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Akhiiarova K, Khusainova R, Minniakhmetov I, Mokrysheva N, Tyurin A. Peak Bone Mass Formation: Modern View of the Problem. Biomedicines 2023; 11:2982. [PMID: 38001982 PMCID: PMC10669090 DOI: 10.3390/biomedicines11112982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/26/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
Peak bone mass is the amount of bone tissue that is formed when a stable skeletal state is achieved at a young age. To date, there are no established peak bone mass standards nor clear data on the age at which peak bone mass occurs. At the same time, the level of peak bone mass at a young age is an important predictor of the onset of primary osteoporosis. The purpose of this review is to analyze the results of studies of levels of peak bone mass in general, the age of its onset, as well as factors influencing its formation. Factors such as hormonal levels, body composition, physical activity, nutrition, heredity, smoking, lifestyle, prenatal predictors, intestinal microbiota, and vitamin and micronutrient status were considered, and a comprehensive scheme of the influence of these factors on the level of peak bone mass was created. Determining the standards and timing of the formation of peak bone mass, and the factors affecting it, will help in the development of measures to prevent its shortage and the consequent prevention of osteoporosis and concomitant diseases.
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Affiliation(s)
- Karina Akhiiarova
- Internal Medicine Department, Bashkir State Medical University, 450008 Ufa, Russia;
| | - Rita Khusainova
- Medical Genetics Department, Bashkir State Medical University, 450008 Ufa, Russia;
- Endocrinology Research Centre, Dmitriya Ulianova Street, 11, 117036 Moscow, Russia; (I.M.); (N.M.)
| | - Ildar Minniakhmetov
- Endocrinology Research Centre, Dmitriya Ulianova Street, 11, 117036 Moscow, Russia; (I.M.); (N.M.)
| | - Natalia Mokrysheva
- Endocrinology Research Centre, Dmitriya Ulianova Street, 11, 117036 Moscow, Russia; (I.M.); (N.M.)
| | - Anton Tyurin
- Internal Medicine Department, Bashkir State Medical University, 450008 Ufa, Russia;
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Cooper DM, Rothstein MA, Amin A, Hirsch JD, Cooper E. Unintended consequences of glucagon-like peptide-1 receptor agonists medications in children and adolescents: A call to action. J Clin Transl Sci 2023; 7:e184. [PMID: 37706005 PMCID: PMC10495825 DOI: 10.1017/cts.2023.612] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 08/13/2023] [Indexed: 09/15/2023] Open
Affiliation(s)
- Dan M. Cooper
- Department of Pediatrics, School of Medicine, Institute for Clinical and Translational Science, University of California at Irvine, Irvine, CA, USA
| | - Mark A. Rothstein
- University of California at Irvine, Institute for Clinical and Translational Science, Irvine, CA, USA
| | - Alpesh Amin
- Department of Medicine, School of Medicine, University of California at Irvine, Irvine, CA, USA
| | - Jan D. Hirsch
- School of Pharmacy and Pharmaceutical Sciences, University of California at Irvine, Irvine, CA, USA
| | - Emma Cooper
- Department of Psychiatry, School of Medicine, University of California at Irvine, Irvine, CA, USA
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3
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Einfluss von Pubertät und Hormonen auf die Knochenentwicklung. GYNAKOLOGISCHE ENDOKRINOLOGIE 2023. [DOI: 10.1007/s10304-022-00491-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Cristi-Montero C, Peña-Jorquera H, Landaeta-Díaz L, Mello JB, Araya-Quintanilla F, Brand C, Reuter C, Jorquera C, Ferrari G. The inverse relationship between fatness and bone mineral content is mediated by the adolescent appendicular skeletal muscle mass index: The Cogni-Action Project. Front Nutr 2022; 9:1040116. [PMID: 36458170 PMCID: PMC9705589 DOI: 10.3389/fnut.2022.1040116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/26/2022] [Indexed: 09/19/2023] Open
Abstract
Background Excess adipose tissue negatively influences bone health during childhood, affecting future bone fragility diseases such as osteoporosis. However, little is known about how adolescent appendicular skeletal muscle mass index (ASMI) may mediate the relation between fatness and bone mineral content (BMC). Methods The sample comprised 1,296 adolescents (50% girls) aged 10-14. A principal component analysis was performed to obtain a factor made up of four fatness indicators (a) neck circumference, (b) kilograms of fat, (c) visceral fat area, and (d) waist-to-height ratio. BMC, kilograms of fat, visceral fat area, and appendicular skeletal muscle mass were obtained by a multi-frequency bioelectrical impedance analyzer. ASMI was calculated as the appendicular skeletal muscle mass divided by height squared (kg/m2). A mediation analysis was performed adjusting by age, sex, maturation, socioeconomic status, physical activity, and adolescents' body weight. We also explore differences by sex and nutritional status. Results The fatness factor explained 71.5% of the proportion variance. Fatness was inversely associated with the ASMI and BMC, while the ASMI was positively related to BMC. Overall, the inverse relationship between fatness and BMC was partially mediated by the adolescents' ASMI (29.7%, indirect effect: B= -0.048, 95%CI -0.077 to -0.022), being higher in girls than in boys (32.9 vs. 29.2%). Besides, the mediation effect was higher in adolescents with normal body weight than with overweight-obese (37.6 vs 23.9%, respectively). Conclusions This finding highlighted the relevance of promoting healthy habits to reduce fatness and improve muscle mass in adolescents. Moreover, this highlights the central role of ASMI mediating the inverse association between fatness and BMC in female and male adolescents. Public health strategies should promote bone health in childhood, reducing the incidence of early osteopenia and osteoporosis.
