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Brudecki J, Rydzik Ł, Wąsacz W, Ruzbarsky P, Czarny W, Warowna M, Ambroży T. Somatic Structure and Ultrasound Parameters of the Calcaneus Bone in Combat Sports Athletes in Relation to Vitamin D 3 Levels. J Clin Med 2024; 13:4960. [PMID: 39201101 PMCID: PMC11355900 DOI: 10.3390/jcm13164960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 08/19/2024] [Accepted: 08/21/2024] [Indexed: 09/02/2024] Open
Abstract
Background/Objectives: Physical activity is widely recognized for its beneficial effects on bone density during adolescence, which could lead to enhanced bone density in later life, thus acting as a health-promoting activity with long-lasting implications. However, not all studies are conclusive regarding the type, intensity, duration, and frequency of the most effective physical activities. This study focuses on combat sports athletes and examines the relationship between their somatic build and heel bone parameters using ultrasound (USG) and their vitamin D3 levels. Methods: The study included 40 male athletes specializing in various combat sports. The measurements of body height, body mass, skinfold thickness, and bone widths at multiple sites were performed to estimate the somatic build. The USG parameters of the heel bone and the blood levels of vitamin D3 were also recorded. Statistical significance was determined using one-way ANOVA, with differences among sports disciplines also examined. Results: The study found significant differences in the body composition and USG bone parameters among athletes from different combat sports (p ≤ 0.05). The calcaneus stiffness index (SI) and speed of sound (SOS) were significantly higher in athletes with normal vitamin D3 levels compared to those with below-normal levels (p = 0.0015 and p = 0.001, respectively). These findings suggest that vitamin D3 may influence bone stiffness and density. Conclusions: The study underscores the importance of maintaining adequate vitamin D3 levels to support bone mineralization in athletes, particularly those training indoors with limited exposure to sunlight. It also highlights the potential of using USG as a non-invasive method to assess bone health, aiding in the optimization of training programs to prevent injuries and improve performance.
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Affiliation(s)
- Janusz Brudecki
- Department of Anthropology, Institute of Biomedical Sciences, University of Physical Education, 31-571 Kraków, Poland;
| | - Łukasz Rydzik
- Institute of Sports Sciences, Faculty of Physical Education and Sport, University of Physical Education, 31-571 Kraków, Poland; (W.W.); (T.A.)
| | - Wojciech Wąsacz
- Institute of Sports Sciences, Faculty of Physical Education and Sport, University of Physical Education, 31-571 Kraków, Poland; (W.W.); (T.A.)
| | - Pavel Ruzbarsky
- Department of Sports Kinanthropology, Faculty of Sports, Universtiy of Presov, 08001 Prešov, Slovakia;
| | - Wojciech Czarny
- Institute of Physical Culture Studies, College of Medical Sciences, University of Rzeszow, 35-310 Rzeszow, Poland;
| | - Marlena Warowna
- Faculty of Health Sciences, Department of Beauty Sciences, Vincent Pol University in Lublin, 20-816 Lublin, Poland;
| | - Tadeusz Ambroży
- Institute of Sports Sciences, Faculty of Physical Education and Sport, University of Physical Education, 31-571 Kraków, Poland; (W.W.); (T.A.)
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Takei S, Torii S, Taketomi S, Iizuka S, Tojima M, Iwanuma S, Iida Y, Tanaka S. Developmental stage and lower quadriceps flexibilities and decreased gastrocnemius flexibilities are predictive risk factors for developing Osgood-Schlatter disease in adolescent male soccer players. Knee Surg Sports Traumatol Arthrosc 2023:10.1007/s00167-023-07378-z. [PMID: 37002485 DOI: 10.1007/s00167-023-07378-z] [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: 06/24/2022] [Accepted: 03/01/2023] [Indexed: 06/19/2023]
Abstract
PURPOSE This study aimed to elucidate the influential predictive risk factors of Osgood-Schlatter disease (OSD) on the support (non-kicking) leg among adolescent soccer players considering peak height velocity (PHV) age and investigate the cut-off values of the predictive variables. METHODS A cohort of 302 Japanese adolescent male soccer players aged 12-13 years were followed over 6 months. All players underwent physical examination, tibial tubercle ultrasonography, anthropometric and whole-body composition measurements, and muscle flexibility test of the support leg at the baseline. The developmental stage was evaluated from the PHV age. The OSD of the support leg was diagnosed 6 months later; players were divided into the OSD and control (CON) groups. The predictive risk factors were analyzed by multivariate logistic regression analysis. RESULTS There were 42 players who had developed OSD at baseline and they were excluded from the study. Among the 209 players, 43 and 166 belonged to the OSD and CON groups, respectively. The predictive risk factors of OSD development were PHV age ± 6 months at baseline (p = 0.046), apophyseal stage of tibial tuberosity maturity at baseline (p < 0.001), quadriceps flexibility ≥ 35° at baseline (p = 0.017), and decrease in gastrocnemius flexibility in 6 months (p = 0.009). CONCLUSION PHV age ± 6 months at baseline, apophyseal stage of the tibial tuberosity at baseline, quadriceps flexibility ≥ 35° at baseline, and decrease in gastrocnemius flexibility in 6 months are predictive risk factors of OSD development in the support leg among adolescent male soccer players. It is crucial to know the PHV age of each player, and not only the flexibility of quadriceps muscle but also the gastrocnemius should be monitored to predict OSD. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Seira Takei
- Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Waseda Institute of Human Growth and Development, Saitama, Japan
| | - Suguru Torii
- Waseda Institute of Human Growth and Development, Saitama, Japan.
- Faculty of Sport Sciences, Waseda University, Saitama, Japan.
| | - Shuji Taketomi
- Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Michio Tojima
- School of Health Sciences, Tokyo International University, Saitama, Japan
| | - Soichiro Iwanuma
- Department of School Education, Teikyo University of Science, Tokyo, Japan
| | - Yukako Iida
- Waseda Institute of Human Growth and Development, Saitama, Japan
- Faculty of Sport Science, Surugadai University, Saitama, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Luginsland LA, Haegele JA, Bennett HJ. Lower extremity joint stiffness of autistic adolescents during running at dual speeds. J Biomech 2023; 149:111478. [PMID: 36780731 DOI: 10.1016/j.jbiomech.2023.111478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 01/13/2023] [Accepted: 01/27/2023] [Indexed: 02/04/2023]
Abstract
Running is one of the most common forms of physical activity for autistic adolescents. However, research examining their lower extremity dynamics is sparse. In particular, no information exists regarding lower extremity joint stiffness in autistic adolescents. This study compared knee and ankle joint stiffness during the absorption phase of running between autistic adolescents and non-autistic controls. Motion capture and ground reaction forces were recorded for 22 autistic adolescents and 17 non-autistic age, sex, and BMI matched peers who ran at self-selected and standardized (3.0 m/s) speeds. Group × speed knee and ankle joint stiffness, change in moment, and range of motion were compared using mixed-model ANOVAs. There were no group × speed interactions for any variable. Autistic adolescents presented with significant (12 % and 19 %) reduced knee and ankle joint stiffness, respectively. In addition, autistic adolescents had significant reduced changes in knee and ankle joint moments by 11 % and 21 %, respectively, compared to their non-autistic peers. Only knee joint stiffness and knee joint moments were sensitive to running speed, each significantly increasing with speed by 6 %. Current literature suggests joint stiffness is an important mechanism for stability and usage of the stretch shortening cycle (or elastic recoil); as such, it is possible that the reduced ankle plantar flexor and knee extensor stiffness found in autistic adolescents in this study could be indicative of reduced efficiency during running. As group differences existed across both speeds, autistic adolescents may benefit from therapeutic and/or educational interventions targeting efficient running mechanics.
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Affiliation(s)
- Lauren A Luginsland
- Department of Human Movement Sciences, 2016 Student Recreation Center, Old Dominion University, Norfolk, VA 23529, United States.
| | - Justin A Haegele
- Department of Human Movement Sciences, 2016 Student Recreation Center, Old Dominion University, Norfolk, VA 23529, United States.
| | - Hunter J Bennett
- Department of Human Movement Sciences, 2016 Student Recreation Center, Old Dominion University, Norfolk, VA 23529, United States.
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Baxter-Jones ADG, Jackowski SA. Sex differences in bone mineral content and bone geometry accrual: a review of the Paediatric Bone Mineral Accural Study (1991-2017). Ann Hum Biol 2022; 48:503-516. [PMID: 35105203 DOI: 10.1080/03014460.2021.2014568] [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: 10/19/2022]
Abstract
CONTEXT Girls' and boys' growth patterns differ in timing and tempo, and they have different lifestyles with regards to diet and physical activity. These factors have all been linked with bone mineral accrual. OBJECTIVE To identify the associations of boys' and girls' growth, maturation, and lifestyle choices relating to parameters of bone geometry and mineral accrual. METHODS Between 1991 and 1993, 251 children aged 8-15 years were recruited into a mixed-longitudinal cohort study (The Paediatric Bone Mineral Accrual Study (PBMAS)) and followed repeatedly over 26 years. RESULTS It was found that girls matured approximately two years earlier than boys (11.8 vs. 13.4 years) but on average were shorter, had less lean mass and had greater fat mass (p < 0.05). There was a dissociation between the growth of bone and its mineralisation in both sexes. Boys had greater bone mass and bone geometry (p < 0.05). Both a healthy childhood diet and high levels of physical activity were associated with improved bone parameters. CONCLUSIONS Most, but not all, of the sex differences observed, were explained by height and lean mass differences. The importance of diet and physical activity on obtaining optimal bone mass during adolescence in both sexes was also paramount.
