investigate whether the bone of an anorexia nervosa recovery cohort is adapted to maximal muscle forces and whether there are alterations in the structure of the tibia in this population, as compared with a control group.
  
  
  METHODS
  This was a cross-sectional study of 22 women in Switzerland who have remained in stable recovery from anorexia nervosa for an average of 27 years. The measurements were compared with those of an age- and gender-matched control group (n = 73).
  
  
  METHODS
  There were no interventions.
  
  
  METHODS
  Bone characteristics of the tibia and maximal voluntary ground reaction force (Fm1LH) were measured.
  
  
  RESULTS
  The variability in volumetric bone mineral content (vBMC) at the 14% site was explained by 54.7% on the grounds of Fm1LH (P < .001). Formerly anorexic women had an 11.6% lower Fm1LH (P = .001), a significantly lower vBMC at 4% and 14% of tibia length, and an 11.9% (P = .001) lower body mass than the age- and gender-matched control population. Present body mass of the anorexia group correlated positively with vBMC at the 14% site (P < .001).
  
  
  CONCLUSIONS
  Despite the fact that findings reflected an adaptation of bone to the acting forces, most results indicated that the test cohort generally suffered from a secondary bone defect. In addition, maximal muscle force was also impaired in the formerly anorexic women.
authors.affiliation: Exercise Physiology (S.M.M., E.A., U.B., M.T.), Institute of Human Movement Sciences, ETH Zurich, CH-8057 Zurich, Switzerland; Statewide Mental Health Program (M.I.), Elk Grove, California 95758; Department of Psychology (S.D.), Division of Clinical Psychology and Psychotherapy, University of Zurich, CH-8050 Zurich, Switzerland; and Laboratory for Muscle Plasticity (M.T.), Balgrist University Hospital, Department of Orthopedics, University of Zurich, CH-8008 Zurich, Switzerland.
authors.forename: Sandro Manuel
authors.initials: SM
authors.lastname: Mueller
authors.affiliation: Exercise Physiology (S.M.M., E.A., U.B., M.T.), Institute of Human Movement Sciences, ETH Zurich, CH-8057 Zurich, Switzerland; Statewide Mental Health Program (M.I.), Elk Grove, California 95758; Department of Psychology (S.D.), Division of Clinical Psychology and Psychotherapy, University of Zurich, CH-8050 Zurich, Switzerland; and Laboratory for Muscle Plasticity (M.T.), Balgrist University Hospital, Department of Orthopedics, University of Zurich, CH-8008 Zurich, Switzerland.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Immoos
authors.affiliation: Exercise Physiology (S.M.M., E.A., U.B., M.T.), Institute of Human Movement Sciences, ETH Zurich, CH-8057 Zurich, Switzerland; Statewide Mental Health Program (M.I.), Elk Grove, California 95758; Department of Psychology (S.D.), Division of Clinical Psychology and Psychotherapy, University of Zurich, CH-8050 Zurich, Switzerland; and Laboratory for Muscle Plasticity (M.T.), Balgrist University Hospital, Department of Orthopedics, University of Zurich, CH-8008 Zurich, Switzerland.
authors.forename: Elmar
authors.initials: E
authors.lastname: Anliker
authors.affiliation: Exercise Physiology (S.M.M., E.A., U.B., M.T.), Institute of Human Movement Sciences, ETH Zurich, CH-8057 Zurich, Switzerland; Statewide Mental Health Program (M.I.), Elk Grove, California 95758; Department of Psychology (S.D.), Division of Clinical Psychology and Psychotherapy, University of Zurich, CH-8050 Zurich, Switzerland; and Laboratory for Muscle Plasticity (M.T.), Balgrist University Hospital, Department of Orthopedics, University of Zurich, CH-8008 Zurich, Switzerland.
authors.forename: Suzana
authors.initials: S
authors.lastname: Drobnjak
authors.affiliation: Exercise Physiology (S.M.M., E.A., U.B., M.T.), Institute of Human Movement Sciences, ETH Zurich, CH-8057 Zurich, Switzerland; Statewide Mental Health Program (M.I.), Elk Grove, California 95758; Department of Psychology (S.D.), Division of Clinical Psychology and Psychotherapy, University of Zurich, CH-8050 Zurich, Switzerland; and Laboratory for Muscle Plasticity (M.T.), Balgrist University Hospital, Department of Orthopedics, University of Zurich, CH-8008 Zurich, Switzerland.
authors.forename: Urs
authors.initials: U
authors.lastname: Boutellier
authors.affiliation: Exercise Physiology (S.M.M., E.A., U.B., M.T.), Institute of Human Movement Sciences, ETH Zurich, CH-8057 Zurich, Switzerland; Statewide Mental Health Program (M.I.), Elk Grove, California 95758; Department of Psychology (S.D.), Division of Clinical Psychology and Psychotherapy, University of Zurich, CH-8050 Zurich, Switzerland; and Laboratory for Muscle Plasticity (M.T.), Balgrist University Hospital, Department of Orthopedics, University of Zurich, CH-8008 Zurich, Switzerland.
authors.forename: Marco
authors.initials: M
authors.lastname: Toigo
mesh_terms: D000293:Adolescent; D000328:Adult; D000375:Aging / Q000502:physiology; D000856:Anorexia Nervosa / Q000150:complications* / Q000534:rehabilitation*; D015519:Bone Density / Q000502:physiology*; D001842:Bone and Bones / Q000502:physiology*; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D013557:Switzerland / Q000453:epidemiology