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Affiliation(s)
- Carlos Cristi-Montero
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Humberto Peña-Jorquera
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Leslie Landaeta-Díaz
- Facultad de Salud y Ciencias Sociales, Universidad de las Américas, Santiago, Chile
| | - Julio B. Mello
- Physical Education School, Faculdade SOGIPA, Porto Alegre, Brazil
- eFiDac Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - Felipe Araya-Quintanilla
- Escuela de Kinesiología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Santiago, Chile
| | - Caroline Brand
- IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
- Graduate Program in Health Promotion, Universidade de Santa Cruz do Sul—UNISC, Santa Cruz do Sul, Brazil
| | - Cézane Reuter
- Graduate Program in Health Promotion, Universidade de Santa Cruz do Sul—UNISC, Santa Cruz do Sul, Brazil
| | - Carlos Jorquera
- Escuela de Nutrición y Dietética, Facultad de Ciencias, Universidad Mayor, Santiago, Chile
| | - Gerson Ferrari
- Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago, Chile
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Adolescent Bone Advantages 3 Years After Resistance Training Trial. Pediatr Exerc Sci 2022; 35:61-69. [PMID: 36150707 DOI: 10.1123/pes.2022-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 07/30/2022] [Accepted: 08/07/2022] [Indexed: 11/17/2022]
Abstract
PURPOSE We assessed maintenance of skeletal advantages 3 years after completion of a 2-year, school-based, controlled exercise trial in adolescent girls. METHOD Middle-school girls participated in a resistance training program embedded in physical education classes. Effort groups (low-effort group [LO] and high-effort group [HI]) were identified; the control group (CON) participated in standard physical education at a separate school. Baseline and follow-up (FU) assessments at 6, 18, and 54 (FU3) months included densitometry, anthropometry, and questionnaires assessing physical maturity and nonintervention organized physical activity. Linear mixed effects models were fit to evaluate bone outcomes across all FU time points for CON versus LO/HI. RESULTS Sixty-eight girls (23 CON/25 HI/20 LO) were 11.6 (0.3) years at baseline. Bone parameters did not differ at baseline, except femoral neck bone mineral density (LO < HI/CON, P < .05). Forty-seven participants provided FU3 assessment: 17 CON/16 HI/14 LO. After adjusting for height, gynecologic age, baseline bone, and organized physical activity, bone gains across all time points were greater for HI versus CON for legs bone mineral content, femoral neck bone mineral content/bone mineral density, and third lumbar vertebra bone mineral content/bone mineral density (P ≤ .05). At FU3, bone values were greater for HI versus CON at subhead, legs, femoral neck, and third lumbar vertebra (P < .03). CONCLUSION Adolescent girls who exerted high effort in a school-based resistance training program demonstrated significant skeletal benefits 3 years after program completion.
