Mother Daughter Relationship Important Key To HPV Vaccination

College women were more likely to be vaccinated against human papillomavirus (HPV) if their mothers communicated with them about sex and if they thought their mothers would approve of their getting vaccinated, according to new Dartmouth research.

Meg Gerrard, PhD, of Dartmouth Medical School and Norris Cotton Cancer Center, Megan Roberts, a PhD student at Dartmouth College, and their colleagues, surveyed 972 female undergraduates at a large Midwestern university between November 2007 and April 2009.

An anonymous questionnaire assessed the undergraduate’s sexual-risk behavior, knowledge of HPV, perceptions of HPV risk, communication from their mothers about sex-related topics (including HPV), and their current vaccination status.

Sixty-five percent of the women reported being sexually active, and 49 percent reported having received at least the first of the three-shot HPV vaccine series.

Those who were unvaccinated were more likely to be interested in future vaccination if they thought their mothers would approve. The young women’s perceptions of their risk of contracting HPV also contributed to their interest in getting vaccinated. Young women whose mothers had discussed values in relation to sex were, as a group, less interested in being vaccinated.

The authors concluded that “mother-daughter communication and approval of vaccination emerged as important predictors of young women’s HPV-vaccination behavior and intentions, even after the women were old enough to not require parental approval.” They also noted that college-age women “are still a very important population to target for vaccination.”

The study was published in the journal Pediatrics. For more information, visit: www.dartmouth.edu/

Late-Stage Ovarian Cancer Therapy Shows Promise In Phase I Trial

The combination of decitabine and carboplatin appears to improve the outcome of women who have late-stage ovarian cancer.

Indiana University researchers report 4 of 10 patients who participated in a phase I clinical trial had no disease progression after six months of treatment. One patient experienced complete resolution of tumor tissue for a period of time.

Advanced ovarian cancer is often diagnosed too late for treatment to be effective. Patients are often told they have virtually no chance of recovery and only months to live.

Women participating in the study were between 51 and 71, and had previously exhausted all approved treatments for ovarian cancer. They enrolled in an Indiana University Melvin and Bren Simon Cancer Center clinical trial designed to increase their sensitivity to the commonly prescribed ovarian cancer drug, platinum-based carboplatin.

Women with ovarian cancer usually survive less than one year after they become resistant to carboplatin and their cancer recurs, said co-principal investigator Daniela Matei, M.D., an associate professor of medicine at the Indiana University School of Medicine. Matei led the clinical portion of the trial.

“Carboplatin is the most efficient drug therapy for ovarian cancer,” Matei said. “Unfortunately, patients with recurrent disease become resistant to the drug after one or two rounds.”

Decitabine was first used to treat the study patients intravenously daily for five days followed on the eighth day with carboplatin. After a month, the regimen begins again.

Six months after the trial began, four of the patients had no disease progression. At eight-and-a-half months, seven patients were alive. Cancerous tissue in one of the patients shrank completely.
Adverse reactions to the treatment regiments were mild, including nausea, fatigue and neutropenia.

Encouraged by the results of the phase I trial, which determined the safety of two different dosing regimens, a phase II trial is now under way with 17 patients already enrolled. Phase II trials are primarily focused on assessing the effectiveness of a drug or treatment protocol.

The study’s other co-principal investigator, Kenneth Nephew, geneticist in the IU Medical Sciences Program-Bloomington, led the report’s biochemical and DNA analysis.

In a bid to resensitize patients to carboplatin, Nephew and Matei and co-investigator Jeanne M. Schilder, M.D., associate professor of obstetrics and gynecology in the Division of Gynecologic Oncology at the IU School of Medicine, turned to the DNA demethylating agent, decitabine.

Why trial patients were responsive to the combination of decitabine and carboplatin is not yet known, but based on the literature and an analysis of biopsy tissue and blood samples, Nephew and Matei suspect decitabine reactivates tumor suppression genes that are turned off in ovarian cancer cells.

One of the hallmarks of ovarian cancer is the aberrant methylation of cytosine, one of DNA’s four nitrogenous bases. Methylation prevents DNA readers from expressing genes. Some of the silenced genes won’t be terribly important, but some, like tumor suppression genes, are. Decitabine is a known methylation inhibitor that can help return tumor suppression genes to an active state, and also improve cells’ susceptibility to anti-cancer drugs like carboplatin.

