101
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Bado I, Gugala Z, Fuqua SAW, Zhang XHF. Estrogen receptors in breast and bone: from virtue of remodeling to vileness of metastasis. Oncogene 2017; 36:4527-4537. [PMID: 28368409 PMCID: PMC5552443 DOI: 10.1038/onc.2017.94] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 02/28/2017] [Accepted: 02/28/2017] [Indexed: 12/11/2022]
Abstract
Bone metastasis is a prominent cause of morbidity and mortality in cancer. High rates of bone colonization in breast cancer, especially in the subtype expressing estrogen receptors (ERs), suggest tissue-specific proclivities for metastatic tumor formation. The mechanisms behind this subtype-specific organ-tropism remains largely elusive. Interestingly, as the major driver of ER+ breast cancer, ERs also have important roles in bone development and homeostasis. Thus, any agents targeting ER will also inevitably affect the microenvironment, which involves the osteoblasts and osteoclasts. Yet, how such microenvironmental effects are integrated with direct therapeutic responses of cancer cells remain poorly understood. Recent findings on ER mutations, especially their enrichment in bone metastasis, raised even more provocative questions on the role of ER in cancer-bone interaction. In this review, we evaluate the importance of ERs in bone metastasis and discuss new avenues of investigation for bone metastasis treatment based on current knowledge.
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Affiliation(s)
- Igor Bado
- Lester and Sue Smith Breast Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030
- Dan L. Duncan Cancer Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030
- Department of Molecular and Cellular Biology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030
| | - Zbigniew Gugala
- Department of Orthopaedic Surgery and Rehabilitation, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555
| | - Suzanne A. W. Fuqua
- Lester and Sue Smith Breast Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030
- Dan L. Duncan Cancer Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030
| | - Xiang H.-F. Zhang
- Lester and Sue Smith Breast Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030
- Dan L. Duncan Cancer Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030
- Department of Molecular and Cellular Biology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030
- McNair Medical Institute, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030
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102
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Brown KA, Patel DR, Darmawan D. Participation in sports in relation to adolescent growth and development. Transl Pediatr 2017; 6:150-159. [PMID: 28795005 PMCID: PMC5532200 DOI: 10.21037/tp.2017.04.03] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Puberty is defined by physical growth, development of secondary sexual characteristics, and maturation of psychosocial skills. The initiation and rate of progression of pubertal events varies among adolescents, but pubertal changes occur in a predictable stepwise manner. Factors including individual differences in physical and psychosocial development, stage of development based on age (early, middle, and late), and the rate of pubertal development, may all contribute to the way in which adolescents experience sports activities. During adolescence, gender differences also become more apparent and may significantly impact sports participation. As practitioners evaluate overall development and adolescent readiness for sports participation, they should consider the different areas of development including: somatic, neurologic, cognitive, psychosocial-function in an integrated and interdependent approach.
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Affiliation(s)
- Kelly A Brown
- Western Michigan University, Homer Stryker MD School of Medicine, Kalamazoo, Michigan 49008, USA
| | - Dilip R Patel
- Western Michigan University, Homer Stryker MD School of Medicine, Kalamazoo, Michigan 49008, USA
| | - Daphne Darmawan
- Western Michigan University, Homer Stryker MD School of Medicine, Kalamazoo, Michigan 49008, USA
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103
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Gabel L, Macdonald HM, Nettlefold L, McKay HA. Physical Activity, Sedentary Time, and Bone Strength From Childhood to Early Adulthood: A Mixed Longitudinal HR-pQCT study. J Bone Miner Res 2017; 32:1525-1536. [PMID: 28326606 DOI: 10.1002/jbmr.3115] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 02/17/2017] [Accepted: 02/21/2017] [Indexed: 11/08/2022]
Abstract
Bone strength is influenced by bone geometry, density, and bone microarchitecture, which adapt to increased mechanical loads during growth. Physical activity (PA) is essential for optimal bone strength accrual; however, less is known about how sedentary time influences bone strength and its determinants. Thus, our aim was to investigate the prospective associations between PA, sedentary time, and bone strength and its determinants during adolescence. We used HR-pQCT at distal tibia (8% site) and radius (7% site) in 173 girls and 136 boys (aged 9 to 20 years at baseline). We conducted a maximum of four annual measurements at the tibia (n = 785 observations) and radius (n = 582 observations). We assessed moderate-to-vigorous PA (MVPA) and sedentary time with accelerometers (ActiGraph GT1M). We aligned participants on maturity (years from age at peak height velocity) and fit a mixed-effects model adjusting for maturity, sex, ethnicity, leg muscle power, lean mass, limb length, dietary calcium, and MVPA in sedentary time models. MVPA was a positive independent predictor of bone strength (failure load [F.Load]) and bone volume fraction (BV/TV) at the tibia and radius, total area (Tt.Ar) and cortical porosity (Ct.Po) at the tibia, and negative predictor of load-to-strength ratio at the radius. Sedentary time was a negative independent predictor of Tt.Ar at both sites and Ct.Po at the tibia and a positive predictor of cortical thickness (Ct.Th), trabecular thickness (Tb.Th), and cortical bone mineral density (Ct.BMD) at the tibia. Bone parameters demonstrated maturity-specific associations with MVPA and sedentary time, whereby associations were strongest during early and mid-puberty. Our findings support the importance of PA for bone strength accrual and its determinants across adolescent growth and provide new evidence of a detrimental association of sedentary time with bone geometry but positive associations with microarchitecture. This study highlights maturity-specific relationships of bone strength and its determinants with loading and unloading. Future studies should evaluate the dose-response relationship and whether associations persist into adulthood. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Leigh Gabel
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Heather M Macdonald
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - Lindsay Nettlefold
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Heather A McKay
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Department of Family Practice, University of British Columbia, Vancouver, Canada
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104
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Mikkola TM, von Bonsdorff MB, Osmond C, Salonen MK, Kajantie E, Eriksson JG. Association of Body Size at Birth and Childhood Growth With Hip Fractures in Older Age: An Exploratory Follow-Up of the Helsinki Birth Cohort Study. J Bone Miner Res 2017; 32:1194-1200. [PMID: 28181712 PMCID: PMC5462094 DOI: 10.1002/jbmr.3100] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 01/30/2017] [Accepted: 02/01/2017] [Indexed: 12/12/2022]
Abstract
Childhood growth has been linked with bone properties in adulthood, whereas less is known about the contribution of early growth to bone fracture risk. We investigated the association of body size at birth and childhood growth with hip fractures and pharmacotherapy for osteoporosis in older age. Men and women, born full term, from the Helsinki Birth Cohort Study (n = 8345) were followed until the age of 68 to 80 years. Height and weight from birth to 11 years were obtained from health care records and diagnoses of hip fractures and osteoporosis drug purchases from national registers. Independent associations of each age period were analyzed using Cox models adjusted for age, childhood and adulthood socioeconomic status, and drugs affecting bone metabolism. In men, the risk of hip fractures was nonlinearly associated with childhood growth. Compared to intermediate increase, low and high increase in height between 2 and 7 years (p < 0.001) were associated with all hip fractures and hip fractures sustained after the age of 50 years. Further, compared to intermediate gain, low and high gain in BMI between 7 and 11 years (p = 0.001) were associated with greater risk of hip fractures in men. In women, growth was not associated with the risk of hip fractures but greater weight (hazard ratio [HR] = 0.85; 95% CI, 0.77 to 0.94; p = 0.001) and BMI (HR 0.86; 95% CI, 0.78 to 0.95; p = 0.003) gain between ages 2 and 7 years were associated with a decreased risk of pharmacotherapy for osteoporosis. In men, growth was not associated with the risk of pharmacotherapy for osteoporosis. In conclusion, growth during childhood may contribute to the risk of hip fractures in later life among men. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Tuija M. Mikkola
- Folkhälsan Research Center, Helsinki, Finland
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Mikaela B. von Bonsdorff
- Folkhälsan Research Center, Helsinki, Finland
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Clive Osmond
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Minna K. Salonen
- Folkhälsan Research Center, Helsinki, Finland
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Eero Kajantie
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
- Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Obstetrics and Gynecology, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Johan G. Eriksson
- Folkhälsan Research Center, Helsinki, Finland
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
- Department of General Practice and Primary Health Care University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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105
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Harding AT, Beck BR. Exercise, Osteoporosis, and Bone Geometry. Sports (Basel) 2017; 5:E29. [PMID: 29910388 PMCID: PMC5968984 DOI: 10.3390/sports5020029] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 05/08/2017] [Accepted: 05/08/2017] [Indexed: 12/17/2022] Open
Abstract
Exercise is commonly recommended in the prevention and management of osteoporosis. The most common method to monitor bone mass and its response to interventions is bone densitometry. While closely associated with risk of fracture, densitometry-derived areal bone mineral density (aBMD) does not provide a reliable indication of bone geometry or morphological adaptation to stimuli. In fact, the effects of exercise interventions on aBMD are frequently modest, and may not fully represent the benefit of exercise to bone. Animal models suggest that mechanical loading indeed influences bone geometry and thus strength. Such an effect in humans has the potential to reduce osteoporotic fracture. The aim of the current narrative review is to provide an overview of what is known about the effects of exercise on bone geometry, with a focus on relevance to osteoporosis.
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Affiliation(s)
- Amy T Harding
- Menzies Health Institute Queensland, Griffith University, Gold Coast campus, Gold Coast 4222, Australia.
- School of Allied Health Sciences, Griffith University, Gold Coast campus, Gold Coast 4222, Australia.
| | - Belinda R Beck
- Menzies Health Institute Queensland, Griffith University, Gold Coast campus, Gold Coast 4222, Australia.
- School of Allied Health Sciences, Griffith University, Gold Coast campus, Gold Coast 4222, Australia.
- The Bone Clinic, Coorparoo, Brisbane 4151, Australia.
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106
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Zhang L, Chen X, Wu J, Yuan Y, Guo J, Biswas S, Li B, Zou J. The effects of different intensities of exercise and active vitamin D on mouse bone mass and bone strength. J Bone Miner Metab 2017; 35:265-277. [PMID: 27357401 DOI: 10.1007/s00774-016-0764-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 05/05/2016] [Indexed: 02/07/2023]
Abstract
Physical exercise is beneficial to bone health. However, little is known how different intensities of exercise affect bone mass and strength. In the present study, we used young mice to study the effects of different intensities of exercise on bone mass and bone strength in comparison to pharmacological doses of active vitamin D (calcitriol). We found that only the medium level of exercise tested showed a positive effect on bone mineral density, trabecular bone volume, and bone strength, which are attributable to a decrease in bone resorption and an increase in bone formation, with the latter being accompanied by an increase in the number of osteogenic mesenchymal stem cells in the bone marrow. Calcitriol increases bone volume and bone strength, yet the combination of calcitriol and medium-intensity exercise did not further improve bone mass or strength. Moreover, calcitriol also showed some protective effect on the bone in mice with high levels of exercise. These results indicate that exercise at medium intensity increases bone mass and strength via affecting both bone formation and resorption and that its beneficial effects on bone mass cannot be further improved by calcitriol.