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Osteosarcopenia as a lifetime syndrome: Could it be prevented? OSTEOSARCOPENIA 2022. [DOI: 10.1016/b978-0-12-820088-9.00012-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Mu S, Xia Y, Wu Q, Ji C, Dai H, Zhang M, Jiao J, Shi F, Liu S, Wang G, Shen T, Tian Y, Yang L, Fu Q, Zhao Y. Response of Bone Metabolism Markers to Ice Swimming in Regular Practitioners. Front Physiol 2021; 12:731523. [PMID: 34899374 PMCID: PMC8662563 DOI: 10.3389/fphys.2021.731523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 11/03/2021] [Indexed: 12/04/2022] Open
Abstract
Objective: Both exercise and cold exposure cause physiological stress and they often occur in combination. However, the effects of exercise during severe cold on variation in bone metabolism in humans have remained elusive. The aim of this study was to investigate the variations in circulating bone metabolism markers after ice swimming (IS). Methods: Eighty-seven women and men aged 42–84 years old were recruited to perform regular IS activities. Serum parathyroid hormone (PTH), total calcium (Ca2+), total phosphorus (Pi), total magnesium (Mg2+), N-terminal osteocalcin (N-MID), total propeptide of procollagen 1 (TPINP), and C-terminal telopeptide of type 1 collagen (β-CTX) were measured 30 min before and 30 min after IS. Bone mineral content (BMC) and bone mineral density (BMD) were assessed at lumbar spine 1–4 (L1–L4) and femoral neck (FN). The IS habits were obtained from questionnaires and the 10-year probability of osteoporotic fracture was calculated using the FRAX® tool with and without a BMD value of the FN. Results: There were significant increases in PTH (median, 40.120–51.540 pg/mL), Ca2+ (median, 2.330–2.400 mmol/L), and Pi (median, 1.100–1.340 mmol/L) and significant decreases in TPINP (median, 38.190–36.610 ng/mL) and β-CTX (median, 0.185–0.171 ng/mL), while there was a trend for increased serum Mg2+ (P = 0.058) but no significant change in N-MID (P = 0.933) after IS in all subjects. The increases in the proportions of cases of hyperparathyroidemia, hypercalcemia, and hyperphosphatemia in those performing IS were statistically significant. The baseline levels and the changes of bone metabolism markers had associations with osteoporosis and bone status, but these may be age and sex dependent. Finally, there were significant correlations among the bone metabolism markers. Conclusion: IS caused significant alterations in bone metabolic markers, specifically, increases in PTH, Ca2+ and Pi should raise concerns about potential cardiovascular health risks in severe cold exercise. Additionally, a divergence between PTH elevation and a decline in bone turnover, which shown a special change of bone metabolism after IS and may suggest potential therapeutic implications of cold exercise in PTH and bone metabolic disorders.
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Affiliation(s)
- Shuai Mu
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qijun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chao Ji
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Huixu Dai
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ming Zhang
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jiao Jiao
- Center of Reproductive Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Feng Shi
- Department of Health Management, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shengye Liu
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Guangbin Wang
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Tao Shen
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ye Tian
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Liqing Yang
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qin Fu
- Department of Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yuhong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
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Proia P, Amato A, Drid P, Korovljev D, Vasto S, Baldassano S. The Impact of Diet and Physical Activity on Bone Health in Children and Adolescents. Front Endocrinol (Lausanne) 2021; 12:704647. [PMID: 34589054 PMCID: PMC8473684 DOI: 10.3389/fendo.2021.704647] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 08/13/2021] [Indexed: 12/15/2022] Open
Abstract
There is growing recognition of the role of diet and physical activity in modulating bone mineral density, bone mineral content, and remodeling, which in turn can impact bone health later in life. Adequate nutrient composition could influence bone health and help to maximize peak bone mass. Therefore, children's nutrition may have lifelong consequences. Also, physical activity, adequate in volume or intensity, may have positive consequences on bone mineral content and density and may preserve bone loss in adulthood. Most of the literature that exists for children, about diet and physical activity on bone health, has been translated from studies conducted in adults. Thus, there are still many unanswered questions about what type of diet and physical activity may positively influence skeletal development. This review focuses on bone requirements in terms of nutrients and physical activity in childhood and adolescence to promote bone health. It explores the contemporary scientific literature that analyzes the impact of diet together with the typology and timing of physical activity that could be more appropriate depending on whether they are children and adolescents to assure an optimal skeleton formation. A description of the role of parathyroid hormone (PTH) and gut hormones (gastric inhibitory peptide (GIP), glucagon-like peptide (GLP)-1, and GLP-2) as potential candidates in this interaction to promote bone health is also presented.
