Introduction Bone mineral density (BMD) is a critical indicator of bone health, reflecting bone strength and mineral content. Physical activity is crucial for maintaining bone health, but not all types of physical activity have the same effect. Different sports activities impose various mechanical loads and stresses on bones, leading to differences in BMD among athletes. This study investigates variations in bone mineral density among elite male athletes engaged in various sports activities. Method This study was conducted following the Preferred Reporting Items for Systematic Reviews (PRISMA) Statement. A literature search was performed in multiple databases, including PubMed, Google Scholar, Scopus, and Web of Science, for studies published between 2000 and 2024. Keywords used were: "bone mineral density", "BMD", "elite athletes", "exercise" and "sports activities" Inclusion criteria were peer-reviewed articles that assessed BMD using dual-energy X-ray absorptiometry (DXA) in male athletes aged 18 to 40 years who have been practicing a specific sport daily for a minimum of 10 years. Studies were excluded if they included youth or non-elite athletes. Data extraction and quality assessment were performed independently by two reviewers, with disagreements resolved by consensus. Results The inclusion criteria were met by 23 studies, which included a total of 278 elite male athletes from various sports disciplines, including weightlifting, gymnastics, swimming, basketball, soccer, and cycling. The review found significant differences in BMD across sports, with weightlifters and gymnasts showing the highest BMD values, particularly at high-load and high-impact sites such as the lumbar spine and femoral neck. Basketball and soccer players showed moderate BMD values, while swimmers and cyclists had the lowest BMD values. Factors contributing to these variations included the type and intensity of mechanical loading, training duration, and sport-specific biomechanics. Conclusion The results of this systematic review highlight that the type of sport significantly influences BMD in elite male athletes. Strenuous and high-impact sports are associated with higher BMD, underscoring the importance of including such activities in training programs to improve bone health. Further research is needed to investigate the long-term effects of different training regimens and the potential benefits of cross-training to mitigate the risk of osteoporosis and bone-related injuries in athletes
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