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Cao J, Wang K, Shi Y, Pan Y, Lyu M, Ji Y. The associations between social support change and physical activity trajectory from late adolescence to young adulthood. BMC Public Health 2023; 23:1496. [PMID: 37544980 PMCID: PMC10405443 DOI: 10.1186/s12889-023-16422-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 07/31/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Previous research examined the associations between social support and physical activity. However, little is known about the associations between social support change and trajectories of physical activity during the transition from late adolescence to young adulthood. METHODS The current study sought to examine these issues among 434 Chinese college students (Mage = 19.15, SDage = 0.61; 46.1% male), who completed questionnaires regarding demographics, physical activity, family support change, and peer support change across three waves (the data from one of the waves was retrospective). RESULTS After controlling for covariates, the findings revealed that: (a) there was an increase in overall physical activity and duration, but a decrease in frequency during the transition from late adolescence (the second year of high school) to young adulthood (the third year of college); (b) family support change did not contribute to trajectories of physical activity, while peer support change significantly predicted the trajectory of overall physical activity, duration, and frequency. CONCLUSIONS The findings extend the literature on physical activity from a developmental perspective by revealing different trends among physical activity duration and frequency, and unpacking different effects of family and peer support change on trajectories of physical activity.
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Affiliation(s)
- Juan Cao
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, 100191, China
| | - Kun Wang
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, 100191, China
| | - YuHui Shi
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, 100191, China
| | - YuQing Pan
- Department of Disease Control and Prevention, Peking University Third Hospital, Beijing, 100191, China
| | - MoHan Lyu
- Faculty of Science, The University of Sydney, Sydney, 2006, Australia
| | - Ying Ji
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, 100191, China.
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Scott R, James R, Barnett CT, Sale C, Varley I. Perspectives from research and practice: A survey on external load monitoring and bone in sport. Front Sports Act Living 2023; 5:1150052. [PMID: 37181251 PMCID: PMC10166824 DOI: 10.3389/fspor.2023.1150052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/28/2023] [Indexed: 05/16/2023] Open
Abstract
Introduction There is limited information regarding the association between external load and estimated bone load in sport, which may be important due to the influence exercise can have on bone accrual and injury risk. The aim of this study was to identify external load measuring tools used by support staff to estimate bone load and assess if these methodologies were supported in research. Methods A survey was comprised of 19 multiple choice questions and the option to elaborate on if/how they monitor external load and if/how they used them to estimate bone load. A narrative review was performed to assess how external load is associated to bone in research. Results Participants were required to be working as support staff in applied sport. Support staff (n = 71) were recruited worldwide with the majority (85%) working with professional elite athletes. 92% of support staff monitored external load in their organisation, but only 28% used it to estimate bone load. Discussion GPS is the most commonly used method to estimate bone load, but there is a lack of research assessing GPS metrics with bone load. Accelerometry and force plates were among the most prevalent methods used to assess external load, but a lack of bone specific measurements were reported by support staff. Further research exploring how external load relates to bone is needed as there is no consensus on which method of external load is best to estimate bone load in an applied setting.