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Affiliation(s)
- Patrizia Proia
- Department of Psychological, Pedagogical and Educational Sciences, Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| | - Alessandra Amato
- Department of Psychological, Pedagogical and Educational Sciences, Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Darinka Korovljev
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Sonya Vasto
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, Palermo, Italy
| | - Sara Baldassano
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, Palermo, Italy
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Mello JB, Pedretti A, García-Hermoso A, Martins CML, Gaya AR, Duncan MJ, Gaya ACA. Exercise in school Physical Education increase bone mineral content and density: Systematic review and meta-analysis. Eur J Sport Sci 2021; 22:1618-1629. [PMID: 34328066 DOI: 10.1080/17461391.2021.1960426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
ABSTRACTThis systematic review and meta-analysis aimed to evaluate the effectiveness of interventions through Physical Education (PE) exercises on bone mineral content (BMC) and density (BMD) of children and adolescents. The research was conducted using the online electronic databases PubMed, Science Direct, Web of Science and Scopus (March 2021). The analysis was restricted to school-based studies that examined the effect of PE interventions on BMC and BMD in schoolchildren (<18 years old). Standardised mean differences (SMD) with 95% confidence interval (CI) and random-effects models were calculated. The heterogeneity and inconsistency of the studies were estimated using Cochran's Q-statistic and I2, respectively. Twenty-two studies with 2,556 participants were selected. PE interventions were associated with a significant increase in BMC (SMD = 1.348; 95% CI, 1.053-1.643) and BMD (SMD = 0.640; 95% CI, 0.417-0.862). Femoral neck subgroup analysis indicate an increase in BMC for boys (SMD = 1.527; 95% CI, 0.990-2.065) and girls (SMD = 1.27; 95% CI, 0.782-1.767), and in BMD for boys (SMD = 0.518; 95% CI, 0.064-0.972) and girls (SMD = 0.817; 95% CI, 0.349-1.284). Finally, increases are reported in the lumbar spine BMC for boys (SMD = 1.860; 95% CI, 1.018-2.700) and girls (SMD = 1.275; 95% CI, 0.782-1.767). This meta-analysis provides insights into the effectiveness of interventions aimed at including physical exercise in PE on bone mass, suggesting that increasing the proportion of curriculum time allocated to PE may improve students' BMD and BMC, especially in the femoral neck and lumbar spine.
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Affiliation(s)
- Júlio B Mello
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Antonio García-Hermoso
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Publica de Navarra, Pamplona, Spain.,Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, Santiago de Chile, Chile
| | | | - Anelise R Gaya
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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Nestares T, Martín-Masot R, de Teresa C, Bonillo R, Maldonado J, Flor-Alemany M, Aparicio VA. Influence of Mediterranean Diet Adherence and Physical Activity on Bone Health in Celiac Children on a Gluten-Free Diet. Nutrients 2021; 13:1636. [PMID: 34068001 PMCID: PMC8152289 DOI: 10.3390/nu13051636] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/25/2021] [Accepted: 05/11/2021] [Indexed: 12/20/2022] Open
Abstract
We aimed to assess the influence of the Mediterranean Diet adherence and physical activity (PA) on body composition, with a particular focus on bone health, in young patients with celiac disease (CD). The CD group (n = 59) included children with CD with a long (>18 months, n = 41) or recent (<18 months, n = 18) adherence to a gluten-free diet (GFD). The non-celiac group (n = 40) included non-celiac children. After adjusting for potential confounders, the CD group showed lower body weight (p = 0.034), lean mass (p = 0.003), bone mineral content (p = 0.006), and bone Z-score (p = 0.036) than non-celiac children, even when the model was further adjusted for adherence to a GFD for at least 18 months. Among CD children, spending greater time in vigorous physical activity was associated with higher lean mass (p = 0.020) and bone mineral density with evidence of statistical significance (p = 0.078) regardless of the time they followed a GFD. In addition, a greater Mediterranean Diet adherence was associated with a higher bone Z-score (p = 0.020). Moreover, lean mass was strongly associated with bone mineral density and independently explained 12% of its variability (p < 0.001). These findings suggest the importance of correctly monitoring lifestyle in children with CD regarding dietary habits and PA levels to improve lean mass and, consequently, bone quality in this population.
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Affiliation(s)
- Teresa Nestares
- Department of Physiology, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain; (M.F.-A.); (V.A.A.)
