by J.D. Davis

Good bones are a personal and professional passion for doctoral student and world-class cyclist Sally Warner.

Whether trying to discover new planets, locate rare animal species, or cure debilitating diseases, researchers are passionate about their areas of study. And when a researcher is studying a condition from which she herself suffers, her passion for knowledge becomes a personal matter.

Meet Sally Warner—doctoral candidate in the University of Utah's Department of Exercise and Sport Science, recipient of a research fellowship, Utah's top female cyclist, and a sufferer of osteopenia, a reduction in bone mass and the beginnings of osteoporosis.

Osteoporosis is a disease associated with loss of bone mass and, ultimately, the weakening of the skeleton. Once thought to be a disease of the elderly, researchers now understand that osteoporosis often begins developing in adolescent women. One-third of all women will eventually contract the disease; one-third of those will die within a year of breaking a bone.

What makes osteoporosis unique is the lack of pain as a symptom. A person may live with the disease for many years and not receive a positive diagnosis until it is too late to reverse bone loss.

Warner was diagnosed with osteopenia while working as an exercise technician at an osteoporosis clinic in Connecticut. "They offered a free bone scan to employees, so I was just taking advantage of the service. It was really a shock when they showed me pictures of my spine," says Warner.

As a young woman, Warner participated in many sports and believes she made the mistake that many young, active girls make today—not consuming enough calories and nutrients to support healthy and normal bone growth. Consequently, her spine development is abnormally low. "I was involved in a number of activities and sports, which meant my cardiovascular condition was great, but my spine didn't develop normally because my body—specifically, my bone structure—was not getting the nutrients needed to properly develop," she says.

According to Warner, the critical period for bone development in young women is their teenage years, up to age 18. By the time a woman reaches 30, her ability to build bone mass has probably peaked. Because bone is constantly developing, women between the ages of 30 and 50 must replace the lost mass with continued exercise and a proper diet fortified with plenty of calcium. After 50, bone loss can be rapid, leading to easily broken bones and difficult recovery.

Warner has spent the past eight years studying bone development and its effects on young women like her. As more women participate in team and individual sports during their teenage years, researching the effects of physical activity on bone development becomes increasingly critical.

A specific component of Warner's research focuses on the role of estrogen in healthy bone growth and maintenance. Estrogen receptors are found in bone and contribute to overall bone strength. Although more research is needed to confirm the benefits of estrogen replacement therapy, many believe estrogen is the answer for slowing bone loss in post-menopausal women.

Determined to study her disease and to help others, Warner earned a master's in biophysical science of sport at the University of Connecticut. While attending a professional conference, she met Janet Shaw, assistant professor of exercise and sport science, who urged Warner to visit Salt Lake to investigate the bone research at Shaw's home department.

Warner's story of arriving at the University of Utah from her hometown of Hartford, Connecticut, is similar to that of many others who suddenly find themselves living in Utah. "My first plan was to work on my Ph.D. in Texas or the Midwest because that's where many of the top programs are located. I soon discovered the U's program was conducting research tied into my interests, and when I realized almost any outdoor activity is available out your front door, I knew this was a good fit for me," says Warner.

Besides her research, Warner's other passion is competitive bike training and racing. Utah Cycle magazine voted her the top female mountain bike cyclist in Utah for 2001 and top all-around female rider for 2001, and she is nationally ranked in a number of mountain and road cycling categories. As a member of Team Biogen (sponsored by a pharmaceutical company that develops drugs to treat multiple sclerosis), Warner travels throughout the country competing in races to raise funds and awareness for multiple sclerosis and to support all athletes who compete with a disability. Each member of the team suffers from a physical disability, yet each still rides at the highest level of cycling competition.

If her osteopenia weren't enough to qualify her for membership on the cycling team, Warner also suffers from a heart arrhythmia that can cause her heart rate to skyrocket. Her heart rate has been recorded at 288 beats per minute (a normal maximum rate for an athlete of her caliber might be 180 to 200), so she must closely watch her training intensity.

Warner's cycling satisfies her desire to remain physically active, and it has also given her a platform from which to educate young female athletes about the importance of training and eating correctly to build proper bone mass. She continues to train and work with top female and male athletes. "I'm sure the girls I train and work with get tired of me staying on them about their training and eating habits," she says.

Participating in athletic activities without replacing essential vitamins and minerals lost during heavy exercise can lead to serious bone and health issues for young women. Warner worries that society has placed too much pressure on young girls to be thin, which results in an insufficient calcium intake for many because of their avoidance of the fat in dairy products.

"Prevention is definitely the key to proper bone growth. It is extremely important for parents to make sure their active daughters are getting enough calories and calcium for proper bone development," says Warner. "Coaches also have to be cognizant that there is a greater risk for young female athletes not creating enough early bone mass," she says.

In addition, Warner explains that activities involving a "jarring" process, such as gymnastics and running, are essential to bone development for young people because the action greatly assists the constant process of bone accepting nutrients. Many children get enough high-impact exercise because of their active lifestyles, but parents need to remain vigilant in getting their children outside, away from television and video games. "NASA is highly interested in studies that look at the inactivity in space resulting in a greater loss of bone mass," says Warner.

Warner will take her message and research to another area of the country next year as she heads to the University of Washington for a postdoctoral fellowship. But leaving isn't going to be easy. "I can't believe how hard it is to leave and how much I'm going to miss everything. People like Scott Miller BS'70 PhD'75 [professor of radiobiology] and Janet Shaw have made this a wonderful place to do research and play hard at the same time," says Warner. And, she adds with a smile, "I'm not going to tell too many people about Salt Lake because I may want to come back."

—J.D. Davis BS'86 is a frequent contributor to Continuum.

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