“Our hypothesis is that decitabine isn’t just targeting active ovarian cancer cells, but also cancer stem cells that seem to survive the first treatments,” Nephew said. “By keeping tumor suppression genes from being methylated, carboplatin and other platinum-based treatments for ovarian cancer have a better chance of success in the late stages.”

The researchers also reported that decitabine appears to have caused six of the 10 patients to become hypersensitive to carboplatin (a mild allergic reaction, treatable with steroids). While Nephew and Matei say that the effect may not be observed in a larger patient population, the scientists say they are intrigued by the phenomenon.

The two-drug treatment protocol is not approved for general use. The IU Simon Cancer Center is the only site for this clinical study.

Also contributing to the report were Fang Fang (lead author), Curt Balch, Timothy Breen, Shu Zhang, Changyu Shen, Lang Li, Carol Kulesavage, and Anthony Snyder. It was funded by the National Cancer Institute, Phi Beta Psi, and Ovar’coming Together.

The study was published in the journal, Cancer. More information can be found by visiting: www.indiana.edu.

FDA Approved Leukemia Drug Shows Promising Activity In Ovarian Cancer Cells

The drug Sprycel, approved for use by the U.S. Food and Drug Administration in patients with chronic myeloid leukemia, significantly inhibited the growth and invasiveness of ovarian cancer cells and also promoted their death, a study by researchers with UCLA’s Jonsson Comprehensive Cancer Center found.

The drug, when paired with a chemotherapy regimen, was even more effective in fighting ovarian cancer in cell lines in which signaling of the Src family kinases, associated with the deadly disease, is activated.

Ovarian cancer, which will strike 21,600 women this year and kill 15,500, causes more deaths than any other cancer of the female reproductive system. Few effective therapies for ovarian cancer exist, so it would be advantageous for patients if a new drug could be found that fights the cancer, said Gottfried Konecny, an assistant professor of hematology/oncology, a Jonsson Cancer Center researcher and first author of the study.

“I think Sprycel could be a potential additional drug for treating patients with Src dependent ovarian cancer,” Konecny said. “It is important to remember that this work is only on cancer cell lines, but it is significant enough that it should be used to justify clinical trials to confirm that women with this type of ovarian cancer could benefit.”

Recent gene expression studies have shown that about one-third of women have ovarian cancers with activated Src pathways, so the drug could potentially help 7,000 ovarian cancer patients every year.

In this study, the UCLA team tested the drug against 34 ovarian cancer cell lines and they conducted genetic analysis on all cell lines. Through these analyses, the researchers were able to identify genes that predict response to Sprycel. If the work is confirmed in human studies, it may be possible to test patients for Src activation and select those who would respond prior to treatment, personalizing their care.

“We were able to identify markers in the pre-clinical setting that would allow us to predict response to Sprycel,” Konecny said. “These may help us in future clinical trials in selecting patients for studies of the drug.”

Sprycel is what is known as a “dirty” kinase inhibitor, meaning it inhibits more than one pathway. Konecny said it also inhibits the focal adhesion kinase and ephrin receptor, also associated with ovarian cancer.

The next step, Konecny said, would be to test the drug on women with ovarian cancer in a clinical trial. The tissue of responders would then be analyzed to determine if the Src and other pathways were activated. If that is confirmed, it would further prove that Sprycel could be used to fight ovarian cancer. In studies, women would be screened before entering a trial and only those with Src dependent cancers could be enrolled to provide further evidence, Konecny said, much like the studies of the molecularly targeted breast cancer drug Herceptin enrolled only women who had HER-2 positive disease.

“Herceptin is different because we knew in advance that the only worked in women with HER-2 amplification,” he said. “In this case, we don’t clearly know that yet. The data reassure us that the drug works where the targets are over-expressed but we need more testing to confirm this.”

The tests combining the drug with chemotherapy are significant because chemotherapy currently is the first line treatment for ovarian cancer patients following surgery. Because Sprycel proved to have a synergistic effect when combined with chemotherapy – both made the other work better – it may be possible to add the targeted therapy as a first line treatment if its efficacy is confirmed in future studies, adding a new tool to an oncologist’s arsenal.

The study appeared in the British Medical Journal.

UCLA’s Jonsson Comprehensive Cancer Center has more than 240 researchers and clinicians engaged in disease research, prevention, detection, control, treatment and education. One of the nation’s largest comprehensive cancer centers, the Jonsson center is dedicated to promoting research and translating basic science into leading-edge clinical studies. In July 2009, the Jonsson Cancer Center was named among the top 12 cancer centers nationwide by U.S. News & World Report, a ranking it has held for 10 consecutive years.