- Biomedical Research Centre (CIBM), Institute of Nutrition and Food Technology “José MataixVerdú” (INYTA), University of Granada, 18071 Granada, Spain
| | - Rafael Martín-Masot
- Pediatric Gastroenterology and Nutrition Unit, Hospital Regional Universitario de Malaga, 29010 Málaga, Spain;
| | | | - Rocío Bonillo
- Department of Physiology, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain; (M.F.-A.); (V.A.A.)
| | - José Maldonado
- Department of Pediatrics, University of Granada, 18071 Granada, Spain;
- Pediatric Gastroenterology and Nutrition Unit, Hospital Universitario Virgen de las Nieves, 18071 Granada, Spain
- Spain Maternal and Child Health Network, Carlos III Health Institute, 28029 Madrid, Spain
| | - Marta Flor-Alemany
- Department of Physiology, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain; (M.F.-A.); (V.A.A.)
- Biomedical Research Centre (CIBM), Institute of Nutrition and Food Technology “José MataixVerdú” (INYTA), University of Granada, 18071 Granada, Spain
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain
| | - Virginia A. Aparicio
- Department of Physiology, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain; (M.F.-A.); (V.A.A.)
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain
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Nguyen VH. School-based nutrition interventions can improve bone health in children and adolescents. Osteoporos Sarcopenia 2021; 7:1-5. [PMID: 33869798 PMCID: PMC8044593 DOI: 10.1016/j.afos.2021.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/26/2021] [Accepted: 03/10/2021] [Indexed: 11/26/2022] Open
Abstract
Objectives Osteoporosis is a major global health problem, and optimizing bone health during childhood and adolescence with adequate calcium and vitamin D intake is a recommendation to prevent the disease. School milk programs may be a viable approach to help children and adolescents increase calcium and vitamin D intakes while improving their bone health. Methods A review of the literature was conducted on school milk programs, including examination of details regarding these studies and their participants, and assessments of their effects on bone health in children and adolescents. Results Nearly all studies reviewed showed significant increases in the bone health behaviors and outcomes that were measured, such as bone mineral density, milk consumption, and calcium and vitamin D intake. Conclusions School milk programs can be effective in improving bone health in children and adolescents, and public health policies should be considered to help support and fund effective programs that promote bone health and prevent osteoporosis in population health.
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Affiliation(s)
- Vu H Nguyen
- Department of Public Health, School of Health Professions, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA.,Community Health Program, Department of Health Sciences, School of Natural Sciences, Columbia College, Columbia, MO, USA
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The effect of physical activity intervention and nutritional habits on anthropometric measures in elementary school children: the health oriented pedagogical project (HOPP). Int J Obes (Lond) 2021; 45:1677-1686. [PMID: 33972698 PMCID: PMC8310789 DOI: 10.1038/s41366-021-00830-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/23/2021] [Accepted: 04/21/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Overweight and obesity are a burden of the modern world that requires urgent action. Prevention has proven to be efficient in the fight against overweight and obesity. As many children gain excessive weight at an early age, intervention during school years are important. While daily physical activity (PA) is known to have an influence on overweight and obesity prevention, the importance of a healthy lifestyle, including dietary habits, should not be underestimated. The aim of this study was to assess how a combination of daily PA and healthy/unhealthy diet affect the anthropometric measures of 4th graders in Norway. METHODS The Health Oriented Pedagogical Project (HOPP) is a longitudinal intervention in primary school children, which includes increased amount of daily physical activity during teaching- active learning. Assessed were weight, muscle and bone mass, as well as fat mass, using a bio-impedance Tanita scale. A dietary survey, Ungkost 2000, with 18 multiple-choice questions was used to evaluate the overall nutrition characteristics of the children. RESULTS Between 2015 and 2018, a total of 917 (intervention group n = 614, control group n = 303) 4th graders from nine different schools from the south-east part of Norway participated. We observed that daily PA and a regular healthy diet increases-while an unhealthy diet decreases-muscle and bone mass despite daily PA. Daily PA appears to counteract some of the effects of an unhealthy diet on weight and fat mass. In addition, daily PA and a regular intake of fruits and berries lowers weight and fat mass in children with overweight. CONCLUSION Combination of daily 45-minute of PA and a healthy diet leads to reductions in body weight and incease in muscle and bone mass in elementary school children.
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Abstract
PURPOSE OF REVIEW The main goal of this narrative review is to assess whether physical activity (PA) influences peak bone mass and fracture risk. RECENT FINDINGS Several randomized controlled trials (RCT) show that short-term PA intervention programs in childhood improve the accrual of bone mineral. There are now also long-term controlled PA intervention studies demonstrating that both boys and girls with daily school PA through puberty gain higher bone mineral content (BMC) and bone mineral density (BMD) and greater bone size than boys and girls with school PA 1-2 times/week. These benefits seem to be followed by a gradual reduction in expected fracture rates, so that in children with daily school PA, the incidence rate ratio (IRR) after 8 years is less than half that expected by age. Daily school PA from before to after puberty is associated with beneficial gains in bone traits and gradually lower relative fracture risk.