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Affiliation(s)
- Reece Scott
- Musculoskeletal, Physical Activity and Metabolic Health Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Ruth James
- Musculoskeletal, Physical Activity and Metabolic Health Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Cleveland T. Barnett
- Musculoskeletal, Physical Activity and Metabolic Health Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Craig Sale
- Institute of Sport, Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, United Kingdom
| | - Ian Varley
- Musculoskeletal, Physical Activity and Metabolic Health Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
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Brailey G, Metcalf B, Lear R, Price L, Cumming S, Stiles V. A comparison of the associations between bone health and three different intensities of accelerometer-derived habitual physical activity in children and adolescents: a systematic review. Osteoporos Int 2022; 33:1191-1222. [PMID: 35089364 PMCID: PMC9106641 DOI: 10.1007/s00198-021-06218-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 09/14/2021] [Indexed: 12/02/2022]
Abstract
Positive associations have been identified between bone outcomes and accelerometer-derived moderate (MPA) and vigorous (VPA) physical activity (PA) in youth; however, it remains unclear which intensity is most beneficial. This systematic review aimed to summarise accelerometer-derived methods used to estimate habitual PA in children and adolescents and determine whether the magnitude of association was consistently stronger for a particular intensity (MPA/MVPA/VPA). Observational studies assessing associations between accelerometer-derived MPA and/or MVPA and VPA with bone outcomes in children and adolescents (≤ 18 years) were identified in MEDLINE, EMBASE, Web of Science, SPORTDiscus and the Cochrane Central Register of Controlled Trials. Thirty articles were included (total n = 20,613 (10,077 males), 4-18 years). Chi-square tests determined whether the proportion of significant associations and strongest within-study associations differed significantly between intensities. Results demonstrated that accelerometer methods were highly variable between studies. Of the 570 associations analysed, 186 were significant (p < 0.05). The proportion of within-study strongest associations differed by PA intensity (3 × 2 χ2 = 86.6, p < 0.001) and was significantly higher for VPA (39%) compared to MVPA (5%; 2 × 2 χ2 = 55.3, p < 0.001) and MPA (9%, 2 × 2 χ2 = 49.1, p < 0.001). Results indicated a greater benefit of VPA over MPA/MVPA; however, variability in accelerometer-derived methods used prevents the precise bone-benefitting amount of VPA from being identified. Long epochs and numerous intensity cut-point definitions mean that bone-relevant PA has likely been missed or misclassified in this population. Future research should explore the use of shorter epochs (1 s) and identify bone-specific activity intensities, rather than using pre-defined activity classifications more relevant to cardiovascular health.
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Affiliation(s)
- Gemma Brailey
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK.
| | - Brad Metcalf
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Rebecca Lear
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Lisa Price
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Sean Cumming
- Department for Health, University of Bath, Bath, UK
| | - Victoria Stiles
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
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Comeras-Chueca C, Villalba-Heredia L, Perez-Lasierra JL, Marín-Puyalto J, Lozano-Berges G, Matute-Llorente Á, Vicente-Rodríguez G, Gonzalez-Aguero A, Casajús JA. Active Video Games Improve Muscular Fitness and Motor Skills in Children with Overweight or Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2642. [PMID: 35270330 PMCID: PMC8910272 DOI: 10.3390/ijerph19052642] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/16/2022] [Accepted: 02/21/2022] [Indexed: 01/27/2023]
Abstract
(1) Background: Childhood obesity is an important public health problem. Children with overweight or obesity often tend to show the pediatric inactivity triad components; these involve exercise deficit disorder, pediatric dynapenia, and physical illiteracy. The aim of the study was to examine the influence of an active video games (AVG) intervention combined with multicomponent exercise on muscular fitness, physical activity (PA), and motor skills in children with overweight or obesity. (2) Methods: A total of 29 (13 girls) children (10.07 ± 0.84 years) with overweight or obesity were randomly allocated in the intervention group (AVG group; n = 21) or in the control group (CG; n = 8). The intervention group performed a 5-month AVG training using the Xbox 360® with the Kinect, the Nintendo Wii®, dance mats, and the BKOOL® interactive cycling simulator, combined with multicomponent exercise, performing three sessions per week. The control group continued their daily activities without modification. Weight, PA using accelerometers, and motor competence using the Test of Gross Motor Development 3rd edition were measured. Muscular fitness was evaluated through the Counter Movement Jump height, maximal isometric strength of knee extension and handgrip strength, and lean mass using Dual-energy X-ray Absorptiometry. Mann−Whitney U and Wilcoxon signed rank tests were performed. The biserial correlation coefficients (r) were calculated. Spearman’s correlation coefficients among PA, muscular fitness, and motor competence variables were also calculated. (3) Results: The AVG group significantly increased their knee extension maximal isometric strength (4.22 kg; p < 0.01), handgrip strength (1.93 kg; p < 0.01), and jump height (1.60 cm; p < 0.01), while the control group only increased the knee extension maximal isometric strength (3.15 kg; p < 0.01). The AVG group improved motor competence and light physical activity (p < 0.05) and decreased sedentary time (p < 0.05). Lean mass improved in both AVG group and CG (p < 0.05). Lastly, the percentage of improvement of motor skills positively correlated with the percentage of improvement in vigorous PA (r = 0.673; p = 0.003) and the percentage of improvement in CMJ (r = 0.466; p = 0.039). (4) Conclusions: A 5-month intervention combining AVG with multicomponent training seems to have positive effects on muscle fitness, motor competence, and PA in children with overweight or obesity.