For more information on the Jonsson Cancer Center, visit our website at http://www.cancer.ucla.edu.

Pregnancy Proteins May Prevent Breast Cancer

Researchers have found that hormones produced during pregnancy induce a protein that directly inhibits the growth of breast cancer. This protein, alpha-fetoprotein (AFP), may serve as a viable, well-tolerated agent for the treatment and prevention of breast cancer, according to findings published in Cancer Prevention Research, a journal of the American Association for Cancer Research.

“Hormones in pregnancy, such as estrogen, all induce AFP, which directly inhibits the growth of breast cancer,” said lead researcher Herbert Jacobson, Ph.D., who is a basic breast cancer researcher in the Center for Immunology and Microbial Diseases and in the Department of Obstetrics, Gynecology and Reproductive Sciences at Albany Medical College, N.Y.

“The body has a natural defense system against breast cancer,” he added. “AFP needs to be safely harnessed and developed into a drug that can be used to protect women from breast cancer.”

Recent studies have shown that hormones released during pregnancy, such as estrogen, progesterone and human chorionic gonadotropin, reduce a woman’s risk for breast cancer. AFP is a protein normally produced by the liver and yolk sac of a fetus. Jacobson and colleagues sought to determine whether administering pregnancy hormones to carcinogen-exposed rats led them to produce AFP, which in turn produces the protective effect of pregnancy in the absence of pregnancy.

Results from this study showed that treatment with estrogen plus progesterone, estrogen alone or human chorionic gonadotropin reduced the incidence of mammary cancers in rats. Furthermore, the researchers noted that each of these treatments elevated the serum level of AFP and that AFP directly inhibited the growth of breast cancer cells growing in culture, suggesting that these hormones of pregnancy are preventing breast cancer through their induction of AFP.

Cancer Prevention Research Editorial Board Member Powel Brown, M.D., Ph.D., said while these preclinical findings are important and suggest a role of AFP in breast cancer prevention, they are not yet ready to be used in the clinic.

“The researchers have not directly demonstrated the cancer preventive activity of AFP, instead they found an association of these hormones preventing mammary tumors. None of these treatments prevented mammary tumors in 100 percent of the rats, it appears to delay mammary tumor formation and prevent breast cancer development in approximately 30 to 50 percent of the rats,” said Brown, professor of medicine and cancer prevention and clinical cancer prevention department chairman at the University of Texas M. D. Anderson Cancer Center.

“This study is promising and suggests that additional animal studies need to be done before translation to humans,” he said. “We may want to further test AFP for its cancer prevention activity.”

Jacobson and colleagues are currently conducting studies in which they have isolated a small piece of AFP molecule and are working to convert it into a breast cancer preventative agent.

For more information, visit: www.aacr.org.

Agave Joins The Fight Against Osteoporosis

Agave, the plant that gave the world tequila contains a substance that seems ideal for use in a new genre of processed foods — dubbed “functional foods” — with health benefits serving as a source of nutrients, scientists reported at the 239th National Meeting of the American Chemical Society (ACS) in San Francisco on March 23.

Foods spiked with “fructans” from the agave plant may help protect against osteoporosis by boosting the body’s absorption of calcium and could have other health benefits, the scientists said.

“Fructans are considered functional food ingredients because they affect body processes in ways that result in better health and reduction in the risk of many diseases,” said Mercedes López, Ph.D., who delivered the report.

“Experimental studies suggest that fructans may be beneficial in diabetes, obesity, stimulating the immune system of the body, decreasing levels of disease-causing bacteria in the intestine, relieving constipation, and reducing the risk of colon cancer,” said López, serving as a representative for the National Polytechnic Institute, Guanajuato, Mexico.

Fructans are non-digestible carbohydrates. They consist of molecules of fructose — the sugar found in honey, grapes, and ripe fruits — linked together into chains. Rich natural sources include artichokes, Jerusalem artichokes, garlic and onions, and chicory. Fructans do not occur in tequila, however, because they change into alcohol when agave is used to make tequila, López said.

So-called “inulin-type” fructans from chicory find wide use in the United States and other countries in ice cream, breakfast cereals, baked goods, sauces, beverages, and other foods. Small fructans have a sweet taste, while those formed from longer chains of fructose have a neutral taste and give foods a smooth, pleasant texture.