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Affiliation(s)
- Magnus K Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, SE - 205 02, Malmö, Sweden.
| | - Björn E Rosengren
- Clinical and Molecular Osteoporosis Research Unit, Department of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, SE - 205 02, Malmö, Sweden
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Abstract
Beyond its functions in locomotion, support and protection of vital organs, bone also interacts with other organs to adjust mineral balance in response to physiological requirements. Bone remodelling is a continuous process of bone resorption and formation for the purpose of maintaining healthy bone mass and growth. Any derangement in this process can cause bone disorders with important clinical consequences. The most prominent features of bone diseases in children include early bone fractures, deformities and pain, which can persist and worsen later in life if an accurate and timely diagnosis is not achieved. Biochemical and genetic testing usually help to discriminate the aetiology of the disease, which determines the subsequent management and follow-up. This review focuses on major genetic metabolic bone diseases in children, their pathophysiological mechanisms, the potential therapeutic interventions and the possible consequences in adulthood of the disease and its treatments.
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Affiliation(s)
- Carlos Gómez-Alonso
- Unidad de Gestión Clínica de Metabolismo Óseo y Mineral, Instituto Reina Sofía de Investigación, RedinRen ISCIII, Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, Spain.
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Cheng L, Pohlabeln H, Ahrens W, Lauria F, Veidebaum T, Chadjigeorgiou C, Molnár D, Eiben G, Michels N, Moreno LA, Page AS, Pitsiladis Y, Hebestreit A. Cross-sectional and longitudinal associations between physical activity, sedentary behaviour and bone stiffness index across weight status in European children and adolescents. Int J Behav Nutr Phys Act 2020; 17:54. [PMID: 32345301 PMCID: PMC7189536 DOI: 10.1186/s12966-020-00956-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 04/13/2020] [Indexed: 12/15/2022] Open
Abstract
Background The associations between physical activity (PA), sedentary behaviour (SB) and bone health may be differentially affected by weight status during growth. This study aims to assess the cross-sectional and longitudinal associations between PA, SB and bone stiffness index (SI) in European children and adolescents, taking the weight status into consideration. Methods Calcaneus SI was first measured by quantitative ultrasound among children aged 2–9 years old in 2007/08. It was measured again after 2 years in the IDEFICS study and after 6 years in the I. Family study. A sample of 2008 participants with time spent at sports clubs, watching TV and playing computer/games self-reported by questionnaire, and a subsample of 1037 participants with SB, light PA (LPA) and moderate-to-vigorous PA (MVPA) objectively measured using Actigraph accelerometers were included in the analyses. Weight status was defined as thin/normal and overweight/obese according to the extended International Obesity Task Force criteria. Linear mixed-effects models were used to estimate the cross-sectional and longitudinal associations between PA, SB and SI percentiles, stratified by weight status. Results The cross-sectional association between weekly duration of watching TV and SI percentiles was negative in thin/normal weight group (β = − 0.35, p = 0.008). However, baseline weekly duration of watching TV (β = − 0.63, p = 0.021) and change after 2 years (β = − 0.63, p = 0.022) as well as the change in weekly duration of playing computer/games after 6 years (β = − 0.75, p = 0.019) were inversely associated with corresponding changes in SI percentiles in overweight/obese group. Change in time spent at sports clubs was positively associated with change in SI percentiles after 2 years (β = 1.28, p = 0.001), with comparable effect sizes across weight status. In the subsample with accelerometer data, we found a positive cross-sectional association between MVPA and SI percentiles in thin/normal weight group. Baseline MVPA predicted changes in SI percentiles after 2 and 6 years in all groups. Conclusions Our results suggested the beneficial effect of PA on SI. However, the increasing durations of screen-based SB might be risk factors for SI development, especially in overweight/obese children and adolescents.
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Affiliation(s)
- Lan Cheng
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.,Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.,Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Fabio Lauria
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | | | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Gabriele Eiben
- Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Nathalie Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, 9000, Ghent, Belgium
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, 50009, Zaragoza, Spain
| | - Angie S Page
- Centre for Exercise, Nutrition & Health Sciences, University of Bristol, Bristol, UK
| | - Yannis Pitsiladis
- Collaborating Centre of Sports Medicine, University of Brighton, Brighton, UK
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.