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Affiliation(s)
- Lingli Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China
| | - Xi Chen
- School of Sports Science, Wenzhou Medical University, Wenzhou, 325035, China
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China
| | - Juanni Wu
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China
| | - Yu Yuan
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China
| | - Jianmin Guo
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China
| | - Soma Biswas
- Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Bio-X Institutes, Ministry of Education, Shanghai Jiao Tong University, Shanghai, 200240, China
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Baojie Li
- Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Bio-X Institutes, Ministry of Education, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Jun Zou
- Scientific Research Department, Shanghai University of Sport, 399 Changhai Road, Yangpu District, Shanghai, 200438, China.
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107
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Gomez-Bruton A, Montero-Marín J, González-Agüero A, Gómez-Cabello A, García-Campayo J, Moreno LA, Casajús JA, Vicente-Rodríguez G. Swimming and peak bone mineral density: A systematic review and meta-analysis. J Sports Sci 2017; 36:365-377. [PMID: 28394711 DOI: 10.1080/02640414.2017.1307440] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This meta-analysis aims to determine the effects of regular swimming on bone mineral density (BMD) in young adults (18-30 years). A systematic search was performed in Pubmed, SPORTDiscus and the Cochrane Library from the earliest possible year to March 2016. Swimmers were compared to non-athletic controls (CG) and to high-impact athletes (HIGH). Effect sizes with the Hedges g in random effects models were developed. Fourteen studies met the inclusion criteria and were included in the meta-analyses. Swimmers presented similar BMD values to CG in whole-body (g = -0.20; P = 0.251), femoral neck (g = -0.05; P = 0.818) and lumbar spine (g = 0.18; P = 0.492); and lower BMD in the whole-body (g = -1.21; P < 0.001), femoral neck (g = -1.51; P < 0.001) and lumbar spine (g = -0.84; P = 0.017) than the HIGH. For the whole-body differences, the higher the latitude the smaller the differences between swimmers and HIGH (B = 0.10; P = 0.001). For the femoral neck differences, age also seemed to reduce the differences between groups (B = 0.19; P = 0.020). Young adult swimmers present similar BMD values than CG and lower values than HIGH.
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Affiliation(s)
- Alejandro Gomez-Bruton
- a Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing , Universidad de Zaragoza , Huesca , Spain.,b GENUD (Growth, Exercise, Nutrition and Development) Research Group , Zaragoza , Spain.,c Centro de Investigación Biomédica en Red de Fisología de la Obesidad y Nutrición , Madrid , Spain
| | - Jesús Montero-Marín
- a Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing , Universidad de Zaragoza , Huesca , Spain.,d redIAPP Reseach Network , Zaragoza , Spain
| | - Alejandro González-Agüero
- a Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing , Universidad de Zaragoza , Huesca , Spain.,b GENUD (Growth, Exercise, Nutrition and Development) Research Group , Zaragoza , Spain.,c Centro de Investigación Biomédica en Red de Fisología de la Obesidad y Nutrición , Madrid , Spain
| | - Alba Gómez-Cabello
- b GENUD (Growth, Exercise, Nutrition and Development) Research Group , Zaragoza , Spain.,c Centro de Investigación Biomédica en Red de Fisología de la Obesidad y Nutrición , Madrid , Spain.,e Centro Universitario de la Defensa , Zaragoza , Spain
| | - Javier García-Campayo
- d redIAPP Reseach Network , Zaragoza , Spain.,f Miguel Servet University Hospital , Zaragoza , Spain
| | - Luis A Moreno
- b GENUD (Growth, Exercise, Nutrition and Development) Research Group , Zaragoza , Spain.,c Centro de Investigación Biomédica en Red de Fisología de la Obesidad y Nutrición , Madrid , Spain.,g Faculty of Health Science (FCS) , Universidad de Zaragoza , Zaragoza , Spain
| | - Jose A Casajús
- a Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing , Universidad de Zaragoza , Huesca , Spain.,b GENUD (Growth, Exercise, Nutrition and Development) Research Group , Zaragoza , Spain.,c Centro de Investigación Biomédica en Red de Fisología de la Obesidad y Nutrición , Madrid , Spain
| | - Germán Vicente-Rodríguez
- a Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing , Universidad de Zaragoza , Huesca , Spain.,b GENUD (Growth, Exercise, Nutrition and Development) Research Group , Zaragoza , Spain.,c Centro de Investigación Biomédica en Red de Fisología de la Obesidad y Nutrición , Madrid , Spain
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108
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Neumeyer AM, Cano Sokoloff N, McDonnell E, Macklin EA, McDougle CJ, Misra M. Bone microarchitecture in adolescent boys with autism spectrum disorder. Bone 2017; 97:139-146. [PMID: 28088646 PMCID: PMC6309443 DOI: 10.1016/j.bone.2017.01.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 01/07/2017] [Accepted: 01/10/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND Boys with autism spectrum disorder (ASD) have lower areal bone mineral density (aBMD) than typically developing controls (TDC). Studies of volumetric BMD (vBMD) and bone microarchitecture provide information about fracture risk beyond that provided by aBMD but are currently lacking in ASD. OBJECTIVES To assess ultradistal radius and distal tibia vBMD, bone microarchitecture and strength estimates in adolescent boys with ASD compared to TDC. DESIGN/METHODS Cross-sectional study of 34 boys (16 ASD, 18 TDC) that assessed (i) aBMD at the whole body (WB), WB less head (WBLH), hip and spine using dual X-ray absorptiometry (DXA), (ii) vBMD and bone microarchitecture at the ultradistal radius and distal tibia using high-resolution peripheral quantitative CT (HRpQCT), and (iii) bone strength estimates (stiffness and failure load) using micro-finite element analysis (FEA). We controlled for age in all groupwise comparisons of HRpQCT and FEA measures. Activity questionnaires, food records, physical exam, and fasting levels of 25(OH) vitamin D and bone markers (C-terminal collagen crosslinks and N-terminal telopeptide (CTX and NTX) for bone resorption, N-terminal propeptide of Type 1 procollagen (P1NP) for bone formation) were obtained. RESULTS ASD participants were slightly younger than TDC participants (13.6 vs. 14.2years, p=0.44). Tanner stage, height Z-scores and fasting serum bone marker levels did not differ between groups. ASD participants had higher BMI Z-scores, percent body fat, IGF-1 Z-scores, and lower lean mass and aBMD Z-scores than TDC at the WB, WBLH, and femoral neck (P<0.1). At the radius, ASD participants had lower trabecular thickness (0.063 vs. 0.070mm, p=0.004), compressive stiffness (56.7 vs. 69.7kN/mm, p=0.030) and failure load (3.0 vs. 3.7kN, p=0.031) than TDC. ASD participants also had 61% smaller cortical area (6.6 vs. 16.4mm2, p=0.051) and thickness (0.08 vs. 0.22mm, p=0.054) compared to TDC. At the tibia, ASD participants had lower compressive stiffness (183 vs. 210kN/mm, p=0.048) and failure load (9.4 vs. 10.8kN, p=0.043) and 23% smaller cortical area (60.3 vs. 81.5mm2, p=0.078) compared to TDC. A lower proportion of ASD participants were categorized as "very physically active" (20% vs. 72%, p=0.005). Differences in physical activity, calcium intake and IGF-1 responsiveness may contribute to group differences in stiffness and failure load. CONCLUSION Bone microarchitectural parameters are impaired in ASD, with reductions in bone strength estimates (stiffness and failure load) at the ultradistal radius and distal tibia. This may result from lower physical activity and calcium intake, and decreased IGF-1 responsiveness.
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Affiliation(s)
- Ann M Neumeyer
- Lurie Center for Autism, Massachusetts General Hospital, Lexington, MA 02421, United States; Harvard Medical School, Boston, MA 02115, United States.
| | - Natalia Cano Sokoloff
- Lurie Center for Autism, Massachusetts General Hospital, Lexington, MA 02421, United States
| | - Erin McDonnell
- Biostatistics Center, Massachusetts General Hospital, Boston, MA 02114, United States
| | - Eric A Macklin
- Harvard Medical School, Boston, MA 02115, United States; Biostatistics Center, Massachusetts General Hospital, Boston, MA 02114, United States
| | - Christopher J McDougle
- Lurie Center for Autism, Massachusetts General Hospital, Lexington, MA 02421, United States; Harvard Medical School, Boston, MA 02115, United States
| | - Madhusmita Misra
- Harvard Medical School, Boston, MA 02115, United States; Pediatric Endocrine and Neuroendocrine Units, Massachusetts General Hospital, Boston, MA 02114, United States
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109
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Langlois J, Omorou AY, Vuillemin A, Briançon S, Lecomte E. Association of socioeconomic, school-related and family factors and physical activity and sedentary behaviour among adolescents: multilevel analysis of the PRALIMAP trial inclusion data. BMC Public Health 2017; 17:175. [PMID: 28178972 PMCID: PMC5299678 DOI: 10.1186/s12889-017-4070-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 01/24/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Social differences among adolescents in physical activity and sedentary behaviour have been identified but are not well explained. The current study aimed to identify socioeconomic, family and school-related associated factors with physical activity and sedentary behaviour among high-school adolescents. METHODS This was a cross-sectional analysis of T0 physical activity and sedentary behaviour of 2523 students 14 - 18 years old recruited for the PRALIMAP trial from 24 French state-run high schools. Data were collected by self-administered questionnaire at the start of grade 10. Adolescents completed the International Physical Activity Questionnaire for physical activity and sedentary behaviour and an ad hoc questionnaire for active commuting and sport participation. Statistical analyses involved linear and logistic regressions. RESULTS Socioeconomic, family or school variables were associated with levels of physical activity and sedentary behaviour for both boys and girls, but no factor, except perceived parental physical activity level, was associated with total energy expenditure (total physical activity) for either gender. Adolescents with privileged and less privileged socioeconomic status reported the same total amount of energy expenditure. CONCLUSIONS Total physical activity score alone is not sufficient to assess the physical activity of adolescents. These findings may have implications for better understanding of social inequalities in this context and recommendations to prevent overweight. TRIAL REGISTRATION This trial is registered at ClinicalTrials.gov ( NCT00814554 ). The date of registration: 23 December 2008. Registration was not required at the time of the start of PRALIMAP for public health and prevention programmes and trials.