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Affiliation(s)
| | - Stefan A Jackowski
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada.,Research Institute, Children's Hospital of Eastern Ontario, Ottawa, Canada
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Kindler J, Zhan D, Sattler ELP, Ishikawa Y, Chen X, Gallo S. Bone density in youth with prediabetes: results from the National Health and Nutrition Examination Survey, 2005-2006. Osteoporos Int 2022; 33:467-474. [PMID: 34523010 DOI: 10.1007/s00198-021-06148-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 09/03/2021] [Indexed: 10/20/2022]
Abstract
UNLABELLED Youth with type 2 diabetes might have suboptimal peak bone mass, but it is unknown whether similar effects are evident in youth with prediabetes. Results from this study suggest that diabetes-related effects on peak bone mass likely occur before disease onset, and involve the muscle-bone unit. INTRODUCTION Type 2 diabetes might adversely influence bone health around the age of peak bone mass, but it is unknown whether diabetes-related effects on areal bone mineral density (aBMD) are evident in youth with prediabetes. We compared age-related trends in aBMD and associations between lean body mass (LBM) and aBMD between children and adolescents with prediabetes vs. normal glucose regulation. METHODS Cross-sectional analysis of data from the National Health and Nutrition Examination Survey (2005-2006) in youth ages 12-20 years (49% female, 34% black) with prediabetes (n = 267) and normal glucose regulation (n = 1664). Whole body aBMD and LBM were assessed via DXA. LBM index (LBMI) and Z-scores for aBMD and LBMI were computed. RESULTS Unadjusted between-group comparisons revealed greater mean weight and LBMI Z-scores in youth with prediabetes vs. normal glucose regulation, but similar bone Z-scores between the two groups. While accounting for differences in BMI Z-score, there was a significant interaction between prediabetes status and age with respect to whole body aBMD Z-score (P < 0.05), such that children with prediabetes tended to have increased aBMD but adolescents and young adults with prediabetes tended have lower aBMD. Furthermore, the positive association between LBMI and whole body aBMD was moderated in youth with prediabetes (P < 0.001), who had slightly lower whole body aBMD for a given LBMI (P = 0.068). Lumbar spine bone measures did not differ between the two groups. CONCLUSIONS Type 2 diabetes-related threats to peak bone mass might occur prior to disease onset, therefore potentially impacting a considerable proportion of US youth.
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Affiliation(s)
- J Kindler
- Department of Nutritional Sciences, University of Georgia, 305 Sanford Drive, 279 Dawson Hall, Athens, GA, 30602, USA.
| | - D Zhan
- Department of Statistics, University of Georgia, Athens, GA, USA
| | - E L P Sattler
- Department of Nutritional Sciences, University of Georgia, 305 Sanford Drive, 279 Dawson Hall, Athens, GA, 30602, USA
- Department of Clinical and Administrative Pharmacy, University of Georgia, Athens, GA, USA
| | - Y Ishikawa
- Department of Nutritional Sciences, University of Georgia, 305 Sanford Drive, 279 Dawson Hall, Athens, GA, 30602, USA
| | - X Chen
- Department of Statistics, University of Georgia, Athens, GA, USA
| | - S Gallo
- Department of Nutritional Sciences, University of Georgia, 305 Sanford Drive, 279 Dawson Hall, Athens, GA, 30602, USA
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Rinaldo N, Gualdi-Russo E, Zaccagni L. Influence of Size and Maturity on Injury in Young Elite Soccer Players. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063120. [PMID: 33803535 PMCID: PMC8003020 DOI: 10.3390/ijerph18063120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 02/06/2023]
Abstract
The involvement of pre-adolescents in soccer is becoming more and more frequent, and this growing participation generates some concerns about the potential factors for sports injuries. The purpose of this study was to investigate sports injuries in younger (U9–U11) and older (U12–U13) children playing soccer at an elite level, analyzing potential anthropometric and maturity risk factors. A total of 88 elite soccer players aged 9–13 years were investigated. Weight, stature, and sitting height were measured at the start and at the end of the competitive season, computing the relative growth velocities. Additional body composition parameters were taken during a second survey. Maturity offset was calculated using predictive equations based on anthropometric traits such as years from age at peak height velocity (YPHV). Injuries suffered during the competitive season were recorded. Maturity and some anthropometric characteristics were significantly different according to the presence or absence of injuries among the players. Multiple logistic regression revealed that YPHV, body mass index (BMI), and calf muscle area were the factors most significantly correlated with injuries. Players with increased BMI, with decreased calf muscle area, and who were closer to their peak height velocity, were at a higher risk of injury. Findings showed that a monitoring program of anthropometric characteristics taking into account the maturational stage needs to be developed to prevent injuries.
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Ludwa IA, Mongeon K, Sanderson M, Gracia Marco L, Klentrou P. Testing the Functional Model of Bone Development: Direct and Mediating Role of Muscle Strength on Bone Properties in Growing Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063154. [PMID: 33803781 PMCID: PMC8003175 DOI: 10.3390/ijerph18063154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/14/2021] [Accepted: 03/16/2021] [Indexed: 11/29/2022]
Abstract
This study examines the functional model of bone development in peri-pubertal boys and girls. Specifically, we implemented a mixed-longitudinal design and hierarchical structural models to provide experimental evidence in support of the conceptual functional model of bone development, postulating that the primary mechanical stimulus of bone strength development is muscle force. To this end, we measured radial and tibial bone properties (speed of sound, SOS), isometric grip and knee extensors strength, bone resorption (urinary NTX concentration), body mass index (BMI), somatic maturity (years from peak height velocity) and skeletal maturity (bone age) in 180 children aged 8–16 years. Measurements were repeated 2–4 times over a period of 3 years. The multilevel structural equation modeling of 406 participant-session observations revealed similar results for radial and tibial SOS. Muscle strength (i.e., grip strength for the radial and knee extension for tibial model) and NTX have a significant direct effect on bone SOS (β = 0.29 and −0.18, respectively). Somatic maturity had a direct impact on muscle strength (β = 0.24) and both a direct and indirect effect on bone SOS (total effect, β = 0.30). Physical activity and BMI also had a significant direct impact on bone properties, (β = 0.06 and −0.18, respectively), and an additional significant indirect effect through muscle strength (β = 0.01 and 0.05, respectively) with small differences per bone site and sex. Muscle strength fully mediated the impact of bone age (β = 0.14) while there was no significant effect of energy intake on either muscle strength or bone SOS. In conclusion, our results support the functional model of bone development in that muscle strength and bone metabolism directly affect bone development while the contribution of maturity, physical activity, and other modulators such as BMI, on bone development is additionally modulated through their effect on muscle strength.
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Affiliation(s)
- Izabella A. Ludwa
- Centre for Bone and Muscle Health, Brock University, St. Catharines, ON L2S 3A1, Canada;
| | - Kevin Mongeon
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Malcolm Sanderson
- Department of Kinesiology, Brock University, St. Catharines, ON L2S 3A1, Canada;
| | - Luis Gracia Marco
- Department of Physical Education and Sports, PROFITH “PROmoting FITness and Health through Physical Activity” Research Group, Sport and Health University Research Institute (iMUDS), University of Granada, 18071 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Panagiota Klentrou
- Centre for Bone and Muscle Health, Brock University, St. Catharines, ON L2S 3A1, Canada;
- Department of Kinesiology, Brock University, St. Catharines, ON L2S 3A1, Canada;
- Correspondence: ; Tel.: +1-905-688-5550 (ext. 4538)
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The Mediating Role of Lean Soft Tissue in the Relationship between Somatic Maturation and Bone Density in Adolescent Practitioners and Non-Practitioners of Sports. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063008. [PMID: 33804074 PMCID: PMC8000751 DOI: 10.3390/ijerph18063008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/08/2021] [Accepted: 03/10/2021] [Indexed: 12/24/2022]
Abstract
This study aimed to identify the mediating effect of lean soft tissue (LST) in the association between somatic maturation and areal bone mineral density (aBMD) in adolescents by sex and sport participation. The sample included 558 adolescents (401 males, mean age of 14.0 years) that were practitioners of sports (11 sport modalities, n = 402) and a non-sport group (n = 157). Somatic maturation was assessed by using a validated peak height velocity prediction equation. Dual-energy X-ray absorptiometry (DXA) was used to assess aBMD (upper and lower limbs, spine and total body less head—TBLH) and LST. For both sexes, LST mediated the association between somatic maturation and aBMD at all skeletal sites (mediation percentage ranging from 36.3% to 75.4%). For sport and non-sport groups, the LST also mediated the association between somatic maturation and aBMD at all skeletal sites (mediation percentage ranging from 51.6% to 85.6%). The direct effect was observed in all groups, except for lower limbs and TBLH in the non-sport group. The association between somatic maturation and aBMD was mediated by LST in adolescents of both sexes and regardless of involvement in organized sports. Our findings highlighted the role of improving LST to mitigate the association of somatic maturation with aBMD.
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Marcucci G, Beltrami G, Tamburini A, Body JJ, Confavreux CB, Hadji P, Holzer G, Kendler D, Napoli N, Pierroz DD, Rizzoli R, Brandi ML. Bone health in childhood cancer: review of the literature and recommendations for the management of bone health in childhood cancer survivors. Ann Oncol 2020; 30:908-920. [PMID: 31111878 DOI: 10.1093/annonc/mdz120] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
In the past decades, new cancer treatment approaches for children and adolescents have led to a decrease in recurrence rates and an increase in long-term survival. Recent studies have focused on the evaluation of the late effects on bone of pediatric cancer-related treatments, such as chemotherapy, radiation and surgery. Treatment of childhood cancer can impair the attainment of peak bone mass, predisposing to premature onset of low bone mineral density, or causing other bone side-effects, such as bone quality impairment or avascular necrosis of bone. Lower bone mineral density and microarchitectural deterioration can persist during adulthood, thereby increasing fracture risk. Overall, long-term follow-up of childhood cancer survivors is essential to define specific groups at higher risk of long-term bone complications, identify unrecognized long-term adverse effects, and improve patient care. Children and adolescents with a cancer history should be carefully monitored, and patients should be informed of possible late complications of their previous medical treatment. The International Osteoporosis Foundation convened a working group to review the bone complications of pediatric cancer survivors, outlining recommendations for the management of bone health, in order to prevent and treat these complications.