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Affiliation(s)
- Cristina Comeras-Chueca
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (C.C.-C.); (G.L.-B.); (Á.M.-L.); (G.V.-R.); (A.G.-A.)
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (L.V.-H.); (J.L.P.-L.); (J.M.-P.)
- EXERNET Red de Investigación en Ejercicio Físico y Salud, 50009 Zaragoza, Spain
| | - Lorena Villalba-Heredia
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (L.V.-H.); (J.L.P.-L.); (J.M.-P.)
- EXERNET Red de Investigación en Ejercicio Físico y Salud, 50009 Zaragoza, Spain
- Faculty of Health Science, Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Jose Luis Perez-Lasierra
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (L.V.-H.); (J.L.P.-L.); (J.M.-P.)
- EXERNET Red de Investigación en Ejercicio Físico y Salud, 50009 Zaragoza, Spain
- Faculty of Health Science, Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Jorge Marín-Puyalto
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (L.V.-H.); (J.L.P.-L.); (J.M.-P.)
- EXERNET Red de Investigación en Ejercicio Físico y Salud, 50009 Zaragoza, Spain
- Faculty of Health Science, Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Gabriel Lozano-Berges
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (C.C.-C.); (G.L.-B.); (Á.M.-L.); (G.V.-R.); (A.G.-A.)
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (L.V.-H.); (J.L.P.-L.); (J.M.-P.)
- EXERNET Red de Investigación en Ejercicio Físico y Salud, 50009 Zaragoza, Spain
| | - Ángel Matute-Llorente
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (C.C.-C.); (G.L.-B.); (Á.M.-L.); (G.V.-R.); (A.G.-A.)
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (L.V.-H.); (J.L.P.-L.); (J.M.-P.)
- EXERNET Red de Investigación en Ejercicio Físico y Salud, 50009 Zaragoza, Spain
| | - Germán Vicente-Rodríguez
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (C.C.-C.); (G.L.-B.); (Á.M.-L.); (G.V.-R.); (A.G.-A.)
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (L.V.-H.); (J.L.P.-L.); (J.M.-P.)
- EXERNET Red de Investigación en Ejercicio Físico y Salud, 50009 Zaragoza, Spain
| | - Alex Gonzalez-Aguero
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (C.C.-C.); (G.L.-B.); (Á.M.-L.); (G.V.-R.); (A.G.-A.)
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (L.V.-H.); (J.L.P.-L.); (J.M.-P.)
- EXERNET Red de Investigación en Ejercicio Físico y Salud, 50009 Zaragoza, Spain
| | - José A. Casajús
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain; (L.V.-H.); (J.L.P.-L.); (J.M.-P.)