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Affiliation(s)
- Johanne Langlois
- University of Lorraine, EA 4360 APEMAC, Nancy, 54000, France. .,National Conservatory of Arts and Crafts (CNAM), 4 rue du Docteur Heydenreich, Nancy, 54000, France.
| | - Abdou Y Omorou
- University of Lorraine, EA 4360 APEMAC, Nancy, 54000, France.,CIC-EC 1433, CHRU Nancy, Clinical Epidemiology and Evaluation, Nancy, 54000, France
| | - Anne Vuillemin
- University of Lorraine, EA 4360 APEMAC, Nancy, 54000, France
| | - Serge Briançon
- University of Lorraine, EA 4360 APEMAC, Nancy, 54000, France
| | - Edith Lecomte
- National Conservatory of Arts and Crafts (CNAM), 4 rue du Docteur Heydenreich, Nancy, 54000, France
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110
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Bone Accrual in Males with Autism Spectrum Disorder. J Pediatr 2017; 181:195-201.e6. [PMID: 27887681 PMCID: PMC5274559 DOI: 10.1016/j.jpeds.2016.10.080] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 09/20/2016] [Accepted: 10/26/2016] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To test the hypothesis that bone accrual over a 4-year period is reduced in boys with autism spectrum disorder (ASD) compared with typically developing controls. STUDY DESIGN Twenty-five boys with ASD and 24 controls were assessed for bone outcomes. Fourteen boys with ASD and 11 controls were assessed both at baseline and after 4 years. The mean subject age was 11.0 ± 1.6 years at study initiation and 14.9 ± 1.6 years at follow-up. Bone mineral density (BMD) was measured at the spine, hip, and whole body using dual-energy X-ray absorptiometry and normalized for age, race, and sex (BMD z-scores). Height adjustments were performed as well. We assessed medical history, physical activity using questionnaires, vitamin D and calcium intake using food records, and serum calcium, phosphorus, 25(OH)-vitamin D, and pubertal hormone levels. RESULTS Boys with ASD had lower spine, hip, and whole body BMD z-scores compared with controls. In those subjects assessed both at baseline and after 4 years, bone accrual rates did not differ between the 2 groups; however, spine and hip BMD z-scores remained lower in the boys with ASD than in controls at follow-up. Notably, the ASD group was less physically active at both time points. CONCLUSION Although pubertal bone accrual was similar to that in controls, BMD in children with ASD remained low over a 4-year follow-up period, suggesting that low BMD is a consequence of prepubertal factors, such as low physical activity. Studies are needed to investigate the causes and consequences of decreased BMD, to assess BMD in females and adults with ASD, and to evaluate therapeutic interventions.
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111
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Fuchs RK, Kersh ME, Carballido-Gamio J, Thompson WR, Keyak JH, Warden SJ. Physical Activity for Strengthening Fracture Prone Regions of the Proximal Femur. Curr Osteoporos Rep 2017; 15:43-52. [PMID: 28133707 PMCID: PMC5317179 DOI: 10.1007/s11914-017-0343-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE OF REVIEW Physical activity improves proximal femoral bone health; however, it remains unclear whether changes translate into a reduction in fracture risk. To enhance any fracture-protective effects of physical activity, fracture prone regions within the proximal femur need to be targeted. RECENT FINDINGS The proximal femur is designed to withstand forces in the weight-bearing direction, but less so forces associated with falls in a sideways direction. Sideways falls heighten femoral neck fracture risk by loading the relatively weak superolateral region of femoral neck. Recent studies exploring regional adaptation of the femoral neck to physical activity have identified heterogeneous adaptation, with adaptation principally occurring within inferomedial weight-bearing regions and little to no adaptation occurring in the superolateral femoral neck. There is a need to develop novel physical activities that better target and strengthen the superolateral femoral neck within the proximal femur. Design of these activities may be guided by subject-specific musculoskeletal modeling and finite-element modeling approaches.
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Affiliation(s)
- Robyn K Fuchs
- Department of Physical Therapy and Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, 1140 W. Michigan St, Indianapolis, IN, CF-120, USA
| | - Mariana E Kersh
- Department of Mechanical Science and Engineering, College of Engineering, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, USA
| | - Julio Carballido-Gamio
- Department of Radiology, School of Medicine, University of Colorado Denver, Denver, CO, USA
| | - William R Thompson
- Department of Physical Therapy and Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, 1140 W. Michigan St, Indianapolis, IN, CF-120, USA
| | - Joyce H Keyak
- Departments of Radiological Sciences, Mechanical and Aerospace Engineering, and Biomedical Engineering, University of California, Irvine, CA, USA
| | - Stuart J Warden
- Department of Physical Therapy and Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, 1140 W. Michigan St, Indianapolis, IN, CF-120, USA.
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Martin SPK, Bachrach LK, Golden NH. Controlled Pilot Study of High-Impact Low-Frequency Exercise on Bone Loss and Vital-Sign Stabilization in Adolescents With Eating Disorders. J Adolesc Health 2017; 60:33-37. [PMID: 27836532 DOI: 10.1016/j.jadohealth.2016.08.028] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 08/13/2016] [Accepted: 08/15/2016] [Indexed: 11/24/2022]
Abstract
PURPOSE Adolescents with anorexia nervosa (AN) face an increased lifetime risk of bone fragility. This randomized controlled study examined the efficacy and safety of a high-impact activity program on markers of bone turnover and stabilization of vital signs (VSS). METHODS Forty-one hospitalized adolescents with AN were randomly assigned to routine care or routine care plus 20 jumps twice daily. Bone markers were measured at baseline days 1-3 (T1), days 4-6 (T2), and days 7-9 (T3). The primary outcome was change in bone-specific alkaline phosphatase (BSAP) at T3 adjusted for BSAP and % median body mass index at T1. Secondary outcomes were serum N-telopeptide (NTX) and osteocalcin at T3. Safety was determined by comparing weight gain, time to VSS and length of stay for each group. RESULTS BSAP, NTX, or osteocalcin did not differ between groups at baseline or at T3. BSAP and NTX at T3 were not associated with group of enrollment or % median body mass index. VSS was significantly reduced in the intervention group compared with the control group (11.6 ± 5.7 days vs. 17 ± 10.5 days, p = .049). There was no significant difference in weight gain or length of stay between groups. CONCLUSIONS Twice-daily jumping activity failed to influence markers of bone turnover in adolescents with AN but was well tolerated, shortened time to vital-sign stabilization and did not slow weight gain.
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Affiliation(s)
- Susanne P K Martin
- Division of Adolescent Medicine, Stanford University School of Medicine, Palo Alto, California.
| | - Laura K Bachrach
- Division of Pediatric Endocrinology, Stanford University School of Medicine, Palo Alto, California
| | - Neville H Golden
- Division of Adolescent Medicine, Stanford University School of Medicine, Palo Alto, California
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113
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Wippert PM, Rector M, Kuhn G, Wuertz-Kozak K. Stress and Alterations in Bones: An Interdisciplinary Perspective. Front Endocrinol (Lausanne) 2017; 8:96. [PMID: 28507534 PMCID: PMC5410657 DOI: 10.3389/fendo.2017.00096] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 04/18/2017] [Indexed: 11/29/2022] Open
Abstract
Decades of research have demonstrated that physical stress (PS) stimulates bone remodeling and affects bone structure and function through complex mechanotransduction mechanisms. Recent research has laid ground to the hypothesis that mental stress (MS) also influences bone biology, eventually leading to osteoporosis and increased bone fracture risk. These effects are likely exerted by modulation of hypothalamic-pituitary-adrenal axis activity, resulting in an altered release of growth hormones, glucocorticoids and cytokines, as demonstrated in human and animal studies. Furthermore, molecular cross talk between mental and PS is thought to exist, with either synergistic or preventative effects on bone disease progression depending on the characteristics of the applied stressor. This mini review will explain the emerging concept of MS as an important player in bone adaptation and its potential cross talk with PS by summarizing the current state of knowledge, highlighting newly evolving notions (such as intergenerational transmission of stress and its epigenetic modifications affecting bone) and proposing new research directions.
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Affiliation(s)
- Pia-Maria Wippert
- Department of Health Sciences, Institute of Sociology of Health and Physical Activity, University of Potsdam, Potsdam, Germany
- Department of Health Sciences and Technology, Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
- *Correspondence: Pia-Maria Wippert,
| | - Michael Rector
- Department of Health Sciences, Institute of Sociology of Health and Physical Activity, University of Potsdam, Potsdam, Germany
| | - Gisela Kuhn
- Department of Health Sciences and Technology, Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Karin Wuertz-Kozak
- Department of Health Sciences, Institute of Sociology of Health and Physical Activity, University of Potsdam, Potsdam, Germany
- Department of Health Sciences and Technology, Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
- Schön Klinik München Harlaching, Munich, Germany
- Spine Center, Academic Teaching Hospital and Spine Research Institute, Paracelsus Private Medical University Salzburg, Salzburg, Austria
- Competence Center for Applied Biotechnology and Molecular Medicine (CABMM), University of Zurich, Zurich, Switzerland
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114
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Sacheck JM. Vigorous Physical Activity in Youth: Just One End of the Physical Activity Spectrum for Affecting Health? Am J Lifestyle Med 2016; 11:116-118. [PMID: 30202320 DOI: 10.1177/1559827616680565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This article provides commentary on the accompanying manuscript entitled "The Case for Vigorous Physical Activity in Youth" by Owens and colleagues. A major strength of the review was its aim to determine whether vigorous physical activity provides greater benefits with respect to several health outcomes among children and youth while also considering the limitations of the current evidence in terms of number of studies and study design. This commentary presents additional topics to consider, practical applications, and conclusions and recommendations that can be drawn from the current evidence. To expand "the case for vigorous physical activity in youth," future studies should consider delineating the relative benefits of vigorous physical activity compared not only with moderate physical activity, but also with light and total activity.
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Affiliation(s)
- Jennifer M Sacheck
- Program in Nutrition Interventions, Communication, and Behavior Change, Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
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115
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Jallai T, Maasalu K, Kums T, Ereline J, Gapeyeva H, Pääsuke M. Comparison of bone mineral density in adolescent male soccer and basketball players. SPORT SCIENCES FOR HEALTH 2016. [DOI: 10.1007/s11332-016-0334-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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116
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Race DL, Sims-Gould J, Tucker LB, Duffy CM, Feldman DE, Gibbon M, Houghton KM, Stinson JN, Stringer E, Tse SM, McKay HA. 'It might hurt, but you have to push through the pain': Perspectives on physical activity from children with juvenile idiopathic arthritis and their parents. J Child Health Care 2016; 20:428-436. [PMID: 26907570 DOI: 10.1177/1367493516632616] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Our primary objective was to gather perspectives of children diagnosed with juvenile idiopathic arthritis (JIA) and their parents as they relate to physical activity (PA) participation. To do so, we conducted a study on 23 children diagnosed with JIA and their parents ( N = 29). We used convenience sampling to recruit participants and qualitative method- logies (one-on-one semi-structured interviews). We adopted a five-step framework analysis to categorize data into themes. Children and their parents described factors that act to facilitate or hinder PA participation. Pain was the most commonly highlighted PA barrier described by children and their parents. However, children who were newly diagnosed with JIA and their parents were more likely to highlight pain as a barrier than were child/parent dyads where children had been previously diagnosed.