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Affiliation(s)
- G Marcucci
- Bone Metabolic Diseases Unit, Department of Biomedical, Experimental and Clinical Sciences, University of Florence
| | - G Beltrami
- Department of Pediatric Orthopaedic Oncology
| | - A Tamburini
- Hematology-Oncology Service, Department of Pediatrics, University Hospital AOU-Careggi, Florence, Italy
| | - J J Body
- Université Libre de Bruxelles, Brussels, Belgium
| | - C B Confavreux
- University of Lyon - INSERM UMR 1033-Lyos - Expert Center for Bone Metastases and Secondary Bone Oncology (CEMOS), Rheumatology Department Hospices Civils de Lyon, Pierre Bénite, France
| | - P Hadji
- Department of Bone Oncology, Endocrinology and Reproductive Medicine, Nord West Hospital, Frankfurt, Germany
| | - G Holzer
- Department of Orthopedics and Traumatology, Medical University of Vienna, Vienna, Austria
| | - D Kendler
- Division of Endocrinology, Department of Medicine, University of British Columbia, Vancouver, Canada
| | - N Napoli
- Unit of Endocrinology and Diabetes, Department of Medicine, Università Campus Bio-Medico di Roma, Roma, Italy; Division of Bone and Mineral Diseases, Washington University in St Louis, St Louis, USA
| | - D D Pierroz
- International Osteoporosis Foundation (IOF), Nyon
| | - R Rizzoli
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - M L Brandi
- Bone Metabolic Diseases Unit, Department of Biomedical, Experimental and Clinical Sciences, University of Florence.
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Takei S, Taketomi S, Tanaka S, Torii S. Growth pattern of lumbar bone mineral content and trunk muscles in adolescent male soccer players. J Bone Miner Metab 2020; 38:338-345. [PMID: 31701340 DOI: 10.1007/s00774-019-01060-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 10/22/2019] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Previous studies have reported that the peak in lean body mass (LBM) precedes the peak in bone mineral content (BMC). However, it is unknown whether the trunk region growth is similar. MATERIALS AND METHODS We investigated the difference between pubertal peak age in the increase of LBM in the trunk (trunk LBM) and pubertal peak age in the increase of BMC in the lumbar spine (lumbar BMC) in a longitudinal study of 201 Japanese male adolescent soccer players. The age of peak height velocity (PHV) and the developmental age were calculated. The participants were followed over a 2-year period, with height and dual-energy X-ray absorptiometry scans taken every 6 months. RESULTS The trunk LBM (ρ = 0.732, p < 0.0001) and the lumbar BMC (ρ = 0.621, p < 0.0001) significantly correlated with the developmental age. The increase of trunk LBM and lumbar BMC was significantly different according to the developmental stages (Kruskal-Wallis test; p < 0.0001 and p < 0.001, respectively). We used a cubic spline to estimate the developmental age, when the increase reached its peak: the peak age of the increase in trunk LBM was estimated to be - 0.08 years (approximately - 1 month) prior to PHV age, whereas the peak age of the increase in lumbar BMC was estimated to be 0.42 years (approximately 5 months) after the PHV age. CONCLUSIONS The maximal increase in trunk LBM occurs just before PHV age and approximately 6 months before the maximal increase in lumbar BMC during the pubertal growth spurt in the Japanese adolescent male soccer players.
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Affiliation(s)
- Seira Takei
- Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongou, Bunkyouku, Tokyo, 113-0033, Japan
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan
| | - Shuji Taketomi
- Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongou, Bunkyouku, Tokyo, 113-0033, Japan
| | - Sakae Tanaka
- Sensory and Motor System Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongou, Bunkyouku, Tokyo, 113-0033, Japan
| | - Suguru Torii
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan.
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Serum Sclerostin, Body Composition, and Sarcopenia in Hemodialysis Patients with Diabetes. Int J Nephrol 2020; 2020:4596920. [PMID: 32095286 PMCID: PMC7035555 DOI: 10.1155/2020/4596920] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 01/02/2020] [Accepted: 01/08/2020] [Indexed: 12/19/2022] Open
Abstract
Sclerostin (Scl) is an osteoblast-inhibiting glycoprotein that is secreted mainly by osteocytes and is regulated by hormonal changes and skeletal loading. Decreased physical function and high serum Scl concentrations have been reported in chronic renal failure patients but little is known to date about the differences between diabetic and non-diabetic patients on hemodialysis who are susceptible to both sarcopenia and bone fragility. Objective.To determine the prevalence of sarcopenia and its association with serum Scl concentrations and metabolic parameters in 92 patients on hemodialysis. Anthropometric data and physical performance were evaluated in this study. Blood samples were collected for Scl, glucose, cholesterol, triglycerides, calcium, phosphate, PTH, and 25 OH-vitamin D measurements. Lean mass was evaluated using multifrequency electro-bioimpedance after dialysis session. Results. Mean age was 63.3 ± 13.6 years, 63% of patients were male, and 44.6% had diabetes. Mean body mass index (BMI) was higher in diabetics (26.6 ± 5.2 vs. 24.1 ± 3.7; p=0.01) and there were no differences in gait speed and handgrip strength between diabetic and non-diabetic subjects. A low skeletal muscle mass index (SMI) was identified in 65.2% of the participants, and among them 76.7% were men and 36.7% were diabetics. Mean serum Scl was 86.9 ± 39.0 pmol/L, which was higher in men (94.6 ± 41.7; p=0.017), in those individuals with low SMI (94.9 ± 40.7; p < 0.001), and in diabetics (97.2 ± 46.6; p < 0.003). After multivariate analysis and adjustments for potential confounders, high serum Scl was independently associated with low SMI and with the presence of diabetes. The following variables correlated positively with diabetes: blood pressure; BMI; waist circumference; waist/hip ratio; plasma glucose; serum Scl; and fat mass. Conclusions. We found higher serum Scl concentrations in hemodialysis patients with diabetes and these were inversely related to muscle mass.
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Burd NA, McKenna CF, Salvador AF, Paulussen KJ, Moore DR. Dietary Protein Quantity, Quality, and Exercise Are Key to Healthy Living: A Muscle-Centric Perspective Across the Lifespan. Front Nutr 2019; 6:83. [PMID: 31245378 PMCID: PMC6563776 DOI: 10.3389/fnut.2019.00083] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Accepted: 05/21/2019] [Indexed: 12/19/2022] Open
Abstract
A healthy eating pattern, regardless of age, should consist of ingesting high quality protein preferably in adequate amounts across all meals throughout the day. Of particular relevance to overall health is the growth, development, and maintenance of skeletal muscle tissue. Skeletal muscle not only contributes to physical strength and performance, but also contributes to efficient macronutrient utilization and storage. Achieving an optimal amount of muscle mass begins early in life with transitions to "steady-state" maintenance as an adult, and then safeguarding against ultimate decline of muscle mass with age, all of which are influenced by physical activity and dietary (e.g., protein) factors. Current protein recommendations, as defined by recommended dietary allowances (RDA) for the US population or the population reference intakes (PRI) in Europe, are set to cover basic needs; however, it is thought that a higher protein intake might be necessary for optimizing muscle mass, especially for adults and individuals with an active lifestyle. It is necessary to balance the accurate assessment of protein quality (e.g., digestible indispensable amino acid score; DIAAS) with methods that provide a physiological correlate (e.g., established measures of protein synthesis, substrate oxidation, lean mass retention, or accrual, etc.) in order to accurately define protein requirements for these physiological outcomes. Moreover, current recommendations need to shift from single nutrient guidelines to whole food based guidelines in order to practically acknowledge food matrix interactions and other required nutrients for potentially optimizing the health effects of food. The aim of this paper is to discuss protein quality and amount that should be consumed with consideration to the presence of non-protein constituents within a food matrix and potential interactions with physical activity to maximize muscle mass throughout life.
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Affiliation(s)
- Nicholas A. Burd
- Department of Kinesiology and Community Health, University of Illinois, Urbana, IL, United States
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, United States
| | - Colleen F. McKenna
- Division of Nutritional Sciences, University of Illinois, Urbana, IL, United States
| | - Amadeo F. Salvador
- Department of Kinesiology and Community Health, University of Illinois, Urbana, IL, United States
| | - Kevin J.M. Paulussen
- Department of Kinesiology and Community Health, University of Illinois, Urbana, IL, United States
| | - Daniel R. Moore
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
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13
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Luiz-de-Marco R, Kemper H, Agostinete RR, Werneck AO, Maillane-Vanegas S, Faustino-da-Silva YDS, Exupério I, Fernandes RA. Sports participation and muscle mass affect sex-related differences in bone mineral density between male and female adolescents: A longitudinal study. SAO PAULO MED J 2019; 137:75-81. [PMID: 31116275 PMCID: PMC9721219 DOI: 10.1590/1516-3180.2018.031040119] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 01/04/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Sports participation plays an important role in bone gain during childhood and adolescence. The aim here was to identify sex-related determinants of bone mineral density (BMD) differences between male and female adolescents, with emphasis on the role of sports participation. DESIGN AND SETTING Longitudinal study conducted in a public university in Presidente Prudente, Brazil. METHODS The sample comprised 48 adolescents aged 11-17 years, of both sexes, who were matched according to sex, age and sports participation. BMD was the main outcome, while muscle mass, sports participation, calendar age and biological maturation were treated as covariates. Participants were followed up after nine months. RESULTS At baseline, BMD values were similar between the sexes. However, adjustment for covariates showed that BMD was higher among girls at all sites, with a contribution from lean soft tissue (LST) in the model (partial eta-squared, ES-r = 0.619 in upper limbs; 0.643 in lower limbs; 0.699 in spine; and 0.599 in whole body). Sports participation only explained the upper-limb variance (ES-r = 0.99). At the follow-up, the results resembled the baseline except in the lower limbs (P = 0.109), in which BMD was similar between the groups. BMD gain over time was similar between girls and boys in all segments, and baseline LST affected upper-limb and whole-body BMD accrual (ES-r = 0.396 and 0.107, respectively). CONCLUSION Whole-body and specific-site BMD differed between baseline and follow-up. However,BMD accrual was similar between the sexes, given that muscle mass constituted the most relevant determinant of the difference between them.