- EXERNET Red de Investigación en Ejercicio Físico y Salud, 50009 Zaragoza, Spain
- Faculty of Health Science, Department of Physiatry and Nursing, Universidad de Zaragoza, 50009 Zaragoza, Spain
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Li Q, Zhou J. Influence of dietary patterns and physical activity on bone mineral content and density, osteoporosis among children with stimulant use. Front Pediatr 2022; 10:976258. [PMID: 36210946 PMCID: PMC9532566 DOI: 10.3389/fped.2022.976258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
AIM To examine the relationship between dietary patterns (DPs) and physical activity (PA) on bone mineral content (BMC), bone mineral density (BMD), and osteoporosis in children with stimulant use. METHODS A cross-sectional study collected information on participants from the National Health and Nutrition Examination Survey (NHANES) via multistage stratified sampling. The baseline variables included the following: age, gender, the dietary approaches to stop hypertension (DASH) score, the Mediterranean diet (MD) score, and the Alternative Healthy Eating Index-2010 (AHEI-2010). The univariate and multivariate linear-regression analyses were carried out to explore the statistical correlation between the DPs and PA on BMC and BMD in children with stimulant use or non-stimulant use. In addition, we also investigated the association between DPs and PA on osteoporosis via logistic regression analyses. RESULTS A total of 6,294 participants were eligibly enrolled in this study eventually. After adjusting age, gender, body mass index (BMI), race, family income, serum 25-hydroxyvitamin D, and serum cotinine, the multivariate linear-regression analysis showed that the MD was positively associated with total femur BMD, total femur BMC, femoral neck BMD, and femoral neck BMC among stimulant use group; high PA was associated with total femur BMD, total femur BMC, femoral neck BMD, femoral neck BMC, lumbar spine BMD, lumbar spine BMC and osteoporosis in stimulant use group. CONCLUSION Improved adherence to MD, DASH, AHEI-2010 or increased physical activity may increase BMD, BMC and reduce the risk of osteoporosis; children with stimulant use should improve their adherence to the MD and do more PA compared with children without stimulant use.
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Affiliation(s)
- Qianqian Li
- Department of Psychological Counseling, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiaxiu Zhou
- Child Health and Mental Health Center, Shenzhen Children's Hospital, Shenzhen, China
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Terryn PJ, Fernandes PR, João F, Veloso A, Baptista F. Modeling the musculoskeletal loading in bone remodeling at the hip of a child. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 210:106365. [PMID: 34455361 DOI: 10.1016/j.cmpb.2021.106365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 08/16/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND OBJECTIVES The mechanical load associated with physical activity affects the bone adaptation process. The bone adaptationeffect varies with age, being more effective during childhood and adolescence, particularly during pre-pubertal years. Bone-strengthening physical activity is recommended for children and adolescents. The number of time periods (bouts) per day of vigorous physical activity seems to be more important than the total cumulative time for optimal bone strength. So, the aim of this study was to evaluate the effects of weight-bearing physical activity on bone mineral density (BMD) of the proximal femur through computational simulation considering the intensity, exposure time (bouts) and regionalization of the results. METHODS For this purpose, a finite element model of a 7 year-old child femur was developed based on computed tomography images. Musculoskeletal loads were obtained from experimental kinematic data of weight-bearing physical activity performed by children of the same age (standing, walking, running, jumping). The effects of physical activity on BMD of several regions of interest of the femur were analyzed using a bone remodeling model. A daily accumulation of 400 min of physical activity (200 min walking and 200 min standing) was considered as reference, against with which the effects of additional 10 min loading bouts were compared: 10 min bouts of vigorous intensity physical activity vs. 10 min bouts of light to moderate intensity physical activity. RESULTS The simulations revealed greater increases in BMD associated with higher intensity and longer duration of physical activity. The largest BMD increases occurs during the first 10 min bout compared to longer durations and in less mineralized central regions compared to regions far from the neutral axis of the bone. CONCLUSION Weight bearing physical activity is more effective in bone remodeling when the musculoskeletal loading is more intense and of short duration and, under these conditions, less mineralized regions are more positively impacted.