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Affiliation(s)
| | | | - Lori B Tucker
- 2 British Columbia Children's Hospital, Vancouver, Canada
| | - Ciaran M Duffy
- 3 University of Ottawa, Ottawa, Canada
- 4 Children's Hospital of Eastern Ontario, Ottawa, Canada
| | | | - Michele Gibbon
- 4 Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - Kristin M Houghton
- 1 University of British Columbia, Vancouver, Canada
- 2 British Columbia Children's Hospital, Vancouver, Canada
| | - Jennifer N Stinson
- 6 The Hospital for Sick Children, Toronto, Canada
- 7 University of Toronto, Toronto, Canada
| | | | - Shirley Ml Tse
- 6 The Hospital for Sick Children, Toronto, Canada
- 7 University of Toronto, Toronto, Canada
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Mantovani AM, Lima MCS, Agostinete RR, Ito IH, Codogno JS, Lynch KR, Fernandes RA. Sports Practice and Bone Mass in Prepubertal Adolescents and Young Adults: A Cross-sectional Analysis. MOTRIZ: REVISTA DE EDUCACAO FISICA 2016. [DOI: 10.1590/s1980-6574201600040018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Alessandra Madia Mantovani
- Laboratory of InVestigation in Exercise – LIVE; Universidade Estadual Paulista Júlio de Mesquita Filho, Brasil
| | | | - Ricardo Ribeiro Agostinete
- Laboratory of InVestigation in Exercise – LIVE; Universidade Estadual Paulista Júlio de Mesquita Filho, Brasil
| | - Igor Hideki Ito
- Laboratory of InVestigation in Exercise – LIVE; Universidade Estadual Paulista Júlio de Mesquita Filho, Brasil
| | - Jamile Sanches Codogno
- Laboratory of InVestigation in Exercise – LIVE; Universidade Estadual Paulista Júlio de Mesquita Filho, Brasil
| | - Kyle Robinson Lynch
- Laboratory of InVestigation in Exercise – LIVE; Universidade Estadual Paulista Júlio de Mesquita Filho, Brasil
| | - Rômulo Araújo Fernandes
- Laboratory of InVestigation in Exercise – LIVE; Universidade Estadual Paulista Júlio de Mesquita Filho, Brasil; Universidade Estadual Paulista Júlio de Mesquita Filho, Brasil
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118
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Meiring RM, Micklesfield LK, McVeigh JA. The effect of loading and ethnicity on annual changes in cortical bone of the radius and tibia in pre-pubertal children. Ann Hum Biol 2016; 43:520-526. [PMID: 26452753 DOI: 10.3109/03014460.2015.1106009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND It is unclear what effect habitual physical activity or ethnicity has on annual changes in bone size and strength in pre-pubertal children. AIM To determine whether the annual relative change in bone size and strength differed between high and low bone loaders and also between black and white pre-pubertal children. SUBJECTS AND METHODS Peripheral quantitative computed tomography (pQCT) scans of the 65% radius and tibia were completed on 41 black and white children (15 boys, 26 girls) between the ages of 8-11 years, at baseline and 1 year later. Children were categorised into either a high or low bone loading group from a peak bone strain score obtained from a bone-specific physical activity questionnaire. Total area (ToA), cortical area (CoA), cortical density (CoD), strength-strain index (SSI), periosteal circumference (PC), endosteal circumference (EC) and cortical thickness (CT) were assessed. RESULTS There was no difference in annual relative change in radial or tibia bone size and strength between the low and high bone loaders. Black children had a greater annual relative change in CoD (p = 0.03) and SSI (p = 0.05) compared to the white children. CONCLUSION Children who performed high bone loading activities over a 1-year period had similar bone growth to children who did low bone loading activities over the same period. Rapid maturational growth over this period may have resulted in bone adapting to the strains of habitual physical activity placed on it. Black children may have greater tibial bone strength compared to white children due to a greater annual increase in cortical density.
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Affiliation(s)
- Rebecca M Meiring
- a Exercise Laboratory, School of Physiology, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa and
| | - Lisa K Micklesfield
- b MRC/WITS Developmental Pathways for Health Research Unit, Department of Pediatrics, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa
| | - Joanne A McVeigh
- a Exercise Laboratory, School of Physiology, Faculty of Health Sciences , University of the Witwatersrand , Johannesburg , South Africa and
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Fritz J, Duckham RL, Rantalainen T, Rosengren BE, Karlsson MK, Daly RM. Influence of a School-based Physical Activity Intervention on Cortical Bone Mass Distribution: A 7-year Intervention Study. Calcif Tissue Int 2016; 99:443-453. [PMID: 27406102 PMCID: PMC5055572 DOI: 10.1007/s00223-016-0174-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Accepted: 07/04/2016] [Indexed: 11/02/2022]
Abstract
Cortical bone mass and density varies across a bones length and cross section, and may be influenced by physical activity. This study evaluated the long-term effects of a pediatric school-based physical activity intervention on tibial cortical bone mass distribution. A total of 170 children (72 girls and 98 boys) from one school were provided with 200 min of physical education per week. Three other schools (44 girls and 47 boys) continued with the standard 60 min per week. Tibial total and cortical area, cortical density, polar stress-strain index (SSI), and the mass and density distribution around the center of mass (polar distribution, mg) and through the bones cortex (radial distribution subdivided into endo-, mid-, and pericortical volumetric BMD: mg/cm3) at three sites (14, 38, and 66 %) were assessed using peripheral quantitative computed tomography after 7 years. Girls in the intervention group had 2.5 % greater cortical thickness and 6.9 % greater SSI at the 66 % tibia, which was accompanied by significantly greater pericortical volumetric BMD compared to controls (all P < 0.05). Region-specific differences in cortical mass were also detected in the anterior, medial, and lateral sectors at the 38 and 66 % tibial sites. There were no group differences at the 14 % tibia site in girls, and no group differences in any of the bone parameters in boys. Additional school-based physical education over seven years was associated with greater tibial structure, strength, and region-specific adaptations in cortical bone mass and density distribution in girls, but not in boys.
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Affiliation(s)
- Jesper Fritz
- Clinical and Molecular Osteoporosis Research Unit, Department of Orthopedics, Institution of Clinical Research, Lund University, Skåne University Hospital, 205 02, Malmö, Sweden.
| | - Rachel L Duckham
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Timo Rantalainen
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Björn E Rosengren
- Clinical and Molecular Osteoporosis Research Unit, Department of Orthopedics, Institution of Clinical Research, Lund University, Skåne University Hospital, 205 02, Malmö, Sweden
| | - Magnus K Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Orthopedics, Institution of Clinical Research, Lund University, Skåne University Hospital, 205 02, Malmö, Sweden
| | - Robin M Daly
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
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120
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Vitamin D and Calcium Intakes, Physical Activity, and Calcaneus BMC among School-Going 13-Year Old Malaysian Adolescents. Nutrients 2016; 8:nu8100666. [PMID: 27783041 PMCID: PMC5084052 DOI: 10.3390/nu8100666] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 10/06/2016] [Accepted: 10/17/2016] [Indexed: 11/30/2022] Open
Abstract
Background: Dietary calcium and vitamin D are essential for bone development. Apart from diet, physical activity may potentially improve and sustain bone health. Objective: To investigate the relationship between the dietary intake of calcium and vitamin D, physical activity, and bone mineral content (BMC) in 13-year-old Malaysian adolescents. Design: Cross-sectional. Setting: Selected public secondary schools from the central and northern regions of Peninsular Malaysia. Participants: The subjects were from the Malaysian Health and Adolescents Longitudinal Research Team Cohort study (MyHeARTs). Methods: The data included seven-day diet histories, anthropometric measurements, and the BMC of calcaneal bone using a portable broadband ultrasound bone densitometer. Nutritionist Pro software was used to calculate the dietary calcium and vitamin D intakes from the diet histories, based on the Nutrient Composition of Malaysian Food Database guidance for the dietary calcium intake and the Singapore Energy and Nutrient Composition of Food Database for vitamin D intake. Results: A total of 289 adolescents (65.7% females) were recruited. The average dietary intakes of calcium and vitamin D were 377 ± 12 mg/day and 2.51 ± 0.12 µg/day, respectively, with the majority of subjects failing to meet the Recommended Nutrient Intake (RNI) of Malaysia for dietary calcium and vitamin D. All the subjects had a normal Z-score for the BMC (−2.00 or higher) with a mean of 0.55 ± 0.01. From the statistical analysis of the factors contributing to BMC, it was found that for those subjects with a higher intake of vitamin D, a higher combination of the intake of vitamin D and calcium resulted in significantly higher BMC quartiles. The regression analysis showed that the BMC might have been influenced by the vitamin D intake. Conclusions: A combination of the intake of vitamin D and calcium is positively associated with the BMC.
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121
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Abstract
Concerns about bone health and potential fragility in children and adolescents have led to a high interest in bone densitometry. Pediatric patients with genetic and acquired chronic diseases, immobility, and inadequate nutrition may fail to achieve expected gains in bone size, mass, and strength, leaving them vulnerable to fracture. In older adults, bone densitometry has been shown to predict fracture risk and reflect response to therapy. The role of densitometry in the management of children at risk of bone fragility is less clear. This clinical report summarizes current knowledge about bone densitometry in the pediatric population, including indications for its use, interpretation of results, and risks and costs. The report emphasizes updated consensus statements generated at the 2013 Pediatric Position Development Conference of the International Society of Clinical Densitometry by an international panel of bone experts. Some of these recommendations are evidence-based, whereas others reflect expert opinion, because data are sparse on many topics. The statements from this and other expert panels provide general guidance to the pediatrician, but decisions about ordering and interpreting bone densitometry still require clinical judgment. The interpretation of bone densitometry results in children differs from that in older adults. The terms "osteopenia" and "osteoporosis" based on bone densitometry findings alone should not be used in younger patients; instead, bone mineral content or density that falls >2 SDs below expected is labeled "low for age." Pediatric osteoporosis is defined by the Pediatric Position Development Conference by using 1 of the following criteria: ≥1 vertebral fractures occurring in the absence of local disease or high-energy trauma (without or with densitometry measurements) or low bone density for age and a significant fracture history (defined as ≥2 long bone fractures before 10 years of age or ≥3 long bone fractures before 19 years of age). Ongoing research will help define the indications and best methods for assessing bone strength in children and the clinical factors that contribute to fracture risk. The Pediatric Endocrine Society affirms the educational value of this publication.
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122
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Laurent MR, Dubois V, Claessens F, Verschueren SMP, Vanderschueren D, Gielen E, Jardí F. Muscle-bone interactions: From experimental models to the clinic? A critical update. Mol Cell Endocrinol 2016; 432:14-36. [PMID: 26506009 DOI: 10.1016/j.mce.2015.10.017] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 10/13/2015] [Accepted: 10/20/2015] [Indexed: 02/06/2023]
Abstract
Bone is a biomechanical tissue shaped by forces from muscles and gravitation. Simultaneous bone and muscle decay and dysfunction (osteosarcopenia or sarco-osteoporosis) is seen in ageing, numerous clinical situations including after stroke or paralysis, in neuromuscular dystrophies, glucocorticoid excess, or in association with vitamin D, growth hormone/insulin like growth factor or sex steroid deficiency, as well as in spaceflight. Physical exercise may be beneficial in these situations, but further work is still needed to translate acceptable and effective biomechanical interventions like vibration therapy from animal models to humans. Novel antiresorptive and anabolic therapies are emerging for osteoporosis as well as drugs for sarcopenia, cancer cachexia or muscle wasting disorders, including antibodies against myostatin or activin receptor type IIA and IIB (e.g. bimagrumab). Ideally, increasing muscle mass would increase muscle strength and restore bone loss from disuse. However, the classical view that muscle is unidirectionally dominant over bone via mechanical loading is overly simplistic. Indeed, recent studies indicate a role for neuronal regulation of not only muscle but also bone metabolism, bone signaling pathways like receptor activator of nuclear factor kappa-B ligand (RANKL) implicated in muscle biology, myokines affecting bone and possible bone-to-muscle communication. Moreover, pharmacological strategies inducing isolated myocyte hypertrophy may not translate into increased muscle power because tendons, connective tissue, neurons and energy metabolism need to adapt as well. We aim here to critically review key musculoskeletal molecular pathways involved in mechanoregulation and their effect on the bone-muscle unit as a whole, as well as preclinical and emerging clinical evidence regarding the effects of sarcopenia therapies on osteoporosis and vice versa.