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Affiliation(s)
- Rafael Luiz-de-Marco
- Master's Student and Researcher of Physical Education, Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Universidade Estadual Paulista (UNESP), and Postgraduate Student, Postgraduate Program on Physical Therapy, Department of Physical Therapy, UNESP, Presidente Prudente (SP), Brazil
| | - Han Kemper
- PhD. Emeritus Professor, Amsterdam UMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Ricardo Ribeiro Agostinete
- MSc. Researcher, Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil
| | - André Oliveira Werneck
- Master's Student and Researcher, Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil
| | - Santiago Maillane-Vanegas
- MSc. Researcher,Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Universidade Estadual Paulista (UNESP), and Doctoral Student, Postgraduate Program on Physical Therapy, Department of Physical Therapy, UNESP, Presidente Prudente (SP), Brazil
| | - Yuri da Silva Faustino-da-Silva
- Master's Student and Researcher of Physical Education, Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Universidade Estadual Paulista (UNESP), and Postgraduate Student, Postgraduate Program on Physical Therapy, Department of Physical Therapy, UNESP, Presidente Prudente (SP), Brazil
| | - Isabella Exupério
- Master's Student and Researcher of Physical Education, Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Universidade Estadual Paulista (UNESP), and Postgraduate Student, Postgraduate Program on Physical Therapy, Department of Physical Therapy, UNESP, Presidente Prudente (SP), Brazil
| | - Rômulo Araújo Fernandes
- PhD. Associate Professor, Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Universidade Estadual Paulista (UNESP); Associate Professor, Postgraduate Program on Physical Therapy, Department of Physical Therapy, UNESP; and Associate Professor, Postgraduate Program on Movement Sciences, Department of Physical Education, UNESP, Presidente Prudente (SP), Brazil
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14
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Bailey RL, Sahni S, Chocano-Bedoya P, Daly RM, Welch AA, Bischoff-Ferrari H, Weaver CM. Best Practices for Conducting Observational Research to Assess the Relation between Nutrition and Bone: An International Working Group Summary. Adv Nutr 2019; 10:391-409. [PMID: 30926984 PMCID: PMC6520043 DOI: 10.1093/advances/nmy111] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/30/2018] [Accepted: 11/12/2018] [Indexed: 12/14/2022] Open
Abstract
Diet is a modifiable factor that can affect bone strength and integrity, and the risk of fractures. Currently, a hierarchy of scientific evidence contributes to our understanding of the role of diet on bone health and fracture risk. The strength of evidence is generally based on the type of study conducted, the quality of the methodology employed, the rigor and integrity of the data collected and analysis plan, and the transparency and completeness of the results. Randomized controlled trials (RCTs) are considered to be the gold standard from a clinical research paradigm, but there is a dearth of high-quality diet-related intervention trials with bone as the primary outcome, forcing the use of observational research to inform research and clinical practices. However, for observational research to be of the most utility, standardization and optimization of the study design, accurate and reliable measurement of key variables, and appropriate data analysis and data reporting are paramount. Although there have been recommendations made in relation to RCTs in the field of nutrition, no clear rubric exists for best practices in conducting observational research with regard to nutrition and bone health. Therefore, the purpose of this paper is to describe the best practices and considerations for designing, conducting, analyzing, interpreting, and reporting observational research specifically for understanding the role of nutrition in bone health, amassed by a global panel of scientific experts with strengths in bone, nutrition epidemiology, physical activity, public health, clinical and translational trials, and observational study methods. The global panel of scientific experts represents the leadership and selected participants from the 10th annual International Symposium for the Nutritional Aspects of Osteoporosis. The topics selected and best practices presented reflect expert opinion and areas of scientific expertise of the authors rather than a systematic or comprehensive literature review or professional reporting guidelines.
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Affiliation(s)
- Regan L Bailey
- Department of Nutrition Science, Purdue University, West Lafayette, IN,Address correspondence to RLB (e-mail: )
| | - Shivani Sahni
- Institute for Aging Research, Hebrew SeniorLife and Harvard Medical School
| | | | - Robin M Daly
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Melbourne, Australia
| | - Ailsa A Welch
- Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, United Kingdom
| | | | - Connie M Weaver
- Department of Nutrition Science, Purdue University, West Lafayette, IN
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15
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Abstract
This commentary highlights 23 noteworthy publications from 2018, selected by leading scientists in pediatric exercise science. These publications have been deemed as significant or exciting in the field as they (a) reveal a new mechanism, (b) highlight a new measurement tool, (c) discuss a new concept or interpretation/application of an existing concept, or (d) describe a new therapeutic approach or clinical tool in youth. In some cases, findings in adults are highlighted, as they may have important implications in youth. The selected publications span the field of pediatric exercise science, specifically focusing on: aerobic exercise and training; neuromuscular physiology, exercise, and training; endocrinology and exercise; resistance training; physical activity and bone strength; growth, maturation, and exercise; physical activity and cognition; childhood obesity, physical activity, and exercise; pulmonary physiology or diseases, exercise, and training; immunology and exercise; cardiovascular physiology and disease; and physical activity, inactivity, and health.
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16
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Abstract
Understanding how exercise and dietary protein alter the turnover and synthesis of body proteins in youth can provide guidelines for the optimal development of lean mass. This review hypothesizes that active youth obtain similar anabolic benefits from exercise and dietary protein as adults, but the requirement for amino acids to support growth renders them more sensitive to these nutrients.
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Affiliation(s)
- Daniel R Moore
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
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17
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Faustino-da-Silva YDSV, Agostinete RR, Werneck AO, Maillane-Vanegas S, Lynch KR, Exupério IN, Ito IH, Fernandes RA. Track and Field Practice and Bone Outcomes among Adolescents: A Pilot Study (ABCD-Growth Study). J Bone Metab 2018; 25:35-42. [PMID: 29564304 PMCID: PMC5854821 DOI: 10.11005/jbm.2018.25.1.35] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 02/20/2018] [Accepted: 02/21/2018] [Indexed: 11/21/2022] Open
Abstract
Background Osteoporosis is considered a public health problem with high worldwide prevalence. One approach to prevention is through the promotion of physical activity, especially exercise, during adolescence. Methods This study compared bone variables in different body segments in adolescents according to participation in track and field. The study included 34 adolescents (22 boys), of whom 17 were track and field athletes and 17 were control subjects. Bone mineral density (BMD, g/cm2) and bone mineral content (BMC, g) were analyzed using dual energy X-ray absorptiometry (total body stratified by body segments). Peak height velocity was used to estimate somatic maturation. Results Athletes had higher BMD (P=0.003) and BMC (P=0.011) values in the lower limbs and higher whole body BMD (P=0.025) than the control group. However, when adjusted for confounding factors, the difference was not maintained. The groups had similar lean soft tissue values (P=0.094). Training overload was positively correlated with BMD in the upper limbs (r=0.504; 95% confidence interval, 0.031-0.793). Although track and field athletes had higher BMD and BMC values in the lower limbs, these differences were not significant when adjusted for confounding factors. Conclusions Track and field participation in adolescence appears to influence BMD and BMC in lower limbs, and fat-free mass seems to mediate this effect. Also, higher training loads were found to be positive for bone health in upper limbs.
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Affiliation(s)
- Yuri da Silva Ventura Faustino-da-Silva
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, São Paulo State University (UNESP), São Paulo, Brazil.,Post-Graduation Program in Physical Therapy, São Paulo State University (UNESP), São Paulo, Brazil
| | - Ricardo Ribeiro Agostinete
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, São Paulo State University (UNESP), São Paulo, Brazil.,Post-Graduation Program in Movement Sciences, Institute of Biosciences, São Paulo State University (UNESP), São Paulo, Brazil
| | - André Oliveira Werneck
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, São Paulo State University (UNESP), São Paulo, Brazil.,Post-Graduation Program in Movement Sciences, Institute of Biosciences, São Paulo State University (UNESP), São Paulo, Brazil
| | - Santiago Maillane-Vanegas
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, São Paulo State University (UNESP), São Paulo, Brazil.,Post-Graduation Program in Physical Therapy, São Paulo State University (UNESP), São Paulo, Brazil
| | - Kyle Robinson Lynch
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, São Paulo State University (UNESP), São Paulo, Brazil.,Post-Graduation Program in Movement Sciences, Institute of Biosciences, São Paulo State University (UNESP), São Paulo, Brazil
| | - Isabella Neto Exupério
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, São Paulo State University (UNESP), São Paulo, Brazil
| | - Igor Hideki Ito
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, São Paulo State University (UNESP), São Paulo, Brazil.,Post-Graduation Program in Movement Sciences, Institute of Biosciences, São Paulo State University (UNESP), São Paulo, Brazil
| | - Romulo Araújo Fernandes
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, São Paulo State University (UNESP), São Paulo, Brazil.,Post-Graduation Program in Movement Sciences, Institute of Biosciences, São Paulo State University (UNESP), São Paulo, Brazil.,Post-Graduation Program in Physical Therapy, São Paulo State University (UNESP), São Paulo, Brazil
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18
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Padua DA, DiStefano LJ, Hewett TE, Garrett WE, Marshall SW, Golden GM, Shultz SJ, Sigward SM. National Athletic Trainers' Association Position Statement: Prevention of Anterior Cruciate Ligament Injury. J Athl Train 2018; 53:5-19. [PMID: 29314903 DOI: 10.4085/1062-6050-99-16] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To provide certified athletic trainers, physicians, and other health care and fitness professionals with recommendations based on current evidence regarding the prevention of noncontact and indirect-contact anterior cruciate ligament (ACL) injuries in athletes and physically active individuals. BACKGROUND Preventing ACL injuries during sport and physical activity may dramatically decrease medical costs and long-term disability. Implementing ACL injury-prevention training programs may improve an individual's neuromuscular control and lower extremity biomechanics and thereby reduce the risk of injury. Recent evidence indicates that ACL injuries may be prevented through the use of multicomponent neuromuscular-training programs. RECOMMENDATIONS Multicomponent injury-prevention training programs are recommended for reducing noncontact and indirect-contact ACL injuries and strongly recommended for reducing noncontact and indirect-contact knee injuries during physical activity. These programs are advocated for improving balance, lower extremity biomechanics, muscle activation, functional performance, strength, and power, as well as decreasing landing impact forces. A multicomponent injury-prevention training program should, at minimum, provide feedback on movement technique in at least 3 of the following exercise categories: strength, plyometrics, agility, balance, and flexibility. Further guidance on training dosage, intensity, and implementation recommendations is offered in this statement.