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How Physical Activity across the Lifespan Can Reduce the Impact of Bone Ageing: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061862. [PMID: 32183049 PMCID: PMC7143872 DOI: 10.3390/ijerph17061862] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/05/2020] [Accepted: 03/10/2020] [Indexed: 02/07/2023]
Abstract
Bone remodeling is a lifelong process, due to the balanced activity of the osteoblasts (OBs), the bone-forming cells, and osteoclasts (OCs), the bone-resorbing cells. This equilibrium is mainly regulated by the WNT-ß-cathenin pathway and the RANK-RANKL/OPG system, respectively. Bone ageing is a process which normally occurs during life due to the imbalance between bone formation and bone resorption, potentially leading to osteoporosis. Bone loss associated with bone ageing is determined by oxidative stress, the result of the increasing production of reactive oxygen species (ROS). The promotion of physical exercise during growth increases the chances of accruing bone and delaying the onset of osteoporosis. Several studies demonstrate that physical exercise is associated with higher bone mineral density and lower fracture incidence, and the resulting bone mineral gain is maintained with ageing, despite a reduction of physical activity in adulthood. The benefits of exercise are widely recognized, thus physical activity is considered the best non-pharmacologic treatment for pathologies such as osteoporosis, obesity, diabetes and cardiovascular disease. We reviewed the physiological mechanisms which control bone remodeling, the effects of physical activity on bone health, and studies on the impact of exercise in reducing bone ageing.
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17
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Kondiboyina V, Raine LB, Kramer AF, Khan NA, Hillman CH, Shefelbine SJ. Skeletal Effects of Nine Months of Physical Activity in Obese and Healthy Weight Children. Med Sci Sports Exerc 2020; 52:434-440. [PMID: 31479005 PMCID: PMC6962537 DOI: 10.1249/mss.0000000000002148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE Obesity during adolescence has multisystem health consequences. The objective of this work was to determine whether preadolescent overweight/obese children's bones respond to a 9-month physical activity intervention by increasing bone density similar to healthy weight children. METHODS Participants included overweight/obese (BMI > 85%) and healthy weight (15% < BMI < 85%) preadolescents (8-9 yr old). Participants in the physical activity group participated in a 9-month physical activity curriculum every day after school. The wait list control group received no intervention. Both groups had overweight/obese children and healthy weight controls. Whole-body bone mineral content, area, and bone mineral apparent density (BMAD) were assessed using dual x-ray absorptiometry) at the beginning and end of the 9-month trial in the physical activity and control group. RESULTS Overweight/obese preadolescent children had higher BMAD than healthy weight children (P < 0.001 for spine, leg, and whole body). However, the density/weight (BMAD/lean mass) was lower in overweight/obese children than that in healthy weight children, indicating that the density of bones in overweight/obese children may not compensate sufficiently for the excessive load due to weight. The change in BMAD over 9 months was greater in healthy weight children than overweight/obese children in the whole body and leg, but not the lumbar spine. Physical activity caused a site-specific increase in bone density, affecting the legs more than the lumbar spine, but there was no significant difference in the effect of exercise between the healthy weight and the overweight/obese group. CONCLUSIONS The smaller change in BMAD over the 9 months and lower BMAD per unit lean mass in overweight/obese compared with healthy weight children may indicate a slower rate of bone mass accrual, which may have implications for bone health during skeletal growth in obese/overweight children.
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Affiliation(s)
| | - Lauren B Raine
- Department of Psychology, Northeastern University, Boston, MA
| | | | - Naiman A Khan
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL
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Tebar WR, Ritti-Dias RM, Saraiva BTC, Suetake VYB, Delfino LD, Christofaro DGD. Physical activity levels are associated with regional bone mineral density in boys. PHYSICIAN SPORTSMED 2019; 47:336-340. [PMID: 30640562 DOI: 10.1080/00913847.2019.1568770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Youth is a crucial period for bone gain, and physical activity (PA) has shown to increase bone mineral density (BMD) in this period. However, whether PA affects regional BMD is unclear. Thus, the aim of this study was to analyze the relationship between PA levels and regional BMD in youths. Methods: The sample included 110 children and adolescents aged 6-14 years. Body mass, height, sitting trunk length, and leg length were obtained for body mass index and maturity offset calculation. The arms, pelvis, spine, trunk, and legs BMD were measured by double energy X-ray absorptiometry. The PA was evaluated by questionnaire, and youths were classified as low, moderately, or highly physically active. Results: The sample included 63.7% boys and 36.3% girls with mean age of sample 9.5 (±1.6) yrs. Age, body mass index, and maturity offset were similar between sexes (p > 0.05). Boys with low PA levels had lower BMD Z-score for arms (-0.20 ± 0.71 vs. 0.30 ± 1.19, p = 0.006) and legs (-0.14 ± 1.00 vs. 0.35 ± 1.06, p = 0.026) compared to highly physically active youths. Multiple linear regression showed a positive linear relationship between legs BMD and PA in boys (β = 0.72 [95% CI = 0.09; 1.36]). Conclusion: In boys, low PA levels are associated with lower BMD in arms and legs.