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Affiliation(s)
- Pieter-Jan Terryn
- IDMEC, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1, Lisboa 1049-001, Portugal
| | - Paulo R Fernandes
- IDMEC, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1, Lisboa 1049-001, Portugal.
| | - Filipa João
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz-Quebrada, Dafundo 1499-002, Portugal
| | - António Veloso
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz-Quebrada, Dafundo 1499-002, Portugal
| | - Fátima Baptista
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz-Quebrada, Dafundo 1499-002, Portugal
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Proia P, Amato A, Drid P, Korovljev D, Vasto S, Baldassano S. The Impact of Diet and Physical Activity on Bone Health in Children and Adolescents. Front Endocrinol (Lausanne) 2021; 12:704647. [PMID: 34589054 PMCID: PMC8473684 DOI: 10.3389/fendo.2021.704647] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 08/13/2021] [Indexed: 12/15/2022] Open
Abstract
There is growing recognition of the role of diet and physical activity in modulating bone mineral density, bone mineral content, and remodeling, which in turn can impact bone health later in life. Adequate nutrient composition could influence bone health and help to maximize peak bone mass. Therefore, children's nutrition may have lifelong consequences. Also, physical activity, adequate in volume or intensity, may have positive consequences on bone mineral content and density and may preserve bone loss in adulthood. Most of the literature that exists for children, about diet and physical activity on bone health, has been translated from studies conducted in adults. Thus, there are still many unanswered questions about what type of diet and physical activity may positively influence skeletal development. This review focuses on bone requirements in terms of nutrients and physical activity in childhood and adolescence to promote bone health. It explores the contemporary scientific literature that analyzes the impact of diet together with the typology and timing of physical activity that could be more appropriate depending on whether they are children and adolescents to assure an optimal skeleton formation. A description of the role of parathyroid hormone (PTH) and gut hormones (gastric inhibitory peptide (GIP), glucagon-like peptide (GLP)-1, and GLP-2) as potential candidates in this interaction to promote bone health is also presented.
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Affiliation(s)
- Patrizia Proia
- Department of Psychological, Pedagogical and Educational Sciences, Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| | - Alessandra Amato
- Department of Psychological, Pedagogical and Educational Sciences, Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Darinka Korovljev
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Sonya Vasto
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, Palermo, Italy
| | - Sara Baldassano
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, Palermo, Italy
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Gardinier JD. The Diminishing Returns of Mechanical Loading and Potential Mechanisms that Desensitize Osteocytes. Curr Osteoporos Rep 2021; 19:436-443. [PMID: 34216359 PMCID: PMC9306018 DOI: 10.1007/s11914-021-00693-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/27/2021] [Indexed: 11/30/2022]
Abstract
Adaptation to mechanical loading is critical to maintaining bone mass and offers therapeutic potential to preventing age-related bone loss and osteoporosis. However, increasing the duration of loading is met with "diminishing returns" as the anabolic response quickly becomes saturated. As a result, the anabolic response to daily activities and repetitive bouts of loading is limited by the underlying mechanisms that desensitize and render bone unresponsive at the cellular level. Osteocytes are the primary cells that respond to skeletal loading and facilitate the overall anabolic response. Although many of osteocytes' signaling mechanisms activated in response to loading are considered anabolic in nature, several of them can also render osteocytes insensitive to further stimuli and thereby creating a negative feedback loop that limits osteocytes' overall response. The purpose of this review is to examine the potential mechanisms that may contribute to the loss of mechanosensitivity. In particular, we examined the inactivation/desensitization of ion channels and signaling molecules along with the potential role of endocytosis and cytoskeletal reorganization. The significance in defining the negative feedback loop is the potential to identify unique targets for enabling osteocytes to maintain their sensitivity. In doing so, we can begin to cultivate new strategies that capitalize on the anabolic nature of daily activities that repeatedly load the skeleton.