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Affiliation(s)
- Michaël R Laurent
- Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, KU Leuven, 3000 Leuven, Belgium; Laboratory of Molecular Endocrinology, Department of Cellular and Molecular Medicine, KU Leuven, 3000 Leuven, Belgium; Centre for Metabolic Bone Diseases, University Hospitals Leuven, 3000 Leuven, Belgium.
| | - Vanessa Dubois
- Laboratory of Molecular Endocrinology, Department of Cellular and Molecular Medicine, KU Leuven, 3000 Leuven, Belgium
| | - Frank Claessens
- Laboratory of Molecular Endocrinology, Department of Cellular and Molecular Medicine, KU Leuven, 3000 Leuven, Belgium
| | - Sabine M P Verschueren
- Research Group for Musculoskeletal Rehabilitation, Department of Rehabilitation Science, KU Leuven, 3000 Leuven, Belgium
| | - Dirk Vanderschueren
- Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, KU Leuven, 3000 Leuven, Belgium
| | - Evelien Gielen
- Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, KU Leuven, 3000 Leuven, Belgium; Centre for Metabolic Bone Diseases, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Ferran Jardí
- Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, KU Leuven, 3000 Leuven, Belgium
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123
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Owens S, Galloway R, Gutin B. The Case for Vigorous Physical Activity in Youth. Am J Lifestyle Med 2016; 11:96-115. [PMID: 30202319 DOI: 10.1177/1559827615594585] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 06/04/2015] [Accepted: 06/15/2015] [Indexed: 12/21/2022] Open
Abstract
Although it is widely recognized that regular physical activity is associated with a variety of health-related benefits in youths, the extent to which vigorous physical activity, as opposed to moderate or light physical activity, may be especially beneficial for youths is not completely understood. This review will examine the evidence for the efficacy of vigorous physical activity for promoting the well-being of youths as indicated by body composition, physical fitness, cardiometabolic biomarkers, and cognitive function. Potential caveats associated with the promotion of vigorous physical activity among youths will also be discussed, as will the inclusion of vigorous physical activity in current recommendations by national organizations for physical activity among youths.
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Affiliation(s)
- Scott Owens
- University of Mississippi, University, Mississippi (SO, RG).,Teachers College, Columbia University, New York (BG).,Medical College of Georgia, Augusta, Georgia (BG)
| | - Riley Galloway
- University of Mississippi, University, Mississippi (SO, RG).,Teachers College, Columbia University, New York (BG).,Medical College of Georgia, Augusta, Georgia (BG)
| | - Bernard Gutin
- University of Mississippi, University, Mississippi (SO, RG).,Teachers College, Columbia University, New York (BG).,Medical College of Georgia, Augusta, Georgia (BG)
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124
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Duckham RL, Rantalainen T, Ducher G, Hill B, Telford RD, Telford RM, Daly RM. Effects of Habitual Physical Activity and Fitness on Tibial Cortical Bone Mass, Structure and Mass Distribution in Pre-pubertal Boys and Girls: The Look Study. Calcif Tissue Int 2016; 99:56-65. [PMID: 26983726 DOI: 10.1007/s00223-016-0128-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 03/04/2016] [Indexed: 10/22/2022]
Abstract
Targeted weight-bearing activities during the pre-pubertal years can improve cortical bone mass, structure and distribution, but less is known about the influence of habitual physical activity (PA) and fitness. This study examined the effects of contrasting habitual PA and fitness levels on cortical bone density, geometry and mass distribution in pre-pubertal children. Boys (n = 241) and girls (n = 245) aged 7-9 years had a pQCT scan to measure tibial mid-shaft total, cortical and medullary area, cortical thickness, density, polar strength strain index (SSIpolar) and the mass/density distribution through the bone cortex (radial distribution divided into endo-, mid- and pericortical regions) and around the centre of mass (polar distribution). Four contrasting PA and fitness groups (inactive-unfit, inactive-fit, active-unfit, active-fit) were generated based on daily step counts (pedometer, 7-days) and fitness levels (20-m shuttle test and vertical jump) for boys and girls separately. Active-fit boys had 7.3-7.7 % greater cortical area and thickness compared to inactive-unfit boys (P < 0.05), which was largely due to a 6.4-7.8 % (P < 0.05) greater cortical mass in the posterior-lateral, medial and posterior-medial 66 % tibial regions. Cortical area was not significantly different across PA-fitness categories in girls, but active-fit girls had 6.1 % (P < 0.05) greater SSIpolar compared to inactive-fit girls, which was likely due to their 6.7 % (P < 0.05) greater total bone area. There was also a small region-specific cortical mass benefit in the posterior-medial 66 % tibia cortex in active-fit girls. Higher levels of habitual PA-fitness were associated with small regional-specific gains in 66 % tibial cortical bone mass in pre-pubertal children, particularly boys.
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Affiliation(s)
- Rachel L Duckham
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Melbourne, VIC, 3125, Australia.
| | - Timo Rantalainen
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Melbourne, VIC, 3125, Australia
| | - Gaele Ducher
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Melbourne, VIC, 3125, Australia
| | - Briony Hill
- School of Psychology, Deakin University, Melbourne, Australia
| | - Richard D Telford
- UC Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
- College of Medicine, Biology and Environment, Australian National University, Canberra, Australia
| | - Rohan M Telford
- UC Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
| | - Robin M Daly
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Melbourne, VIC, 3125, Australia
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125
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Abstract
This article reviews the manifestations and risk factors associated with osteoporosis in childhood, the definition of osteoporosis and recommendations for monitoring and prevention. As well, this article discusses when a child should be considered a candidate for osteoporosis therapy, which agents should be prescribed, duration of therapy and side effects. There has been significant progress in our understanding of risk factors and the natural history of osteoporosis in children over the past number of years. This knowledge has fostered the development of logical approaches to the diagnosis, monitoring, and optimal timing of osteoporosis intervention in this setting. Current management strategies are predicated upon monitoring at-risk children to identify and then treat earlier rather than later signs of osteoporosis in those with limited potential for spontaneous recovery. On the other hand, trials addressing the prevention of the first-ever fracture are still needed for children who have both a high likelihood of developing fractures and less potential for recovery. This review focuses on the evidence that shapes the current approach to diagnosis, monitoring, and treatment of osteoporosis in childhood, with emphasis on the key pediatric-specific biological principles that are pivotal to the overall approach and on the main questions with which clinicians struggle on a daily basis. The scope of this article is to review the manifestations of and risk factors for primary and secondary osteoporosis in children, to discuss the definition of pediatric osteoporosis, and to summarize recommendations for monitoring and prevention of bone fragility. As well, this article reviews when a child is a candidate for osteoporosis therapy, which agents and doses should be prescribed, the duration of therapy, how the response to therapy is adjudicated, and the short- and long-term side effects. With this information, the bone health clinician will be poised to diagnose osteoporosis in children and to identify when children need osteoporosis therapy and the clinical outcomes that gauge efficacy and safety of treatment.
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Affiliation(s)
- L M Ward
- Pediatric Bone Health Clinical and Research Programs, Children's Hospital of Eastern Ontario, Ottawa, ON, K1H 8L1, Canada.
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada.
| | - V N Konji
- Pediatric Bone Health Clinical and Research Programs, Children's Hospital of Eastern Ontario, Ottawa, ON, K1H 8L1, Canada
| | - J Ma
- Pediatric Bone Health Clinical and Research Programs, Children's Hospital of Eastern Ontario, Ottawa, ON, K1H 8L1, Canada
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada
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126
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Medina-Gomez C, Heppe DHM, Yin JL, Trajanoska K, Uitterlinden AG, Beck TJ, Jaddoe VWV, Rivadeneira F. Bone Mass and Strength in School-Age Children Exhibit Sexual Dimorphism Related to Differences in Lean Mass: The Generation R Study. J Bone Miner Res 2016; 31:1099-106. [PMID: 26599073 DOI: 10.1002/jbmr.2755] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 11/20/2015] [Accepted: 11/21/2015] [Indexed: 11/12/2022]
Abstract
Bone strength, a key determinant of fracture risk, has been shown to display clear sexual dimorphism after puberty. We sought to determine whether sex differences in bone mass and hip bone geometry as an index of strength exist in school-age prepubertal children and the degree to which the differences are independent of body size and lean mass. We studied 3514 children whose whole-body and hip scans were measured using the same densitometer (GE-Lunar iDXA) at a mean age of 6.2 years. Hip dual-energy X-ray absorptiometry (DXA) scans underwent hip structural analyses (HSA) with derivation of bone strength indices. Sex differences in these parameters were assessed by regression models adjusted for age, height, ethnicity, weight, and lean mass fraction (LMF). Whole-body bone mineral density (BMD) and bone mineral content (BMC) levels were 1.3% and 4.3% higher in girls after adjustment by LMF. Independent of LMF, boys had 1.5% shorter femurs, 1.9% and 2.2% narrower shaft and femoral neck with 1.6% to 3.4% thicker cortices than girls. Consequent with this geometry configuration, girls observed 6.6% higher stresses in the medial femoral neck than boys. When considering LMF, the sexual differences on the derived bone strength indices were attenuated, suggesting that differences in muscle loads may reflect an innate disadvantage in bone strength in girls, as consequence of their lower muscular acquisition. In summary, we show that bone sexual dimorphism is already present at 6 years of age, with boys having stronger bones than girls, the relation of which is influenced by body composition and likely attributable to differential adaptation to mechanical loading. Our results support the view that early life interventions (ie, increased physical activity) targeted during the pre- and peripubertal stages may be of high importance, particularly in girls, because before puberty onset, muscle mass is strongly associated with bone density and geometry in children. © 2015 American Society for Bone and Mineral Research.
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Affiliation(s)
- Carolina Medina-Gomez
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Denise H M Heppe
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jia-Lian Yin
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Katerina Trajanoska
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Thomas J Beck
- Beck Radiological Innovations Inc., Baltimore, MD, USA.,Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
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127
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Psychosomatic problems in relation to alcohol use and physical exercise: a study between 1988 and 2011 among adolescents in Sweden. J Public Health (Oxf) 2016. [DOI: 10.1007/s10389-016-0729-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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128
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Weaver CM, Gordon CM, Janz KF, Kalkwarf HJ, Lappe JM, Lewis R, O'Karma M, Wallace TC, Zemel BS. The National Osteoporosis Foundation's position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations. Osteoporos Int 2016; 27:1281-1386. [PMID: 26856587 PMCID: PMC4791473 DOI: 10.1007/s00198-015-3440-3] [Citation(s) in RCA: 722] [Impact Index Per Article: 90.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 11/10/2015] [Indexed: 12/21/2022]
Abstract
Lifestyle choices influence 20-40 % of adult peak bone mass. Therefore, optimization of lifestyle factors known to influence peak bone mass and strength is an important strategy aimed at reducing risk of osteoporosis or low bone mass later in life. The National Osteoporosis Foundation has issued this scientific statement to provide evidence-based guidance and a national implementation strategy for the purpose of helping individuals achieve maximal peak bone mass early in life. In this scientific statement, we (1) report the results of an evidence-based review of the literature since 2000 on factors that influence achieving the full genetic potential for skeletal mass; (2) recommend lifestyle choices that promote maximal bone health throughout the lifespan; (3) outline a research agenda to address current gaps; and (4) identify implementation strategies. We conducted a systematic review of the role of individual nutrients, food patterns, special issues, contraceptives, and physical activity on bone mass and strength development in youth. An evidence grading system was applied to describe the strength of available evidence on these individual modifiable lifestyle factors that may (or may not) influence the development of peak bone mass (Table 1). A summary of the grades for each of these factors is given below. We describe the underpinning biology of these relationships as well as other factors for which a systematic review approach was not possible. Articles published since 2000, all of which followed the report by Heaney et al. [1] published in that year, were considered for this scientific statement. This current review is a systematic update of the previous review conducted by the National Osteoporosis Foundation [1]. [Table: see text] Considering the evidence-based literature review, we recommend lifestyle choices that promote maximal bone health from childhood through young to late adolescence and outline a research agenda to address current gaps in knowledge. The best evidence (grade A) is available for positive effects of calcium intake and physical activity, especially during the late childhood and peripubertal years-a critical period for bone accretion. Good evidence is also available for a role of vitamin D and dairy consumption and a detriment of DMPA injections. However, more rigorous trial data on many other lifestyle choices are needed and this need is outlined in our research agenda. Implementation strategies for lifestyle modifications to promote development of peak bone mass and strength within one's genetic potential require a multisectored (i.e., family, schools, healthcare systems) approach.