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Affiliation(s)
- William R Tebar
- Post Graduation Program in Movement Sciences, Sao Paulo State University - UNESP , Presidente Prudente , Brazil
| | - Raphael M Ritti-Dias
- Departament of Physical Education, Universidade Nove de Julho - UNINOVE , Sao Paulo , Brazil
| | - Bruna T C Saraiva
- Post Graduation Program in Movement Sciences, Sao Paulo State University - UNESP , Presidente Prudente , Brazil
| | - Vinícius Y B Suetake
- GEAFS Research Group - Department of Physical Education, Sao Paulo State University - UNESP , Presidente Prudente , Brazil
| | - Leandro D Delfino
- GEAFS Research Group - Department of Physical Education, Sao Paulo State University - UNESP , Presidente Prudente , Brazil
| | - Diego G D Christofaro
- Post Graduation Program in Movement Sciences, Sao Paulo State University - UNESP , Presidente Prudente , Brazil.,Post Graduation Program in Physiotherapy, Sao Paulo State University - UNESP , Presidente Prudente , Brazil
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Hofmann C, Girschick H, Lapa C, Semler O, Jakob F. [Fractures and bone mineral density in childhood]. Z Rheumatol 2019; 78:636-644. [PMID: 31338681 DOI: 10.1007/s00393-019-0671-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND In juvenile idiopathic arthritis and related chronic inflammatory diseases, proinflammatory cytokines inhibit bone formation and stimulate bone resorption. Anti-inflammatory drugs, such as glucocorticoids and nonsteroidal antirheumatic drugs (NSARD) have as a side effect the potential to inhibit growth and maintenance of bone. These issues are of particular importance for the growing skeleton in childhood and adolescence. OBJECTIVE This article presents a narrative overview about the dimension of the problem, a critical evaluation of diagnostic procedures and a discussion of available countermeasures. METHODS A systematic literature search was carried out and the available evidence was evaluated based on the authors' knowledge and clinical experience as experts in the field. RESULTS AND CONCLUSION In recent years solid data have been accumulated with respect to the interpretation of bone mineral density (BMD) measurements in children and adolescents. Based on these data from the literature and given that the radiation exposure is also very low, it is now possible to clinically apply BMD measurements in this population using dual energy X‑ray absorption (DXA) technology for risk evaluation and diagnosis, taking the respective phase of development and body length into consideration. Dynamic measurements over time appear to be especially valuable in the context of individual clinical data. Hence, BMD measurements can be helpful in monitoring bone health, especially in juvenile idiopathic arthritis and other related inflammatory diseases. Apart from the specific indications for extended diagnostics and bone targeted pharmacological treatment, this method can also contribute to the management of preventive measures, such as sufficient calcium and vitamin D intake and targeted exercise interventions. Even in times of extremely effective antirheumatic drugs, children with chronic inflammatory diseases still bear a risk for bone health.
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Affiliation(s)
- Christine Hofmann
- Kinderklinik und Poliklinik, Pädiatrische Rheumatologie und Osteologie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Herrmann Girschick
- Klinik für Kinder- und Jugendmedizin, Vivantes Klinikum im Friedrichshain, Berlin, Deutschland
| | - Constantin Lapa
- Klinik und Poliklinik für Nuklearmedizin, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - Oliver Semler
- Medizinische Fakultät und Uniklinik Köln, Klinik und Poliklinik für Kinder- und Jugendmedizin, Universität zu Köln, Köln, Deutschland
| | - Franz Jakob
- Orthopädische Klinik im König-Ludwig-Haus, Bernhard-Heine-Centrum für Bewegungsforschung, Brettreichstr. 11, 97074, Würzburg, Deutschland.
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