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19
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Kindler JM, Pollock NK, Ross HL, Modlesky CM, Singh H, Laing EM, Lewis RD. Obese Versus Normal-Weight Late-Adolescent Females have Inferior Trabecular Bone Microarchitecture: A Pilot Case-Control Study. Calcif Tissue Int 2017; 101:479-488. [PMID: 28710506 PMCID: PMC5705220 DOI: 10.1007/s00223-017-0303-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 07/06/2017] [Indexed: 12/16/2022]
Abstract
Though still a topic of debate, the position that skeletal health is compromised with obesity has received support in the pediatric and adult literature. The limited data relating specifically to trabecular bone microarchitecture, however, have been relatively inconsistent. The aim of this pilot cross-sectional case-control study was to compare trabecular bone microarchitecture between obese (OB) and normal-weight (NW) late-adolescent females. A secondary aim was to compare diaphyseal cortical bone outcomes between these two groups. Twenty-four non-Hispanic white females, ages 18-19 years, were recruited into OB (n = 12) or NW (n = 12) groups based on pre-specified criteria for percent body fat (≥32 vs. <30, respectively), body mass index (>90th vs. 20th-79th, respectively), and waist circumference (≥90th vs. 25th-75th, respectively). Participants were also individually matched on age, height, and oral contraceptive use. Using magnetic resonance imaging, trabecular bone microarchitecture was assessed at the distal radius and proximal tibia metaphysis, and cortical bone architecture was assessed at the mid-radius and mid-tibia diaphysis. OB versus NW had lower apparent trabecular thickness (radius and tibia), higher apparent trabecular separation (radius), and lower apparent bone volume to total volume (radius; all P < 0.050). Some differences in radius and tibia trabecular bone microarchitecture were retained after adjusting for insulin resistance or age at menarche. Mid-radius and mid-tibia cortical bone volume and estimated strength were lower in the OB compared to NW after adjusting for fat-free soft tissue mass (all P < 0.050). These trabecular and cortical bone deficits might contribute to the increased fracture risk in obese youth.
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Affiliation(s)
- Joseph M Kindler
- Department of Foods and Nutrition, The University of Georgia, 279 Dawson Hall, 305 Sanford Drive, Athens, GA, USA
| | - Norman K Pollock
- Department of Pediatrics, Augusta University, HS-1640 Health Sciences Campus, Augusta, GA, USA
| | - Hannah L Ross
- Department of Foods and Nutrition, The University of Georgia, 279 Dawson Hall, 305 Sanford Drive, Athens, GA, USA
| | - Christopher M Modlesky
- Department of Kinesiology, The University of Georgia, Ramsey Center, 330 River Rd, Athens, GA, USA
| | - Harshvardhan Singh
- Department of Kinesiology & Applied Physiology, University of Delaware, 201 N STAR Health Sciences Complex, Newark, DE, USA
| | - Emma M Laing
- Department of Foods and Nutrition, The University of Georgia, 279 Dawson Hall, 305 Sanford Drive, Athens, GA, USA
| | - Richard D Lewis
- Department of Foods and Nutrition, The University of Georgia, 279 Dawson Hall, 305 Sanford Drive, Athens, GA, USA.
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20
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McCormack SE, Cousminer DL, Chesi A, Mitchell JA, Roy SM, Kalkwarf HJ, Lappe JM, Gilsanz V, Oberfield SE, Shepherd JA, Winer KK, Kelly A, Grant SFA, Zemel BS. Association Between Linear Growth and Bone Accrual in a Diverse Cohort of Children and Adolescents. JAMA Pediatr 2017; 171:e171769. [PMID: 28672287 PMCID: PMC5632753 DOI: 10.1001/jamapediatrics.2017.1769] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
IMPORTANCE Prevention of osteoporosis in adulthood begins with optimizing bone health in early life. The longitudinal association between growth and bone accretion during childhood is not fully understood. OBJECTIVES To assess the acquisition of whole-body (WB) and skeletal site-specific bone mineral content (BMC) relative to linear growth in a healthy, diverse, longitudinal cohort of children, adolescents, and young adults and to test for differences related to sex and African American race. DESIGN, SETTING, AND PARTICIPANTS This investigation was a mixed longitudinal study with annual assessments for up to 7 years at 5 US clinical centers. Participants were healthy children, adolescents, and young adults. The study dates were July 2002 through March 2010. The dates of the analysis were June through December 2016. MAIN OUTCOMES AND MEASURES Anthropometrics, BMC, and body composition via dual-energy x-ray absorptiometry. The superimposition by translation and rotation (SITAR) analysis method was used to define the mean trajectories for height, WB lean soft tissue, appendicular lean soft tissue, and WB and skeletal site-specific BMC acquisition and to measure the age and magnitude of peak velocity for each parameter. The SITAR modeling was performed separately by sex and self-reported race. RESULTS Among 2014 healthy children, adolescents, and young adults (1022 [50.7%] female and 479 [23.8%] African American) aged 5 to 19 years at study entry, the mean age of peak height velocity was 13.1 years (95% CI, 13.0-13.2 years) in African American boys vs 13.4 years (95% CI, 13.3-13.4 years) in non-African American boys (difference, -0.3 years; 95% CI, -0.4 to -0.1 years) and 11.0 years (95% CI, 10.8-11.1 years) in African American girls vs 11.6 years (95% CI, 11.5-11.6 years) in non-African American girls (difference, -0.6 years; 95% CI, -0.7 to -0.5 years). Age of peak acquisition of WB BMC was 14.0 years (95% CI, 13.8-14.1 years) in African American boys vs 14.0 years (95% CI, 13.9-14.1 years) in non-African American boys (difference, -0.0 years; 95% CI, -0.2 to 0.2 years) and 12.1 years (95% CI, 12.0-12.3 years) in African American girls vs 12.4 years (95% CI, 12.3-12.5 years) in non-African American girls (difference, -0.3 years; 95% CI, -0.4 to -0.1 years). At age 7 years, children had acquired 69.5% to 74.5% of maximal observed height but only 29.6% to 38.1% of maximal observed WB BMC. Adolescents gained 32.7% to 35.8% of maximal observed WB BMC during the 2 years before and 2 years after peak height velocity. Another 6.9% to 10.7% of maximal observed WB BMC occurred after linear growth had ceased. In the group at highest risk for fracture, non-African American boys, peak fracture incidence occurred approximately 1 year before peak height velocity. CONCLUSIONS AND RELEVANCE In this longitudinal study, height gains substantially outpaced gains in BMC during childhood, which could contribute to fracture risk. A significant proportion of bone is accrued after adult height is achieved. Therefore, late adolescence represents a potentially underrecognized window of opportunity to optimize bone mass.
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Affiliation(s)
- Shana E. McCormack
- Division of Endocrinology and Diabetes, Department of Pediatrics, The Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Diana L. Cousminer
- Division of Human Genetics, Department of Pediatrics, The Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Alessandra Chesi
- Division of Human Genetics, Department of Pediatrics, The Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Jonathan A. Mitchell
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, The Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Sani M. Roy
- Division of Endocrinology, Department of Pediatrics, Cook Children’s Medical Center, Fort Worth, Texas
| | - Heidi J. Kalkwarf
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Joan M. Lappe
- College of Nursing, Creighton University, Omaha, NebraskaOsteoporosis Research Center, School of Medicine, Creighton University, Omaha, Nebraska
| | - Vicente Gilsanz
- Department of Radiology, Children’s Hospital Los Angeles, Keck School of Medicine of USC, University of Southern California, Los AngelesDepartment of Pediatrics, Children’s Hospital Los Angeles, Keck School of Medicine of USC, University of Southern California, Los Angeles
| | - Sharon E. Oberfield
- Division of Pediatric Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Columbia University, New York, New York
| | - John A. Shepherd
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
| | - Karen K. Winer
- Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Bethesda, Maryland
| | - Andrea Kelly
- Division of Endocrinology and Diabetes, Department of Pediatrics, The Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Struan F. A. Grant
- Division of Endocrinology and Diabetes, Department of Pediatrics, The Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, PhiladelphiaDivision of Human Genetics, Department of Pediatrics, The Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Babette S. Zemel
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, The Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia
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21
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Kindler JM, Pollock NK, Laing EM, Oshri A, Jenkins NT, Isales CM, Hamrick MW, Ding KH, Hausman DB, McCabe GP, Martin BR, Hill Gallant KM, Warden SJ, Weaver CM, Peacock M, Lewis RD. Insulin Resistance and the IGF-I-Cortical Bone Relationship in Children Ages 9 to 13 Years. J Bone Miner Res 2017; 32:1537-1545. [PMID: 28300329 PMCID: PMC5489353 DOI: 10.1002/jbmr.3132] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 03/03/2017] [Accepted: 03/04/2017] [Indexed: 12/27/2022]
Abstract
IGF-I is a pivotal hormone in pediatric musculoskeletal development. Although recent data suggest that the role of IGF-I in total body lean mass and total body bone mass accrual may be compromised in children with insulin resistance, cortical bone geometric outcomes have not been studied in this context. Therefore, we explored the influence of insulin resistance on the relationship between IGF-I and cortical bone in children. A secondary aim was to examine the influence of insulin resistance on the lean mass-dependent relationship between IGF-I and cortical bone. Children were otherwise healthy, early adolescent black and white boys and girls (ages 9 to 13 years) and were classified as having high (n = 147) or normal (n = 168) insulin resistance based on the homeostasis model assessment of insulin resistance (HOMA-IR). Cortical bone at the tibia diaphysis (66% site) and total body fat-free soft tissue mass (FFST) were measured by peripheral quantitative computed tomography (pQCT) and dual-energy X-ray absorptiometry (DXA), respectively. IGF-I, insulin, and glucose were measured in fasting sera and HOMA-IR was calculated. Children with high HOMA-IR had greater unadjusted IGF-I (p < 0.001). HOMA-IR was a negative predictor of cortical bone mineral content, cortical bone area (Ct.Ar), and polar strength strain index (pSSI; all p ≤ 0.01) after adjusting for race, sex, age, maturation, fat mass, and FFST. IGF-I was a positive predictor of most musculoskeletal endpoints (all p < 0.05) after adjusting for race, sex, age, and maturation. However, these relationships were moderated by HOMA-IR (pInteraction < 0.05). FFST positively correlated with most cortical bone outcomes (all p < 0.05). Path analyses demonstrated a positive relationship between IGF-I and Ct.Ar via FFST in the total cohort (βIndirect Effect = 0.321, p < 0.001). However, this relationship was moderated in the children with high (βIndirect Effect = 0.200, p < 0.001) versus normal (βIndirect Effect = 0.408, p < 0.001) HOMA-IR. These data implicate insulin resistance as a potential suppressor of IGF-I-dependent cortical bone development, though prospective studies are needed. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Joseph M Kindler
- Department of Foods and Nutrition, The University of Georgia, Athens, GA, USA
| | | | - Emma M Laing
- Department of Foods and Nutrition, The University of Georgia, Athens, GA, USA
| | - Assaf Oshri
- Department of Human Development and Family Science, The University of Georgia, Athens, GA, USA
| | - Nathan T Jenkins
- Department of Kinesiology, The University of Georgia, Athens, GA, USA
| | - Carlos M Isales