Scientific studies have suggested that fructans stimulate the growth of healthful bacteria in the large intestine in a way that increases the body’s absorption of minerals, including the calcium and magnesium important for bone growth.

In the new study, López and colleagues set out to determine what effects agave fructans actually have on bone growth. They tested the effects of agave fructans on laboratory mice, used as stand-ins for humans in such research. Mice fed agave fructans absorbed more calcium from food, excreted less calcium in their feces, and showed a 50 percent increase in levels of a protein associated with the build-up of new bone tissue.

“These results suggest that the supplementation of the standard diet with agave fructans prevented bone loss and improved bone formation, indicating the important role of agave fructans on the maintenance of healthy bone,” López said. “They can be used in many products for children and infants to help prevent various diseases, and can even be used in ice cream as a sugar substitute.”

López said her findings suggest that agave fructans could be used in all of the same foods as chicory fructans. One advantage: Agave grows abundantly in Mexico and other countries with climates that do not favor growth of chicory.

In addition, the scientists cited hints from past research that agave fructans may have greater health benefits. Agave fructans, for instance, seem to stimulate production of greater amounts incretins than the inulin-type fructans from chicory. Incretins are a group of gastrointestinal hormones that increase in the amount of insulin released by the pancreas. That could be beneficial for individuals with diabetes or high blood sugar levels who are at risk of diabetes, López said. One incretin stimulated by agave fructans is a good satiety enhancer, which would make people feel full on less food.

“We still have a long way to go to determine for which health benefits agave fructans perform better than chicory fructans,” López said. “However, the early results are encouraging, and we working on it.”

For more information on the study, visit: www.acs.org.

Own The Bone Prevents Fragility Fractures

As many as half of all women and a quarter of men over the age of 50 can expect to sustain a fractured bone related to osteoporosis or low bone density. To enhance prevention and treatment of these fragility fractures, NewYork-Presbyterian Hospital/Columbia University Medical Center has implemented an innovative program called Own the Bone developed by the American Orthopaedic Association.

“Research has shown that patients who have had a fragility fracture are four times more likely to experience another fracture than those who have never had a fracture. The Own the Bone program will help us ensure that our patients with fragility fractures are screened and appropriately treated for osteoporosis,” said Dr. William Macaulay, chief of the Division of Adult Reconstruction and director of the Center for Hip and Knee Replacement at NewYork-Presbyterian Hospital/Columbia University Medical Center, and the Anne Youle Stein Professor of Clinical Orthopaedic Surgery at Columbia University College of Physicians and Surgeons.

Own the Bone is a national Web-based quality-improvement registry that features measures for reducing future fractures, including nutrition counseling and education, physical activity recommendations, lifestyle coaching, pharmacology and bone density testing.

The program provides physicians with immediate quantitative feedback to demonstrate how they are positively affecting patient care.

Fragility fractures, broken bones that result from a fall from standing height or less, are most commonly caused by osteoporosis.

The American Bone Health Prevalence Report stated that more people in the United States suffer a fragility fracture each year than are diagnosed with a heart attack, stroke or breast cancer combined, and is projected to significantly increase as the population ages.

According to the National Committee for Quality Assurance, only 1 in 5 Medicare patients have received the osteoporosis care they needed after a fracture.

For more information on the program, visit www.nyp.org.

Osteopathic Manipulative Treatment Improves Back Function in Late Pregnancy

As pregnancy progresses, tasks that involve the low back often get more difficult for women. It is harder to bend over, lift, sit or walk for long periods of time and back pain increases.

Treating back pain, and improving daily function relative to tasks that involve the low back is a challenge because pregnant women are limited to treatments that will not create problems for their developing baby, said the Osteopathic Research Center.

“Osteopathic manipulative treatment (OMT) is a viable option for improving function related to the low back and reducing back pain in the third trimester of pregnancy because its does not appear to have any negative side effects,” said John C. Licciardone, D.O., M.S., M.B.A., the lead author of a study on OMT in the third trimester of pregnancy that was recently published in the American Journal of Obstetrics and Gynecology.

Results from this study showed that osteopathic manipulative treatment slows or halts the deterioration of back-specific function in the third trimester of pregnancy.

Osteopathic manipulative treatment is a system of hands-on diagnosis and treatment that is used to reduce pain, restore range of motion and to restore normal function and balance in the body.