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Affiliation(s)
- C M Weaver
- Department of Nutritional Sciences, Women's Global Health Institute, Purdue University, 700 W. State Street, West Lafayette, IN, 47907, USA
| | - C M Gordon
- Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital, 3333 Burnet Avenue, MLC 4000, Cincinnati, OH, 45229, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Ave, Cincinnati, OH, 45267, USA
| | - K F Janz
- Departments of Health and Human Physiology and Epidemiology, University of Iowa, 130 E FH, Iowa City, IA, 52242, USA
| | - H J Kalkwarf
- Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7035, Cincinnati, OH, 45229, USA
| | - J M Lappe
- Schools of Nursing and Medicine, Creighton University, 601 N. 30th Street, Omaha, NE, 68131, USA
| | - R Lewis
- Department of Foods and Nutrition, University of Georgia, Dawson Hall, Athens, GA, 30602, USA
| | - M O'Karma
- The Children's Hospital of Philadelphia Research Institute, 3535 Market Street, Room 1560, Philadelphia, PA, 19104, USA
| | - T C Wallace
- Department of Nutrition and Food Studies, George Mason University, MS 1 F8, 10340 Democracy Lane, Fairfax, VA, 22030, USA.
- National Osteoporosis Foundation, 1150 17th Street NW, Suite 850, Washington, DC, 20036, USA.
- National Osteoporosis Foundation, 251 18th Street South, Suite 630, Arlington, VA, 22202, USA.
| | - B S Zemel
- University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Room 1560, Philadelphia, PA, 19104, USA
- Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, 3535 Market Street, Room 1560, Philadelphia, PA, 19104, USA
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129
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Mosti MP, Flemmen G, Hoff J, Stunes AK, Syversen U, Wang E. Impaired skeletal health and neuromuscular function among amphetamine users in clinical treatment. Osteoporos Int 2016; 27:1003-1010. [PMID: 26501558 DOI: 10.1007/s00198-015-3371-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 10/11/2015] [Indexed: 11/25/2022]
Abstract
SUMMARY This study examined musculoskeletal health in amphetamine users, compared with healthy age-matched controls. We show that amphetamine users have reduced bone mass at several skeletal sites and attenuated maximal muscle strength and force development capacity in the lower extremities. INTRODUCTION Amphetamine use may cause poor bone quality and elevated risk of osteoporosis. The purpose of this study was to investigate whether amphetamine users exhibit reduced regional and whole body bone mineral density (BMD), altered bone metabolism, and how muscle function may relate to the patient groups' skeletal health. METHODS We assessed hip, lumbar spine and whole body BMD, and trabecular bone score (TBS) by dual x-ray absorptiometry (DXA), and bone metabolism markers in serum and maximal strength and force development capacity in 36 amphetamine users (25 men, 30 ± 7 years; 11 women 35 ± 10 years) and in 37 healthy controls (23 men, 31 ± 9 years; 14 women, 35 ± 7 years). RESULTS Whole body BMD was lower in amphetamine users (8% in males and 7% females, p < 0.01), as were BMD at the total hip and sub-regions of the hip (9-11% in men and 10-11 % in women, p < 0.05). Male users had 4% lower TBS (p < 0.05) and higher serum level of type 1 collagen amino-terminal propeptide (p < 0.01). This coincided with reduced lower extremity maximal strength of 30% (males, p < 0.001) and 25% (females, p < 0.05) and 27% slower muscular force development in males compared to controls (p < 0.01). CONCLUSIONS These findings demonstrate that amphetamine users suffer from a generalized reduction in bone mass, which was associated with attenuated maximal muscle strength and force development capacity in the lower extremities.
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Affiliation(s)
- M P Mosti
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
| | - G Flemmen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olav's University Hospital, Trondheim, Norway
| | - J Hoff
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Physical Medicine and Rehabilitation, St. Olav's University Hospital, Trondheim, Norway
| | - A K Stunes
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - U Syversen
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Endocrinology, St. Olav's University Hospital, Trondheim, Norway
| | - E Wang
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
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130
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Daly RM, Ducher G, Hill B, Telford RM, Eser P, Naughton G, Seibel MJ, Telford RD. Effects of a Specialist-Led, School Physical Education Program on Bone Mass, Structure, and Strength in Primary School Children: A 4-Year Cluster Randomized Controlled Trial. J Bone Miner Res 2016; 31:289-98. [PMID: 26260216 DOI: 10.1002/jbmr.2688] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 08/06/2015] [Accepted: 08/07/2015] [Indexed: 11/09/2022]
Abstract
This 4-year cluster randomized controlled trial of 365 boys and 362 girls (mean age 8.1 ± 0.3 years) from grade 2 in 29 primary schools investigated the effects of a specialist-taught physical education (PE) program on bone strength and body composition. All children received 150 min/week of common practice (CP) PE from general classroom teachers but in 13 schools 100 min/week of CP PE was replaced by specialized-led PE (SPE) by teachers who emphasized more vigorous exercise/games combined with static and dynamic postural activities involving muscle strength. Outcome measures assessed in grades 2, 4, and 6 included: total body bone mineral content (BMC), lean mass (LM), and fat mass (FM) by DXA, and radius and tibia (4% and 66% sites) bone structure, volumetric density and strength, and muscle cross-sectional area (CSA) by pQCT. After 4-years, gains in total body BMC, FM, and muscle CSA were similar between the groups in both sexes, but girls in the SPE group experienced a greater gain in total body LM (mean 1.0 kg; 95% CI, 0.2 to 1.9 kg). Compared to CP, girls in the SPE group also had greater gains in cortical area (CoA) and cortical thickness (CoTh) at the mid-tibia (CoA, 5.0% [95% CI, 0.2% to 1.9%]; CoTh, 7.5% [95% CI, 2.4% to 12.6%]) and mid-radius (CoA, 9.3% [95% CI, 3.5% to 15.1%]; CoTh, 14.4% [95% CI, 6.1% to 22.7%]), whereas SPE boys had a 5.2% (95% CI, 0.4% to 10.0%) greater gain in mid-tibia CoTh. These benefits were due to reduced endocortical expansion. There were no significant benefits of SPE on total bone area, cortical density or bone strength at the mid-shaft sites, nor any appreciable effects at the distal skeletal sites. This study indicates that a specialist-led school-based PE program improves cortical bone structure, due to reduced endocortical expansion. This finding challenges the notion that periosteal apposition is the predominant response of bone to loading during the prepubertal and early-pubertal period.
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Affiliation(s)
- Robin M Daly
- Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, Australia
| | - Gaele Ducher
- Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, Australia
| | - Briony Hill
- School of Psychology, Deakin University, Melbourne, Australia
| | - Rohan M Telford
- Centre for Research and Action in Public Health, Department of Health, University of Canberra, Canberra, Australia
| | - Prisca Eser
- Swiss Cardiovascular Centre Bern, University Hospital (Inselspital), Bern, Switzerland
| | - Geraldine Naughton
- School of Exercise Science, Australian Catholic University, Melbourne, Australia
| | - Markus J Seibel
- Bone Research Program, ANZAC Research Institute, The University of Sydney, Sydney, Australia
| | - Richard D Telford
- UC Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
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131
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Weatherholt AM, Warden SJ. Tibial Bone Strength is Enhanced in the Jump Leg of Collegiate-Level Jumping Athletes: A Within-Subject Controlled Cross-Sectional Study. Calcif Tissue Int 2016; 98:129-39. [PMID: 26543032 PMCID: PMC4724485 DOI: 10.1007/s00223-015-0078-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 10/28/2015] [Indexed: 12/01/2022]
Abstract
An efficient method of studying skeletal adaptation to mechanical loading is to assess side-to-side differences (i.e., asymmetry) within individuals who unilaterally exercise one side of the body. Within-subject controlled study designs have been used to explore skeletal mechanoadaptation at upper extremity sites; however, there is no established model in the lower extremities. The current study assessed tibial diaphysis and distal tibia asymmetry in collegiate-level jumping athletes (N = 12). To account for normal crossed asymmetry, data in jumping athletes were compared to asymmetry in a cohort of athletic controls not routinely exposed to elevated unilateral lower extremity loading (N = 11). Jumpers exhibited side-to-side differences between their jump and lead legs at both the tibial diaphysis and distal tibia, with differences at the former site persisting following comparison to dominant-to-nondominant leg differences in controls. In particular, jump-to-lead leg differences for cortical area and thickness at the tibial diaphysis in jumpers were 3.6% (95% CI 0.5-6.8%) and 3.5% (95% CI 0.4-6.6%) greater than dominant-to-nondominant differences in controls, respectively (all p < 0.05). Similarly, jump-to-lead leg differences in jumpers for tibial diaphysis maximum second moment of area and polar moment of inertia were 7.2% (95% CI 1.2-13.2%) and 5.7% (95% CI 1.7-9.8%) greater than dominant-to-nondominant differences in controls, respectively (all p < 0.05). Assessment of region-specific differences of the tibial diaphysis in jumpers indicated that the jump leg had greater pericortical radii on the medial and posterior sides and greater radial cortical thickness posteromedially when compared to the lead leg. These data suggest that athletes who perform repetitive and forceful unilateral jumping may be a useful and efficient within-subject controlled model for studying lower extremity skeletal mechanoadaptation.
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Affiliation(s)
- Alyssa M Weatherholt
- Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, 1140 W. Michigan Street, Indianapolis, IN, 46202, USA
| | - Stuart J Warden
- Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, 1140 W. Michigan Street, Indianapolis, IN, 46202, USA.
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, IN, 46202, USA.