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Xu F, Zhang Q, Wang LK, Tang QX, Sun CQ, Deng HW. Estimates of the effects of physical activity on osteoporosis using multivariable Mendelian randomization analysis. Osteoporos Int 2021; 32:1359-1367. [PMID: 33439309 PMCID: PMC8195838 DOI: 10.1007/s00198-020-05786-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 12/07/2020] [Indexed: 11/27/2022]
Abstract
UNLABELLED This study estimates causality of physical activity (PA) on bone mineral density (BMD) by conducting multivariable Mendelian randomization (MR). The findings suggest that habitual vigorous PA increases lumbar spine BMD, and higher overall acceleration average would improve forearm BMD. The results could promote PA intervention targeting individuals with optimized type. INTRODUCTION Evidence from epidemiologic studies showed type, frequency, and duration of PA influenced BMD. However, these observational studies may be confounded by many factors, resulting in spurious associations. We aimed to conduct multivariable MR to estimate the causal effect of self-reported and device-measured PA on osteoporosis. METHODS Three self-reported and two device-measured PA-related traits were selected as exposures. Outcomes were BMD at different skeletal sites: femoral neck BMD (FN BMD), lumbar spine BMD (LS BMD), and forearm BMD (FA BMD). Exposure datasets were obtained from UK Biobank with total 377,234 subjects. Outcome datasets were obtained from GEFOS consortium with 53,236 subjects. Standard MR analysis and multivariable MR were conducted to assess the total and direct causal effect of PA on BMD. RESULTS For self-reported PA, inverse-normalized moderate-to-vigorous had a direct causal effect on FN BMD independently (β = - 1.116 (95% confidence interval, 95%CI: - 2.210, - 0.023), P = 0.045); vigorous PA showed a direct effect (β = 3.592 (95%CI: 0.310, 6.874), P = 0.032) on LS BMD independently. While overall acceleration average and fraction of accelerations both had a direct causal effect on FA BMD independently. CONCLUSIONS Habitual vigorous PA could increase LS BMD. Individuals with higher overall acceleration average would have a higher FA BMD.
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Affiliation(s)
- F Xu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, People's Republic of China
- Tulane Center for Biomedical Informatics and Genomics, School of Medicine, Tulane University, New Orleans, LA, 70112, USA
| | - Q Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, People's Republic of China
- Tulane Center for Biomedical Informatics and Genomics, School of Medicine, Tulane University, New Orleans, LA, 70112, USA
| | - L-K Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, People's Republic of China
| | - Q-X Tang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, People's Republic of China
| | - C-Q Sun
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, People's Republic of China.
- School of Nursing, Zhengzhou University, Zhengzhou, 450001, Henan, People's Republic of China.
| | - H-W Deng
- Tulane Center for Biomedical Informatics and Genomics, School of Medicine, Tulane University, New Orleans, LA, 70112, USA.
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Tamolienė V, Remmel L, Gruodyte-Raciene R, Jürimäe J. Relationships of Bone Mineral Variables with Body Composition, Blood Hormones and Training Volume in Adolescent Female Athletes with Different Loading Patterns. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126571. [PMID: 34207239 PMCID: PMC8296434 DOI: 10.3390/ijerph18126571] [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: 05/27/2021] [Revised: 06/15/2021] [Accepted: 06/15/2021] [Indexed: 12/24/2022]
Abstract
The aim of this investigation was to determine the relationships of areal bone mineral density (aBMD) and content (BMC) with body composition, blood hormone and training load variables in adolescent female athletes with different loading patterns. The participants were 73 healthy adolescent females (14–18 years), who were divided into three groups: rhythmic gymnasts (RG; n = 33), swimmers (SW; n = 20) and untrained controls (UC; n = 20). Bone mineral and body compositional variables were measured by dual-energy X-ray absorptiometry, and insulin-like growth factor-1 (IGF-1), estradiol and leptin were analyzed from blood samples. In addition, aerobic performance was assessed by a peak oxygen consumption test. No differences (p > 0.05) in weekly training volume were observed between rhythmic gymnasts (17.6 ± 5.3 h/week) and swimmers (16.1 ± 6.9 h/week). Measured areal bone mineral density and bone mineral content values were higher in rhythmic gymnasts compared with other groups (p < 0.05), while no differences (p > 0.05) in measured bone mineral values were seen between swimmers and untrained control groups. Multiple regression models indicated that IGF-1 alone explained 14% of the total variance (R2 × 100) in lumbar spine aBMD, while appendicular muscle mass and training volume together explained 37% of the total variance in femoral neck BMC in the rhythmic gymnast group only. In swimmers, age at menarche, estradiol and appendicular muscle mass together explained 68% of the total variance in lumbar spine BMC, while appendicular muscle mass was the only predictor and explained 19 to 53% of the total variance in measured bone mineral values in untrained controls. In conclusion, adolescent rhythmic gymnasts with specific weight-bearing athletic activity present higher areal bone mineral values in comparison with swimmers and untrained controls. Specific training volume together with appendicular muscle mass influenced cortical bone development at the femoral neck site of the skeleton in rhythmic gymnasts, while hormonal values influenced trabecular bone development at the lumbar spine site in both athletic groups with different loading patterns.