The Phase II randomized clinical trial of 144 subjects showed that women in the usual obstetric care+osteopathic manipulative treatment group reported less deterioration of back-specific function on the Roland-Morris Disability Scale than women in the usual obstetric care+sham ultrasound and the usual obstetric care only groups when these groups were compared using an intention-to-treat analysis. This study is the first randomized, placebo-controlled trial to explore the potential effects of osteopathic manipulative treatment during the third trimester of pregnancy.

In the study, conducted by The Osteopathic Research Center in conjunction with the Department of Obstetrics and Gynecology at the University of North Texas Health Science Center in Fort Worth, Texas, women were enrolled between the 28th and 30th week of pregnancy.

After being randomized to one of the three treatment groups, the women in the usual obstetric care+osteopathic manipulative treatment and usual obstetric care+sham ultrasound groups received treatments immediately following each of their third trimester prenatal visits. Women were excluded or dropped from the study if they were determined to be at high risk by their obstetrician. The median age for women included in the study was 24 years.

Licicardone noted that outcomes were statistically significant relative to improved low back function in the OMT group. “The results also showed a trend toward pain reduction in the group that received OMT, but pain remained the same or increased in the other groups.”

Usual obstetric care was defined in this study as the conventional prenatal care received during pregnancy. Osteopathic manipulative treatment is generally considered a complementary treatment that is not included as part of routine prenatal care.

“This study is exciting because pregnant women frequently experience a negative impact on their ability to function and perform tasks related to daily living as their pregnancy progresses,” said Licciardone, the principal investigator for the project, and the executive director of The Osteopathic Research Center. “Since pregnant women are limited in the medications they can take for pain, osteopathic manipulative treatment offers a way to improve back function and decrease pain in the third trimester of pregnancy, when a majority of women experience these symptoms.”

“What is also interesting about this study is that osteopathic physicians (D.O.s) who provide obstetrical care can potentially include osteopathic manipulative treatment as part of their prenatal care for patients,” Licciardone said. “For more than 100 years, osteopathic physicians who have treated pregnant women using osteopathic manipulation have claimed that their patients have less pain, better function and improved delivery outcomes. This study may be the first step in confirming the clinical success of osteopathic physicians in this area of medicine.”

Licciardone added, “If osteopathic obstetricians view this study as the first step in developing a strong evidence base to support the use of OMT to improve back function and pain in the third trimester of pregnancy, this study could have a significant clinical impact on prenatal care, and it could have important economic implications for treating common back-related symptoms and functional disabilities in late pregnancy.”

Full text of the article is available online at http://www.ajog.org/.

Clot-Busting Therapy After Stroke Essential For Women

New research shows women who don’t receive a clot-busting drug after a stroke fare worse than men who are not treated.

“Women need to be treated for stroke as soon as possible,” said study author Dr. Michael D. Hill, MSc, FRCPC, with the University of Calgary in Alberta, Canada. “We found that women who weren’t treated had a worse quality of life after stroke than men. However, the good news is that women who were treated responded just as well as men to the treatment.”

For the study, scientists examined information from a stroke database on 2,113 people who had experienced a stroke. Of those, 232 were treated with the clot-busting drug known as tissue plasminogen activator (tPA) and 44 percent were women.

Men and women were separately placed in groups based on whether they received tPA within three hours after their stroke. After six months, the people were interviewed by phone about their ability to function and quality of life.

The study found that women who did not receive the clot-busting drug were 12 percent less likely than men to have a good outcome six months later, or 58 percent of the women compared to 70 percent of men. However, women who were treated with these medications fared about the same as men who took the clot-buster drug.

“There could be many reasons why women who weren’t treated with the clot-busting drug fared worse than men, including biological reasons,” said Hill. “One social reason may be that more than 30 percent of women were widowed compared to seven percent of men at the time of stroke, and therefore did not have a spouse who could act as a caregiver. Also, post-stroke depression is more common in women than in men, which slows down recovery.”

The study is published in the March print issue of Neurology. The study was supported by the Canadian Stroke Network, one of Canada’s Networks of Centers of Excellence program, and the Ontario Ministry of Health and Long-Term Care.

For more information, visit the American Academy of Neurology at: www.aan.com.

Lasofoxifene Helps Reduce Risk of Bone Fractures, Breast Cancer And Other Postmenopausal Conditions

Low doses of the medication lasofoxifene can reduce the risk of vertebral and non-vertebral fractures, ER-positive breast cancer, coronary heart disease and stroke in postmenopausal women with osteoporosis, according to the findings of a new study in the latest issue of the New England Journal of Medicine.