- Department of Neuroscience and Regenerative Medicine, Augusta University, Augusta, GA, USA
| | - Mark W Hamrick
- Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA, USA
| | - Ke-Hong Ding
- Department of Neuroscience and Regenerative Medicine, Augusta University, Augusta, GA, USA
| | - Dorothy B Hausman
- Department of Foods and Nutrition, The University of Georgia, Athens, GA, USA
| | - George P McCabe
- Department of Statistics, Purdue University, West Lafayette, IN, USA
| | - Berdine R Martin
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | | | - Stuart J Warden
- Department of Physical Therapy, Indiana University, Indianapolis, IN, USA
| | - Connie M Weaver
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Munro Peacock
- Department of Medicine, Indiana University, Indianapolis, IN, USA
| | - Richard D Lewis
- Department of Foods and Nutrition, The University of Georgia, Athens, GA, USA
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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: 743] [Impact Index Per Article: 92.9] [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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Kindler JM, Pollock NK, Laing EM, Jenkins NT, Oshri A, Isales C, Hamrick M, Lewis RD. Insulin Resistance Negatively Influences the Muscle-Dependent IGF-1-Bone Mass Relationship in Premenarcheal Girls. J Clin Endocrinol Metab 2016; 101:199-205. [PMID: 26574958 PMCID: PMC4701844 DOI: 10.1210/jc.2015-3451] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
CONTEXT IGF-1 promotes bone growth directly and indirectly through its effects on skeletal muscle. Insulin and IGF-1 share a common cellular signaling process; thus, insulin resistance may influence the IGF-1-muscle-bone relationship. OBJECTIVE We sought to determine the effect of insulin resistance on the muscle-dependent relationship between IGF-1 and bone mass in premenarcheal girls. DESIGN, SETTING, AND PARTICIPANTS This was a cross-sectional study conducted at a university research center involving 147 girls ages 9 to 11 years. MAIN OUTCOME MEASURES Glucose, insulin, and IGF-1 were measured from fasting blood samples. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated from glucose and insulin. Fat-free soft tissue (FFST) mass and bone mineral content (BMC) were measured by dual-energy x-ray absorptiometry. Our primary outcome was BMC/height. RESULTS In our path model, IGF-1 predicted FFST mass (b = 0.018; P = .001), which in turn predicted BMC/height (b = 0.960; P < .001). IGF-1 predicted BMC/height (b = 0.001; P = .002), but not after accounting for the mediator of this relationship, FFST mass. The HOMA-IR by IGF-1 interaction negatively predicted FFST mass (b = -0.044; P = .034). HOMA-IR had a significant and negative effect on the muscle-dependent relationship between IGF-1 and BMC/height (b = -0.151; P = .047). CONCLUSIONS Lean body mass is an important intermediary factor in the IGF-1-bone relationship. For this reason, bone development may be compromised indirectly via suboptimal IGF-1-dependent muscle development in insulin-resistant children.
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Affiliation(s)
- J M Kindler
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
| | - N K Pollock
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
| | - E M Laing
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
| | - N T Jenkins
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
| | - A Oshri
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
| | - C Isales
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
| | - M Hamrick
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
| | - R D Lewis
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
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Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize the recent clinical findings surrounding the muscle-bone relationships in children, while considering muscle adiposity, endocrine factors, and lifestyle influences (i.e., diet and exercise) involved in pediatric musculoskeletal development. RECENT FINDINGS Positive relationships between cortical bone geometry and muscle mass, size and function have been reported. Prospective studies in particular have helped clarify some of the inconsistent relationships between muscle and cortical bone volumetric density. Muscle fat is associated with impaired glucose handling and muscular functionality, which may in turn have a downstream effect on cortical bone growth during adolescence. Lifestyle factors such as healthful diets and higher impact physical activities can promote optimal skeletal development by improving the muscular phenotype and endocrine profile. SUMMARY Muscle and bone are two intricately-related tissue types; however, factors such as sex, maturation, study design, and outcome measures studied can modify this relationship. Further research is warranted to understand the impact of muscle adiposity on cardiometabolic health, muscle function and, subsequently, pediatric musculoskeletal development and fracture risk. Following age-specific diet and physical activity recommendations should be a major focus in obtaining optimal muscle and bone development throughout maturation.
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Affiliation(s)
- Joseph M Kindler
- aDepartment of Foods and Nutrition, College of Family and Consumer Sciences, University of Georgia, Athens bDepartment of Cellular Biology and Anatomy, Medical College of Georgia, Georgia Regents University, Augusta, Georgia, USA
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Roldán SI, Restrepo LG, Isaza JF, Vélez LG, Buschang PH. Are maximum bite forces of subjects 7 to 17 years of age related to malocclusion? Angle Orthod 2015; 86:456-61. [PMID: 26347948 DOI: 10.2319/051315-323.1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To determine the effects of occlusion on maximum bite force of growing subjects. MATERIALS AND METHODS Incisor and first molar bite force of children and adolescents was evaluated. Four cohorts were measured annually for 3 years, starting at approximately 7, 9, 12, and 15 years of age, respectively. The initial sample included 182 females and 198 males; there were 130 subjects with normal occlusion, 111 with Class I malocclusion, and 139 with Class II malocclusion. Multilevel analyses were performed to model the growth changes and compare groups. RESULTS Maximum bite force increased significantly (P < .05) over time. Incisal forces peaked at 14.3 and 15.3 years of age for females and males, respectively. Maximum molar bite force peaked at 16 years for both males and females. Subjects with normal occlusion had significantly higher bite force than subjects with malocclusion. Maximum molar bite force exhibited a significant testing effect, with forces increasing 2.6 kg each year that the tests were repeated. CONCLUSIONS Malocclusion has a detrimental effect on bite force. Changes in maximum bite force are also due to age, sex, and repeated testing.
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Affiliation(s)
- Samuel I Roldán
- a Assistant Professor, Department of Orthodontics, CES University, Grupo de Investigación en Bioingeniería GIB, CES-EAFIT, Medellín, Colombia
| | - Luis G Restrepo
- b Instructor, Department of Orthodontics, CES University, Grupo de Investigación en Bioingeniería GIB, CES-EAFIT, Medellín, Colombia
| | - Juan F Isaza
- c Assistant Professor, Department of Product Design Engineering, EAFIT University, Grupo de Investigación en Bioingeniería GIB, CES-EAFIT, Medellín, Colombia
| | | | - Peter H Buschang
- e Regents Professor, Department of Orthodontics, Texas A&M University Baylor College of Dentistry, Dallas, Tex
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Jackowski SA, Kontulainen SA, Cooper DML, Lanovaz JL, Beck TJ, Baxter-Jones ADG. Adolescent physical activity and bone strength at the proximal femur in adulthood. Med Sci Sports Exerc 2015; 46:736-44. [PMID: 24002345 DOI: 10.1249/mss.0000000000000154] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Physical activity (PA) enhances bone structural strength at the proximal femur in adolescence, but whether these benefits are maintained into early adulthood remains unknown. The purpose of this study was to investigate whether males and females, described as active, average, and inactive during adolescence, display differences in structural strength at the proximal femur in early adulthood (20-30 yr). METHODS One hundred four participants (55 males and 49 females) from the Pediatric Bone Mineral Accrual Study (PBMAS) were categorized into adolescent PA groupings (inactive, average, and active) using the Physical Activity Questionnaire for Adolescents. Cross-sectional area and section modulus (Z) at the narrow neck, intertrochanter, and femoral shaft (S) sites of the proximal femur were assessed using hip structural analysis in young adulthood from femoral neck dual-energy x-ray absorptiometry scans. Group differences were assessed using ANCOVA, controlling for adult height (Ht), adult weight (Wt), adolescent bone geometry, sex, percentage adult total body lean tissue (LTM%), and adult PA levels. RESULTS Active adolescents had significantly greater adjusted bone geometric measures at all sites than their inactive classified peers during adolescence (P < 0.05). In adulthood, when adjusted for Ht, Wt, adolescent bone geometry, sex, LTM%, and adult PA levels, adolescent participants categorized as active had significantly greater adjusted adult bone geometric measures at the proximal femur than adult participants who were classified as inactive during adolescence (P < 0.05). CONCLUSIONS Skeletal advantages associated with adolescence activity appear to confer greater geometric bone structural strength at the proximal femur in young adulthood.
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Affiliation(s)
- Stefan A Jackowski
- 1College of Kinesiology, University of Saskatchewan, Saskatoon, SK, CANADA; 2Department of Anatomy and Cell Biology, University of Saskatchewan, Saskatoon, SK, CANADA; and 3Department of Medical Imaging, John Hopkins University Baltimore, MD
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Jackowski SA, Lanovaz JL, Van Oort C, Baxter-Jones ADG. Does lean tissue mass accrual during adolescence influence bone structural strength at the proximal femur in young adulthood? Osteoporos Int 2014; 25:1297-304. [PMID: 24326885 DOI: 10.1007/s00198-013-2592-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 11/26/2013] [Indexed: 10/25/2022]
Abstract
UNLABELLED The purpose of this study was to identify whether young adult bone structural strength at the hip is associated with adolescent lean tissue mass (LTM) accrual. It was observed that those individuals who accrued more LTM from adolescence to adulthood had significantly greater adult bone structural strength at the hip. INTRODUCTION The purpose of this study was to identify whether young adult bone cross-sectional area (CSA), section modulus (Z), and outer diameter (OD) at the hip were associated with adolescent LTM accrual. METHODS One hundred three young adult participants (55 males, 48 females) were tertiled into adolescent LTM accrual groupings. LTM accrual was assessed by serial measures using dual energy X-ray absorptiometry (DXA) from adolescence to young adulthood (21.3 ± 1.3 years). CSA, Z, and OD at the narrow neck (NN) and femoral shaft (S) sites of the proximal femur were assessed in young adulthood (21.3 ± 4.5 years), using hip structural analysis. Group differences were assessed using an analysis of covariance, controlling for adult height, weight, sex, and physical activity levels. RESULTS It was found that individuals with higher adjusted adolescent LTM accrual had significantly greater adult adjusted values of NNCSA (2.49 ± 0.06 vs 2.77 ± 0.07 cm(2)), NN Z (1.18 ± 0.04 vs 1.37 ± 0.04 cm(3)), NN OD (3.07 ± 0.04 vs 3.21 ± 0.04 cm), SCSA (3.45 ± 0.08 vs 3.88 ± 0.09 cm(3)), and SZ (1.77 ± 0.05 vs 2.00 ± 0.05 cm(3)) than individuals with lower LTM accrual (p < 0.05). CONCLUSIONS These findings suggest that the amount of LTM accrued from adolescence to young adulthood has a positive influence on adult bone structural strength at the proximal femur.