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132
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Carson JA, Manolagas SC. Effects of sex steroids on bones and muscles: Similarities, parallels, and putative interactions in health and disease. Bone 2015; 80:67-78. [PMID: 26453497 PMCID: PMC4600533 DOI: 10.1016/j.bone.2015.04.015] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 03/23/2015] [Accepted: 04/07/2015] [Indexed: 12/31/2022]
Abstract
Estrogens and androgens influence the growth and maintenance of bones and muscles and are responsible for their sexual dimorphism. A decline in their circulating levels leads to loss of mass and functional integrity in both tissues. In the article, we highlight the similarities of the molecular and cellular mechanisms of action of sex steroids in the two tissues; the commonality of a critical role of mechanical forces on tissue mass and function; emerging evidence for an interplay between mechanical forces and hormonal and growth factor signals in both bones and muscles; as well as the current state of evidence for or against a cross-talk between muscles and bone. In addition, we review evidence for the parallels in the development of osteoporosis and sarcopenia with advancing age and the potential common mechanisms responsible for the age-dependent involution of these two tissues. Lastly, we discuss the striking difference in the availability of several drug therapies for the prevention and treatment of osteoporosis, as compared to none for sarcopenia. This article is part of a Special Issue entitled "Muscle Bone Interactions".
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Affiliation(s)
- James A Carson
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208 USA
| | - Stavros C Manolagas
- Division of Endocrinology and Metabolism, Center for Osteoporosis and Metabolic Bone Diseases, University of Arkansas for Medical Sciences and the Central Arkansas Veterans Healthcare System, Little Rock, AR, USA.
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133
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Janz KF, Letuchy EM, Burns TL, Francis SL, Levy SM. Muscle Power Predicts Adolescent Bone Strength: Iowa Bone Development Study. Med Sci Sports Exerc 2015; 47:2201-6. [PMID: 25751769 PMCID: PMC4549233 DOI: 10.1249/mss.0000000000000648] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE To assess association between lower body muscle power and bone strength as well as the mediating effect of muscle cross-sectional area (MCSA) on that association. METHODS Participants (141 males and 162 females) were approximately 17 yr. Muscle power was predicted using vertical jump and the Sayers equation. Using peripheral quantitative computed tomography (pQCT), bone strength indices were obtained at two locations of the tibia, corresponding to primary stressors acting upon each site: bone strength index for compression (BSI) at the distal 4% site; density-weighted polar section modulus strength-strain index (SSIp) and cortical bone area (CoA) at the 66% midshaft site for torsion. Muscle cross-sectional area was measured at the 66% site. Pearson bivariate and partial correlation coefficients were estimated to quantify the strength of the associations among variables. Direct and indirect mediation model effects were estimated, and 95% bootstrap confidence intervals were constructed to test the causal hypothesis. Height and maturity were examined as covariates. RESULTS Pearson correlation coefficients among muscle power, MCSA, and bone strength were statistically significant (P < 0.01) and ranged from r = 0.54 to r = 0.78. After adjustment for covariates, associations were reduced (r = 0.37 to 0.69) (P < 0.01). Mediation models for males for BSI, SSIp, and CoA accounted for 38%, 66%, and 54% of the variance in bone strength, respectively. Models for females for BSI, SSIp, and CoA accounted for 46%, 77%, and 66% of the variance, respectively. CONCLUSIONS We found strong and consistent associations as well as direct and indirect pathways, among muscle power, MCSA, and tibia strength. These results support the use of muscle power as a component of health-related fitness in bone health interventions for older adolescents.
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Affiliation(s)
- Kathleen F. Janz
- Department of Health and Human Physiology, College of Liberal Arts and Sciences, University of Iowa, Ames, IA
- Department of Epidemiology, College of Public Health, University of Iowa, Ames, IA
| | - Elena M. Letuchy
- Department of Epidemiology, College of Public Health, University of Iowa, Ames, IA
| | - Trudy L. Burns
- Department of Epidemiology, College of Public Health, University of Iowa, Ames, IA
| | - Shelby L. Francis
- Department of Health and Human Physiology, College of Liberal Arts and Sciences, University of Iowa, Ames, IA
| | - Steven M. Levy
- Department of Epidemiology, College of Public Health, University of Iowa, Ames, IA
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Ames, IA
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Herrmann D, Buck C, Sioen I, Kouride Y, Marild S, Molnár D, Mouratidou T, Pitsiladis Y, Russo P, Veidebaum T, Ahrens W. Impact of physical activity, sedentary behaviour and muscle strength on bone stiffness in 2-10-year-old children-cross-sectional results from the IDEFICS study. Int J Behav Nutr Phys Act 2015; 12:112. [PMID: 26377674 PMCID: PMC4574210 DOI: 10.1186/s12966-015-0273-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 08/29/2015] [Indexed: 11/17/2022] Open
Abstract
Background Physical activity (PA), weight-bearing exercises (WBE) and muscle strength contribute to skeletal development, while sedentary behaviour (SB) adversely affects bone health. Previous studies examined the isolated effect of PA, SB or muscle strength on bone health, which was usually assessed by x-ray methods, in children. Little is known about the combined effects of these factors on bone stiffness (SI) assessed by quantitative ultrasound. We investigated the joint association of PA, SB and muscle strength on SI in children. Methods In 1512 preschool (2- < 6 years) and 2953 school children (6–10 years), data on calcaneal SI as well as on accelerometer-based sedentary time (SED), light (LPA), moderate (MPA) and vigorous PA (VPA) were available. Parents reported sports (WBE versus no WBE), leisure time PA and screen time of their children. Jumping distance and handgrip strength served as indicators for muscle strength. The association of PA, SB and muscle strength with SI was estimated by multivariate linear regression, stratified by age group. Models were adjusted for age, sex, country, fat-free mass, daylight duration, consumption of dairy products and PA, or respectively SB. Results Mean SI was similar in preschool (79.5 ± 15.0) and school children (81.3 ± 12.1). In both age groups, an additional 10 min/day in MPA or VPA increased the SI on average by 1 or 2 %, respectively (p ≤ .05). The negative association of SED with SI decreased after controlling for MVPA. LPA was not associated with SI. Furthermore, participation in WBE led to a 3 and 2 % higher SI in preschool (p = 0.003) and school children (p < .001), respectively. Although muscle strength significantly contributed to SI, it did not affect the associations of PA with SI. In contrast to objectively assessed PA, reported leisure time PA and screen time showed no remarkable association with SI. Conclusion This study suggests that already an additional 10 min/day of MPA or VPA or the participation in WBE may result in a relevant increase in SI in children, taking muscle strength and SB into account. Our results support the importance of assessing accelerometer-based PA in large-scale studies. This may be important when deriving dose–response relationships between PA and bone health in children.
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Affiliation(s)
- Diana Herrmann
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359, Bremen, Germany.
| | - Christoph Buck
- Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359, Bremen, Germany.
| | - Isabelle Sioen
- Department of Public Health, Ghent University, 4K3, De Pintelaan 185, 9000, Ghent, Belgium.
| | - Yiannis Kouride
- Research and Education Institute of Child Health, 138 Limassol Ave, #205, 2015, Strovolos, Cyprus.
| | - Staffan Marild
- Department of Paediatrics, Queen Silvia Children's Hospital, University of Gothenburg, Rondvägen 15, 41685, Gothenburg, Sweden.
| | - Dénes Molnár
- Department of Pediatrics, Medical Faculty, University of Pecs, Jozsef A. u. 7, 7623, Pecs, Hungary.
| | - Theodora Mouratidou
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, C/Domingo Miral s/n, 50009, Zaragoza, Spain.
| | - Yannis Pitsiladis
- Centre for Sport and Exercise Science and Medicine (SESAME), University of Brighton, Welkin House, 30 Carlisle Road, Eastbourne, BN20 7SN, UK.
| | - Paola Russo
- Institute of Food Sciences, National Research Council, Via Roma 64, 83100, Avellino, Italy.
| | - Toomas Veidebaum
- Department of Chronic Diseases, Centre of Behavioural and Health Sciences, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia.
| | - Wolfgang Ahrens
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359, Bremen, Germany. .,Faculty of Mathematics and Computer Science, Bremen University, Bibliothekstraße 1, 28359, Bremen, Germany.
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135
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Herrmann D, Pohlabeln H, Gianfagna F, Konstabel K, Lissner L, Mårild S, Molnar D, Moreno LA, Siani A, Sioen I, Veidebaum T, Ahrens W. Association between bone stiffness and nutritional biomarkers combined with weight-bearing exercise, physical activity, and sedentary time in preadolescent children. A case-control study. Bone 2015; 78:142-9. [PMID: 25952968 DOI: 10.1016/j.bone.2015.04.043] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 04/18/2015] [Accepted: 04/27/2015] [Indexed: 11/24/2022]
Abstract
Physical activity (PA) and micronutrients such as calcium (Ca), vitamin D (25OHD), and phosphate (PO) are important determinants of skeletal development. This case-control study examined the association of these nutritional biomarkers and different PA behaviours, such as habitual PA, weight-bearing exercise (WBE) and sedentary time (SED) with bone stiffness (SI) in 1819 2-9-year-old children from the IDEFICS study (2007-2008). SI was measured on the calcaneus using quantitative ultrasound. Serum and urine Ca and PO and serum 25OHD were determined. Children's sports activities were reported by parents using a standardised questionnaire. A subsample of 1089 children had accelerometer-based PA data (counts per minute, cpm). Moderate-to-vigorous PA (MVPA) and SED were estimated. Children with poor SI (below the 15th age-/sex-/height-specific percentile) were defined as cases (N=603). Randomly selected controls (N=1216) were matched by age, sex, and country. Odds ratios (OR) for poor SI were calculated by conditional logistic regression for all biomarkers and PA behaviour variables separately and combined (expressed as tertiles and dichotomised variables, respectively). ORs were adjusted for fat-free mass, dairy product consumption, and daylight duration. We observed increased ORs for no sports (OR=1.39, p<0.05), PA levels below 524 cpm (OR=1.85, p<0.05) and MVPA below 4.2% a day (OR=1.69, p<0.05) compared to WBE, high PA levels (<688 cpm) and high MVPA (6.7%), respectively. SED was not associated with SI. ORs were moderately elevated for low serum Ca and 25OHD. However, biomarkers were not statistically significantly associated with SI and did not modify the association between PA behaviours and SI. Although nutritional biomarkers appear to play a minor role compared to the osteogenic effect of PA and WBE, it is noteworthy that the highest risk for poor SI was observed for no sports or low MVPA combined with lower serum Ca (<2.5 mmol/l) or lower 25OHD (<43.0 nmol/l).
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Affiliation(s)
- Diana Herrmann
- Department of Epidemiological Methods and Etiologic Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359 Bremen, Germany.
| | - Hermann Pohlabeln
- Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359 Bremen, Germany.
| | - Francesco Gianfagna
- Research Centre in Epidemiology and Preventive Medicine - EPIMED, Department of Clinical and Experimental Medicine, University of Insubria, Via O Rossi 9, 21100 Varese, Italy; Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Via dell'Elettronica, 86077 Pozzilli, Italy.
| | - Kenn Konstabel
- Department of Chronic Diseases, Centre of Behavioural and Health Sciences, National Institute for Health Development, Hiiu St 42, 11619 Tallinn, Estonia.
| | - Lauren Lissner
- Department of Public Health and Community Medicine, University of Gothenburg, Medicinaregatan 16, 40530 Gothenburg, Sweden.
| | - Staffan Mårild
- Department of Paediatrics, Queen Silvia Children's Hospital, University of Gothenburg, Rondvägen 10, SE 41686 Gothenburg, Sweden.
| | - Dénes Molnar
- Department of Pediatrics, University of Pécs, József A. u. 7, 7623 Pécs, Hungary.