Lasofoxifene is a non-steroidal selective estrogen receptor modulator (SERM) that has been shown to decrease bone loss and bone weakening, and reduce cholesterol levels, all common problems in postmenopausal women. However, its impact on other health issues for this population was not well understood.

“This is the first SERM that reduces the risk of all of these conditions at once,” says Steven Cummings, M.D., of the San Francisco Coordinating Center at the California Pacific Medical Center (CPMC) Research Institute, and the lead author of the study. “Not only did it reduce vertebral fractures, which was not unexpected, it also reduced the risk of non-vertebral fractures – injuries to the arms, legs, ribs, hips – that are the most common injuries to people with osteoporosis and the main causes of disability.”

The researchers followed 8,556 women, ages 59 to 80, over the course of 5 years. Two thirds of the women were given a daily dose of lasofoxifene (either 0.25mg or 0.5mg) and the other third were given a placebo.

The women were given lateral spine radiographs at 12, 24, 36, and 60 months to measure bone density and identify possible fractures. The women also underwent annual mammograms and clinical breast exams to detect breast cancer.

At the end of the five years patients who took lasofoxifene experienced fewer vertebral fractures than the placebo group – a 58 percent reduction in the patients taking 0.5mg a day and 31 percent in the lower dose group – and non-vertebral fractures (24 percent and 10 percent respectively). Those taking lasofoxifene also experienced increases in bone density compared to the placebo group.

Patients taking lasofoxifene experienced a reduction in their risk of estrogen receptor (ER) positive breast cancer (81 percent and 48 percent respectively), and a reduction in LDL (the so-called bad) cholesterol of around 16 percent.

The researchers say the results were not all positive. Patients taking lasofoxifene were at higher risk of experiencing a venous thromboembolic event or blood clot.

“We know that other SERMs, such as raloxifene, also increase a person’s risk of blood clots, so this finding was not a surprise to us,” says Dr. Cummings. “Even so, we have never found a treatment that has the array of beneficial effects as lasofoxifene with fewer serious side effects. With other treatments, such as Tamoxifen and estrogen, we have seen an increased risk for women of endometrial cancer but in lasofoxifene we did not see that at all.”

While the study results are promising the drug is unlikely to be available to women in the U.S. any time soon. The FDA recently rejected pharmaceutical company Pfizer’s request for approval, meaning that while it is approved and available in Europe, it is not available here in the U.S.

Dr. Cummings and several of the other researchers involved in this study received consulting grants from Pfizer, the manufacturer of lasofoxifene. However, to reduce questions about conflict of interest or bias an independent scientific advisory committee, consisting of investigators not employed by Pfizer, oversaw the study design and analysis, and wrote the paper and approved it for publication, said CPMC.

For more information, visit: www.cpmc.org.

Female Athletes More Susceptible To Injuries Compared To Counterparts

Female athletes experience dramatically higher rates of specific musculoskeletal injuries and medical conditions compared to male athletes, according to exercise physiologist Vicki Harber in the Faculty of Physical Education and Recreation at the University of Alberta.

According to her paper, depending on the sport, there can be a two- to sixfold difference in these types of injuries between male and female athletes. That’s because many training programs developed for female athletes are built on research using young adult males and don’t take the intrinsic biological differences between the sexes into account.

Harber has authored a comprehensive guide for coaches, parents and administrators, entitled The Female Athlete Perspective, and published by Canadian Sport for Life (CS4L), which addresses these and other medical issues known to influence women’s participation in sport.

The paper is based on a thorough review of the current literature on the subject, Harber’s extensive knowledge as a researcher in female athlete health and her work in the development of female athletes.

Musculoskeletal injuries, particularly knee and shoulder injuries, are most prevalent, with increased probability of re-injury, said Harber, noting that many of these injuries are preventable. Building awareness about appropriate support for young female athletes and changes to training programs are critical to help them reach their athletic and personal potential, injury-free.

Harber found the risk of the Female Athlete Triad — three separate but interrelated conditions of disordered eating, amenorrhea and osteoporosis — is another area that urgently needs attention for young female athletes.

For female athletes to thrive injury-free, attention must be paid to their proper nutrition to ensure both the athletic performance and healthy reproductive performance associated with bone health and overall wellbeing, Harber found.

For more information, visit: http://www.physedandrec.ualberta.ca/.