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Affiliation(s)
- S A Jackowski
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, Canada,
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Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine. Clin J Sport Med 2014; 24:3-20. [PMID: 24366013 DOI: 10.1097/jsm.0000000000000060] [Citation(s) in RCA: 130] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Kontulainen SA, Kawalilak CE, Johnston JD, Bailey DA. Prevention of Osteoporosis and Bone Fragility. Am J Lifestyle Med 2013. [DOI: 10.1177/1559827613487664] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The importance of optimal bone growth in childhood and adolescence has been recognized as one of the key strategies in osteoporotic fracture prevention. Low birth size, poor childhood growth, and low peak bone mass at the cessation of growth have been linked to the later risk of osteoporosis and hip fracture. Formerly, the focus was merely on maximizing bone mineral accrual because a high peak bone mineral mass may prevent attainment of a critical “fracture threshold” associated with age-related bone loss and osteoporosis. More recently, the focus has shifted away from bone mineral accrual—as measured by dual-energy X-ray absorptiometry (DXA)—toward the optimization of bone strength. This is partly because of the advances in bone imaging that have enabled estimation of bone strength beyond bone mass. In this review, we briefly describe long-bone growth and structural development and our abilities to assess bone properties by medical imaging tools. In addition, we summarize the evidence of factors contributing to skeletal growth, bone fragility, and the development of strong, healthy bones.
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Affiliation(s)
- Saija Annukka Kontulainen
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada (SAK, CEK, DAB)
- Department of Mechanical Engineering, College of Engineering, University of Saskatchewan, Saskatoon, SK, Canada (JDJ)
- School of Human Movement Studies, University of Queensland, Brisbane, Australia (DAB)
| | - Chantal Elizabeth Kawalilak
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada (SAK, CEK, DAB)
- Department of Mechanical Engineering, College of Engineering, University of Saskatchewan, Saskatoon, SK, Canada (JDJ)
- School of Human Movement Studies, University of Queensland, Brisbane, Australia (DAB)
| | - James Duncan Johnston
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada (SAK, CEK, DAB)
- Department of Mechanical Engineering, College of Engineering, University of Saskatchewan, Saskatoon, SK, Canada (JDJ)
- School of Human Movement Studies, University of Queensland, Brisbane, Australia (DAB)
| | - Donald Alexander Bailey
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada (SAK, CEK, DAB)
- Department of Mechanical Engineering, College of Engineering, University of Saskatchewan, Saskatoon, SK, Canada (JDJ)
- School of Human Movement Studies, University of Queensland, Brisbane, Australia (DAB)
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Al-Shaar L, Nabulsi M, Maalouf J, El-Rassi R, Vieth R, Beck TJ, El-Hajj Fuleihan G. Effect of vitamin D replacement on hip structural geometry in adolescents: a randomized controlled trial. Bone 2013; 56:296-303. [PMID: 23810841 DOI: 10.1016/j.bone.2013.06.020] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 06/12/2013] [Accepted: 06/18/2013] [Indexed: 11/21/2022]
Abstract
BACKGROUND We have shown in a randomized controlled trial that vitamin D increases bone mass, lean mass and bone area in adolescent girls, but not boys. These increments may translate into improvements in bone geometry and therefore bone strength. This study investigated the impact of vitamin D on hip geometric dimensions from DXA-derived hip structural analyses in adolescents who participated in the trial. METHODS 167 girls (mean age 13.1 years) and 171 boys (mean age 12.7 years) were randomly assigned to receive weekly placebo oil or vitamin D3, at doses of 1400 IU or 14,000 IU, in a double blind placebo-controlled 1-year trial. DXA images were obtained at baseline and one year, and hip images were analyzed using the hip structural analysis (HSA) software to derive parameters of bone geometry. These include outer diameter (OD), cross sectional area (CSA), section modulus (Z), and buckling ratio (BR) at the narrow neck (NN), intertrochanteric (IT), and shaft (S) regions. Analysis of Covariance (ANCOVA) was used to examine group differences for changes of bone structural parameters. RESULTS In the overall group of girls, vitamin D supplementation increased aBMD (7.9% and 6.8% in low and high doses, versus 4.2% in placebo) and reduced the BR of NN (6.1% and 2.4% in low and high doses, versus 1.9% in placebo). It also improved aBMD (7.9% and 5.2% versus 3.6%) and CSA (7.5% and 5.1% versus 4.1%) of the IT and OD of the S (2.4% and 2.5% versus 0.8% respectively). Significant changes in the OD and BR of the NN, in the overall group of girls remained, after adjusting for lean mass, and were unaffected with further adjustments for lifestyle, pubertal status, and height measures. Conversely, boys did not exhibit any significant changes in any parameters of interest. A dose effect was not detected and subgroup analyses revealed no beneficial effect of vitamin D by pubertal stage. CONCLUSIONS Vitamin D supplementation improved bone mass and several DXA-derived structural bone parameters, in adolescent girls, but not boys. This occurred at a critical site, the femoral neck, and if maintained through adulthood could improve bone strength and lower the risk of hip fractures.
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Affiliation(s)
- Laila Al-Shaar
- Calcium Metabolism and Osteoporosis Program, Department of Medicine, Lebanon
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Young age at diagnosis, male sex, and decreased lean mass are risk factors of osteoporosis in long-term survivors of osteosarcoma. J Pediatr Hematol Oncol 2013; 35:54-60. [PMID: 23128330 DOI: 10.1097/mph.0b013e318275193b] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Long-term survival of children with osteosarcoma has increased, but most suffer from osteoporosis in adulthood. The aim of this study was to investigate the prevalence and identify the risk factors of osteoporosis. METHODS Forty long-term survivors of osteosarcoma and 55 controls were enrolled. The mean age of the survivors was 21.8 ± 5.2 years. They were diagnosed at younger than 23 years of age (mean, 14.9 + 5.0 y). Bone mineral densities (BMD) and body compositions were measured by dual-energy x-ray absorptiometry. RESULTS Nineteen (47.5%) subjects had osteoporosis and 12 (30.0%) had osteopenia. The regions affected by osteoporosis were: femur neck of osteosarcoma site (47.5%), unaffected femur neck (12.5%), lumbar spine (12.5%), and total body (15.0%). Twelve subjects (30.0%) had 14 episodes of fractures. The identified risk factors of osteoporosis were young age at diagnosis, male sex, and low lean mass. Subjects diagnosed before attainment of puberty (male ≤ 16 y, female ≤ 14 y) were found to have a higher prevalence of osteoporosis (37.5% vs. 10.0%, P < 0.01). Males had a higher prevalence of osteopenia or osteoporosis than females (86.4% vs. 66.7%, P < 0.01). Total lean mass was positively correlated with unaffected femur neck BMD. Regional lean mass in affected limb was significantly reduced along with affected femur neck BMD. CONCLUSIONS In long-term survivors of osteosarcoma, prevalence of osteoporosis and fracture was higher than expected. Initial evaluation and regular follow-up of BMD should be performed in all osteosarcoma patients, especially in those who did not attain puberty, males, and those with a low lean mass.
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Osborne DL, Weaver CM, McCabe LD, McCabe GP, Novotny R, Van Loan MD, Going S, Matkovic V, Boushey CJ, Savaiano DA. Body size and pubertal development explain ethnic differences in structural geometry at the femur in Asian, Hispanic, and white early adolescent girls living in the U.S. Bone 2012; 51:888-95. [PMID: 22944607 PMCID: PMC3491564 DOI: 10.1016/j.bone.2012.08.125] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 08/16/2012] [Accepted: 08/18/2012] [Indexed: 12/21/2022]
Abstract
UNLABELLED Variation in structural geometry is present in adulthood, but when this variation arises and what influences this variation prior to adulthood remains poorly understood. Ethnicity is commonly the focus of research of skeletal integrity and appears to explain some of the variation in quantification of bone tissue. However, why ethnicity explains variation in skeletal integrity is unclear. METHODS Here we examine predictors of bone cross sectional area (CSA) and section modulus (Z), measured using dual-energy X-ray absorptiometry (DXA) and the Advanced Hip Analysis (AHA) program at the narrow neck of the femur in adolescent (9-14 years) girls (n=479) living in the United States who were classified as Asian, Hispanic, or white if the subject was 75% of a given group based on parental reported ethnicity. Protocols for measuring height and weight follow standardized procedures. Total body lean mass (LM) and total body fat mass (FM) were quantified in kilograms using DXA. Total dietary and total dairy calcium intakes from the previous month were estimated by the use of an electronic semi-quantitative food frequency questionnaire (eFFQ). Physical activity was estimated for the previous year by a validated self-administered modifiable activity questionnaire for adolescents with energy expenditure calculated from the metabolic equivalent (MET) values from the Compendium of Physical Activities. Multiple regression models were developed to predict CSA and Z. RESULTS Age, time from menarche, total body lean mass (LM), total body fat mass (FM), height, total calcium, and total dairy calcium all shared a significant (p<0.05), positive relationship with CSA. Age, time from menarche, LM, FM, and height shared significant (p<0.05), positive relationships with Z. For both CSA and Z, LM was the most important covariate. Physical activity was not a significant predictor of geometry at the femoral neck (p≥0.339), even after removing LM as a covariate. After adjusting for covariates, ethnicity was not a significant predictor in regression models for CSA and Z. CONCLUSION Variability in bone geometry at the narrow neck of the femur is best explained by body size and pubertal maturation. After controlling for these covariates there were no differences in bone geometry between ethnic groups.