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University School of Health Sciences, University of Zaragoza, C/Domingo Miral s/n, 50009 Zaragoza, Spain.
| | - Alfonso Siani
- Institute of Food Sciences, National Research Council, Via Roma 64, 83100 Avellino, Italy.
| | - Isabelle Sioen
- Department of Public Health, Ghent University, UZ 2 Blok A De Pintelaan 185, 9000 Ghent, Belgium.
| | - Toomas Veidebaum
- Department of Chronic Diseases, Centre of Behavioural and Health Sciences, National Institute for Health Development, Hiiu St 42, 11619 Tallinn, Estonia.
| | - Wolfgang Ahrens
- Department of Epidemiological Methods and Etiologic Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359 Bremen, Germany; Faculty of Mathematics and Computer Science, Bremen University, Bibliothekstr. 1, 28359 Bremen, Germany.
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136
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Abstract
Fractures are common during childhood; however, they can also be the presenting symptom of primary or secondary causes of bone fragility. The challenge is to identify those children who warrant further investigation. In children who present with multiple fractures that are not commonly associated with mild to moderate trauma or whose fracture count is greater than what is typically seen for their age, an initial evaluation, including history, physical examination, biochemistry, and spinal radiography, should be performed. In children with bone pain or evidence of more significant bone fragility, referral for specialist evaluation and consideration of pharmacologic treatment may be warranted.
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Affiliation(s)
- Jennifer Harrington
- Division of Endocrinology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario M5G1X8, Canada.
| | - Etienne Sochett
- Division of Endocrinology, Department of Pediatrics, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario M5G1X8, Canada
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137
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Falk B, Rigby WA, Akseer N. Adolescent idiopathic scoliosis: the possible harm of bracing and the likely benefit of exercise. Spine J 2015; 15:1169-71. [PMID: 24846846 DOI: 10.1016/j.spinee.2014.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 05/08/2014] [Indexed: 02/03/2023]
Affiliation(s)
- Bareket Falk
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, 500 Glenridge Ave., St. Catharines, ON L2S 3A1, Canada; Centre for Bone and Muscle Health, Faculty of Applied Health Sciences, Brock University, 500 Glenridge Ave., St. Catharines, ON L2S 3A1, Canada.
| | - W Alan Rigby
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, 500 Glenridge Ave., St. Catharines, ON L2S 3A1, Canada
| | - Nasreen Akseer
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, 500 Glenridge Ave., St. Catharines, ON L2S 3A1, Canada
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138
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Accuracy of a custom physical activity and knee angle measurement sensor system for patients with neuromuscular disorders and gait abnormalities. SENSORS 2015; 15:10734-52. [PMID: 25954954 PMCID: PMC4482003 DOI: 10.3390/s150510734] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 04/15/2015] [Accepted: 04/30/2015] [Indexed: 11/24/2022]
Abstract
Long-term assessment of ambulatory behavior and joint motion are valuable tools for the evaluation of therapy effectiveness in patients with neuromuscular disorders and gait abnormalities. Even though there are several tools available to quantify ambulatory behavior in a home environment, reliable measurement of joint motion is still limited to laboratory tests. The aim of this study was to develop and evaluate a novel inertial sensor system for ambulatory behavior and joint motion measurement in the everyday environment. An algorithm for behavior classification, step detection, and knee angle calculation was developed. The validation protocol consisted of simulated daily activities in a laboratory environment. The tests were performed with ten healthy subjects and eleven patients with multiple sclerosis. Activity classification showed comparable performance to commercially available activPAL sensors. Step detection with our sensor system was more accurate. The calculated flexion-extension angle of the knee joint showed a root mean square error of less than 5° compared with results obtained using an electro-mechanical goniometer. This new system combines ambulatory behavior assessment and knee angle measurement for long-term measurement periods in a home environment. The wearable sensor system demonstrated high validity for behavior classification and knee joint angle measurement in a laboratory setting.
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139
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Sayers A, Deere K, Tobias JH. The effect of vigorous physical activity and body composition on cortical bone mass in adolescence. J Bone Miner Res 2015; 30:584. [PMID: 25380296 DOI: 10.1002/jbmr.2400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Adrian Sayers
- Musculoskeletal Research Unit, University of Bristol, Learning and Research Southmead Hospital, Westbury on Trym, Bristol, United Kingdom
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140
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Janz KF, Thomas DQ, Ford MA, Williams SM. Top 10 research questions related to physical activity and bone health in children and adolescents. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2015; 86:5-12. [PMID: 25664669 DOI: 10.1080/02701367.2014.995019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Evidence strongly supports a positive, causal effect of physical activity on bone strength and suggests long-term benefits of childhood physical activity to the prevention of osteoporosis. The contribution of healthy bone development in youth is likely to be as important to fracture prevention as the amount of late adulthood bone loss. Families, schools (particularly physical education), and communities are key settings for health promotion focused on bone-enhancing physical activity. However, little research has explored the topic of health promotion and physical education as they pertain to bone health, so best practices are not known. Based on our understanding of the literature, we present the top 10 research questions in health promotion and physical education that should be answered to advance bone-enhancing physical activity in children and adolescents.
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141
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Tan VPS, Macdonald HM, McKay HA. Reply to The effect of vigorous physical activity and body composition on cortical bone mass in adolescence. J Bone Miner Res 2015; 30:585-6. [PMID: 25381875 DOI: 10.1002/jbmr.2399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Vina P S Tan
- Center for Hip Health and Mobility, University of British Columbia, Vancouver, BC, Canada; Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada; School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Wallace IJ, Judex S, Demes B. Effects of load-bearing exercise on skeletal structure and mechanics differ between outbred populations of mice. Bone 2015; 72:1-8. [PMID: 25460574 DOI: 10.1016/j.bone.2014.11.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Revised: 11/15/2014] [Accepted: 11/17/2014] [Indexed: 11/18/2022]
Abstract
Effects of load-bearing exercise on skeletal structure and mechanical properties can vary between inbred strains of mice. Here, we examine whether such variation also exists at the population level. An experiment was performed with two outbred mouse stocks that have been reproductively isolated for >120 generations (Hsd:ICR, Crl:CD1). Growing females from each stock were either treated with a treadmill-running regimen for 1 month or served as controls. Limb forces were recorded with a force plate and cage activity monitored to verify that they were similar between stocks. After the experiment, femoral cortical and trabecular bone structure were quantified with micro-CT in the mid-diaphysis and distal metaphysis, respectively, and diaphyseal structural strength was determined with mechanical testing. Among Hsd:ICR mice, running led to significant improvements in diaphyseal bone quantity, structural geometry, and mechanical properties, as well as enhanced trabecular morphology. In contrast, among Crl:CD1 mice, the same running regimen had little effect on cortical and trabecular structure and significantly reduced diaphyseal resistance to fracture. In neither stock was body mass, muscle mass, or cage activity level different between runners and controls. Given that most environmental variables were controlled in this study, the differential effects of exercise on Hsd:ICR and Crl:CD1 bones were likely due to genetic differences between stocks. These results suggest that the benefits of loading for bone may vary between human populations (e.g., ethnic groups), in which case exercise programs and technologies designed to promote bone health with mechanical signals may be more advantageous to certain populations than others.
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Affiliation(s)
- Ian J Wallace
- Department of Anthropology, Stony Brook University, Stony Brook, NY 11794, USA.
| | - Stefan Judex
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY 11794, USA
| | - Brigitte Demes
- Department of Anatomical Sciences, Stony Brook University, Stony Brook, NY 11794, USA
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143
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Wallace IJ, Nesbitt A, Mongle C, Gould ES, Grine FE. Age-related variation in limb bone diaphyseal structure among Inuit foragers from Point Hope, northern Alaska. Arch Osteoporos 2014; 9:202. [PMID: 25491658 DOI: 10.1007/s11657-014-0202-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 11/26/2014] [Indexed: 02/03/2023]
Abstract
UNLABELLED Age-related deterioration of limb bone diaphyseal structure is documented among precontact Inuit foragers from northern Alaska. These findings challenge the concept that bone loss and fracture susceptibility among modern Inuit stem from their transition away from a physically demanding traditional lifestyle toward a more sedentary Western lifestyle. INTRODUCTION Skeletal fragility is rare among foragers and other traditional-living societies, likely due to their high physical activity levels. Among modern Inuit, however, severe bone loss and fractures are apparently common. This is possibly because of recent Western influences and increasing sedentism. To determine whether compromised bone structure and strength among the Inuit are indeed aberrant for a traditional-living group, data were collected on age-related variation in limb bone diaphyseal structure from a group predating Western influences. METHODS Skeletons of 184 adults were analyzed from the Point Hope archaeological site. Mid-diaphyseal structure was measured in the humerus, radius, ulna, femur, and tibia using CT. Structural differences were assessed between young, middle-aged, and old individuals. RESULTS In all bones examined, both females and males exhibited significant age-related reductions in bone quantity. With few exceptions, total bone (periosteal) area did not significantly increase between young and old age in either sex, nor did geometric components of bending rigidity (second moments of area). CONCLUSIONS While the physically demanding lifestyles of certain traditional-living groups may protect against bone loss and fracture susceptibility, this is not the case among the Inuit. It remains possible, however, that Western characteristics of the modern Inuit lifestyle exacerbate age-related skeletal deterioration.
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Affiliation(s)
- I J Wallace
- Department of Anthropology, Stony Brook University, Stony Brook, NY, 11794-4364, USA,
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Dyremyhr ÅE, Diaz E, Meland E. How adolescent subjective health and satisfaction with weight and body shape are related to participation in sports. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2014; 2014:851932. [PMID: 25013414 PMCID: PMC4074947 DOI: 10.1155/2014/851932] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 05/02/2014] [Accepted: 05/28/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Physical exercise has positive effects on health. However, its associations with self-rated health and body image, which are important predictors for adolescents' wellbeing and later morbidity, are complex. METHODS Cross-sectional survey among 2527 Norwegian adolescents. We examined the relations between self-reported gender, body size, amount and type of exercise and measures of self-rated health, drive for thinness, and desire to change body, with binary logistic regression analyses. RESULTS Girls and overweight students reported to a greater extent than their peers impaired self-rated health, weight concerns, and desire to change their body. Increasing amount of time spent on sports was related to improved self-rated health in a dose-response manner. Both girls and boys who engaged in individual sports with an advantage of leanness, but only girls engaged in team sports, reported an increased desire to change the body. However, weight concern was not related to amount or type of sports. CONCLUSIONS Physical exercise is positively related to self-reported health but has negative associations with body image for many adolescents. Health promotion efforts should consider this paradox and stimulate physical activity and sports along with body acceptance.
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Affiliation(s)
- Åse Eriksen Dyremyhr
- Department of Global Public Health and Primary Care, Research Group of General Practice, Kalfarveien 31, 5018 Bergen, Norway
| | - Esperanza Diaz
- Department of Global Public Health and Primary Care, Research Group of General Practice, Kalfarveien 31, 5018 Bergen, Norway
| | - Eivind Meland
- Department of Global Public Health and Primary Care, Research Group of General Practice, Kalfarveien 31, 5018 Bergen, Norway
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