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Affiliation(s)
- D L Osborne
- Dept. of Anthropology, University of Nebraska, Lincoln, NE 68588, USA.
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Jackowski SA, Kontulainen SA, Cooper DML, Lanovaz JL, Baxter-Jones ADG. Maturational timing does not predict HSA estimated adult bone geometry at the proximal femur. Bone 2011; 49:1270-8. [PMID: 21924389 DOI: 10.1016/j.bone.2011.08.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Revised: 08/26/2011] [Accepted: 08/27/2011] [Indexed: 10/17/2022]
Abstract
Late maturational timing is documented to be detrimental to bone strength primarily at the distal radius. Studies at the proximal femur have focused on bone mass and the results remain controversial. The purpose of this study was to examine the long term relationship between the onset of maturation and the development of estimated cross sectional area (CSA) and section modulus (Z) at the proximal femur. Two hundred and twenty six individuals (108 males and 118 females) from the Saskatchewan Pediatric Bone Mineral Accrual Study (PBMAS) were classified into maturity groups based on age of attainment of peak height velocity. CSA and Z were serially assessed at the narrow neck (NN), intertrochanter (IT) and proximal shaft (S) sites using hip structural analysis (HSA). Multilevel models were constructed to examine the development of CSA and Z by maturity group. Cross sectional observations indicated that during adolescence, early maturing males had significantly greater CSA and Z than late maturing males at all sites of the proximal femur, while early maturing females had greater Z at the NN and S, and greater CSA at the NN, IT and S sites compared to late maturing females. When age, body size, body composition, physical activity and dietary intake were controlled no significant effects of maturational timing were found at the NN, IT or S regions (p>0.05) in either males or females. In this population of healthy individuals there appears to be no effect of the onset of maturation on estimated CSA and Z development at the proximal femur in both males and females. This may be a result of the proximal femur's loading environment. Future research is required to determine the role of loading on the relationship between maturational timing and bone structure and strength development at the proximal femur.
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Affiliation(s)
- Stefan A Jackowski
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada.
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Jackowski SA, Kontulainen SA, Cooper DML, Lanovaz JL, Baxter-Jones ADG. The timing of BMD and geometric adaptation at the proximal femur from childhood to early adulthood in males and females: a longitudinal study. J Bone Miner Res 2011; 26:2753-61. [PMID: 21773991 DOI: 10.1002/jbmr.468] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
During adolescence, the peak velocity in bone mass accretion preceded the peak velocity of estimated geometry at the hip. Whether this pattern continues into adulthood when maximum values are achieved remains unknown. The purpose of this study was (1) to identify the ages at which peak values of areal BMD (aBMD), cross-sectional area (CSA), and section modulus (Z) occur, (2) to determine the percent of adult peak attained during adolescence, and (3) to determine the relationship between body composition and the timing of the adult peak values. One-hundred and sixty-five (92 females) individuals' aBMD, CSA, and Z values were assessed serially at the narrow neck (NN), intertrochanter (IT), and shaft (S) using hip structural analysis (HSA). Peak bone values and the ages of attainment were assessed using factorial MANOVA. In males, aBMDp (NN 19.4 ± 2.7 years, IT 20 ± 3.4 years, and S 21.8 ± 2.8 years) occurred significantly earlier than CSAp at all sites (NN 21.6 ± 3.2 years, IT 21.1 ± 3.4 years, and S 22.3 ± 3.1 years) and earlier than Zp at the NN (22 ± 3.2 years) and IT (21.3 ± 2.9 years). In females, aBMDp (NN 17.9 ± 2.7 years, IT 18.7 ± 3.5 years, and S 19.7 ± 3.3 years) occurred significantly earlier than CSAp at all sites (NN 20.6 ± 3.6 years, IT 19.4 ± 3.9 years, and S 21.0 ± 3.3 years) and earlier than Zp at the NN (20.7 ± 3.4 years) and S (20.6 ± 3.5 years). The changes in bone mass precede changes in geometric CSA, and this timing may be integral for the development and maintenance of bone strength.
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Affiliation(s)
- Stefan A Jackowski
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
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Cardadeiro G, Baptista F, Zymbal V, Rodrigues LA, Sardinha LB. Ward's area location, physical activity, and body composition in 8- and 9-year-old boys and girls. J Bone Miner Res 2010; 25:2304-12. [PMID: 20737470 DOI: 10.1002/jbmr.229] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Bone strength is the result of its material composition and structural design, particularly bone mass distribution. The purpose of this study was to analyze femoral neck bone mass distribution by Ward's area location and its relationship with physical activity (PA) and body composition in children 8 and 9 years of age. The proximal femur shape was defined by geometric morphometric analysis in 88 participants (48 boys and 40 girls). Using dual-energy X-ray absorptiometry (DXA) images, 18 landmarks were digitized to define the proximal femur shape and to identify Ward's area position. Body weight, lean and fat mass, and bone mineral were assessed by DXA, PA by accelerometry, and bone age by the Tanner-Whitehouse III method. Warps analysis with Thin-Plate Spline software showed that the first axis explained 63% of proximal femur shape variation in boys and 58% in girls. Most of this variation was associated with differences in Ward's area location, from the central zone to the superior aspect of the femoral neck in both genders. Regression analysis demonstrated that body composition explained 4% to 7% of the proximal femur shape variation in girls. In boys, body composition variables explained a similar amount of variance, but moderate plus vigorous PA (MVPA) also accounted for 6% of proximal femur shape variation. In conclusion, proximal femur shape variation in children ages 8 and 9 was due mainly to differences in Ward's area position determined, in part, by body composition in both genders and by MVPA in boys. These variables were positively associated with a central Ward's area and thus with a more balanced femoral neck bone mass distribution.
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Affiliation(s)
- Graça Cardadeiro
- Exercise and Health Laboratory, Faculty of Human Movement, Technical University of Lisbon, Lisbon, Portugal
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Sayers A, Marcus M, Rubin C, McGeehin MA, Tobias JH. Investigation of sex differences in hip structure in peripubertal children. J Clin Endocrinol Metab 2010; 95:3876-83. [PMID: 20484488 PMCID: PMC2917783 DOI: 10.1210/jc.2009-2446] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT There is evidence that sex differences in hip structure are increased during puberty, possibly as a consequence of associated changes in body composition. OBJECTIVES The objective of the study was to explore relationships between sex, puberty, hip structure, and body composition. DESIGN/SETTING The design was a longitudinal birth cohort study: The Avon Longitudinal Study of Parents and Children. PARTICIPANTS Participants included 3914 boys and girls (mean age 13.8 yr). OUTCOME MEASURES Measures included dual-energy x-ray absorptiometry-derived femoral neck width (FNW), cortical thickness (CT), bending strength [cross-sectional moment of inertia (CSMI)], section modulus, buckling ratio (BR), and femoral neck and total hip bone mineral density. RESULTS FNW, CT, and CSMI were higher in boys, whereas BR was lower in girls (P<0.001). Differences in hip structure were studied according to puberty (self-completion Tanner stage questionnaires). FNW, CT, and CSMI were higher in Tanner stage IV/V vs. I/II, particularly in boys (P<0.001, puberty-sex interaction). BR was lower in Tanner stage IV/V, particularly in girls (P=0.008, puberty-sex interaction). Adjusting for height, fat mass, and lean mass resulted in differential attenuation in the sexes, such that CT attenuated by about 80% and about 40% in boys and girls, respectively (P=0.004, puberty-sex interaction for adjusted CT, Tanner stages I/II vs. IV/V). The difference in BR showed little attenuation after adjustment. CONCLUSION During puberty, hip-bending strength increases, particularly in boys, due to their greater FNW, reflecting changes in height, fat mass, and lean mass. In contrast, BR falls during puberty, particularly in girls, reflecting their smaller FNW relative to CT, involving mechanisms partly independent of height and body composition.
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Affiliation(s)
- Adrian Sayers
- Academic Rheumatology, Clinical Science at North Bristol, University of Bristol, and Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, United Kingdom
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Vicente-Rodríguez G, Ortega FB, Rey-López JP, España-Romero V, Blay VA, Blay G, Martín-Matillas M, Moreno LA. Extracurricular physical activity participation modifies the association between high TV watching and low bone mass. Bone 2009; 45:925-30. [PMID: 19664736 DOI: 10.1016/j.bone.2009.07.084] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Revised: 06/17/2009] [Accepted: 07/29/2009] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To examine whether different sedentary behaviours are associated with the risk of low bone mineral content in adolescents, and if so, whether extracurricular physical-sporting activity influences this association. MATERIALS AND METHODS A total of 277 adolescents from Zaragoza (168 females and 109 males) aged 13.0-18.5 yr within frame work of the multicentre AVENA study participated in this study. Bone mineral content (BMC), lean mass, and fat mass were measured with DXA. Physical activity and sedentary independent variables: participation in extracurricular physical-sporting activity (PA), h/d of television watching, playing video/computer games during school days and on weekend days and doing homework/studying. They all were assessed by questionnaire. The main outcome was low BMC, as defined by BMC Z-score for age and sex < percentile 10. Logistic regression was used to test the interaction and association of PA and sedentary variables with low BMC, after controlling for confounders like height, maturational status or lean mass. RESULTS Among the sedentary variables studied, only television watching > or =3 h/d was associated with an increased risk for low BMC in males (OR, 95% CI: 7.01, 1.73 to 28.40), after controlling for sexual maturation. When PA was in the models, television watching was not any longer associated with low BMC, while PA was so (OR, 95% CI: 0.23, 0.09 to 0.55). Involvement in such activity reduced the risk of low bone mass by 76% (P<0.01) independently of body mass, height and fat mass, but not of the lean mass. CONCLUSION Watching television for 3 or more h/d seems to be associated with an increased risk for low BMC in male adolescents. However, this association is mediated by participation in PA, suggesting that negative consequences of excessive television watching on adolescent bone health could be counteracted by sport participation. Longitudinal data and randomized controlled trials will confirm or contrast our findings.
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Affiliation(s)
- G Vicente-Rodríguez
- Growth, Exercise, Nutrition and Development (GENUD) research group, Zaragoza, Spain.
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