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Affiliation(s)
- Vita Tamolienė
- Institute of Sports Science and Innovations, Lithuanian Sports University, LT-44221 Kaunas, Lithuania;
| | - Liina Remmel
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, 50090 Tartu, Estonia;
| | - Rita Gruodyte-Raciene
- Department of Physical and Social Education, Lithuanian Sports University, LT-44221 Kaunas, Lithuania;
| | - Jaak Jürimäe
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, 50090 Tartu, Estonia;
- Correspondence:
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Jürimäe J, Karvelyte V, Remmel L, Tamm AL, Purge P, Gruodyte-Raciene R, Kamandulis S, Maasalu K, Gracia-Marco L, Tillmann V. Sclerostin, preadipocyte factor-1 and bone mineral values in eumenorrheic adolescent athletes with different training patterns. J Bone Miner Metab 2021; 39:245-252. [PMID: 32880010 DOI: 10.1007/s00774-020-01141-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 08/09/2020] [Indexed: 01/21/2023]
Abstract
INTRODUCTION The specific aims of the study were to compare possible differences in sclerostin and preadipocyte factor-1 (Pref-1) between rhythmic gymnasts (RG), swimmers (SW) and untrained controls (UC), and to investigate the relationships of sclerostin and Pref-1 with bone mineral characteristics in studied groups. MATERIALS AND METHODS This study included 62 eumenorrheic adolescents (RG = 22; SW = 20; UC = 20). Bone mineral and body composition characteristics were measured by dual-energy X-ray absorptiometry, and sclerostin, Pref-1, osteocalcin and C-terminal telopeptide of type I collagen (CTx) were measured. RESULTS Sclerostin was higher (P = 0.001) in RG (129.35 ± 51.01 pg/ml; by 74%) and SW (118.05 ± 40.05 pg/ml; by 59%) in comparison with UC (74.32 ± 45.41 pg/ml), while no differences (P = 0.896) were seen in Pref-1 (RG: 1.42 ± 0.16 ng/ml; SW: 1.41 ± 0.20 ng/ml; UC: 1.39 ± 0.26 ng/ml) between groups. Osteocalcin (RG: 7.74 ± 4.09 ng/ml; SW: 8.05 ± 4.18 ng/ml; UC: 7.04 ± 3.92 ng/ml; P = 0.843) and CTx (RG: 0.73 ± 0.22 ng/ml; SW: 0.64 ± 0.16 ng/ml; UC: 0.62 ± 0.20 ng/ml; P = 0.173) were not different between groups. Sclerostin correlated (P < 0.05) with whole-body bone mineral content (r = 0.61) and lumbar spine (LS) areal bone mineral density (aBMD) (r = 0.43) in RG, and femoral neck aBMD (r = 0.45) in UC. No correlation was found between sclerostin and bone mineral values in SW, and Pref-1 was not correlated with any bone mineral characteristics in studied groups. Sclerostin was the independent variable that explained 14% of the total variance (R2 × 100) in LS aBMD value only in RG. CONCLUSIONS Adolescent athletes have higher sclerostin compared to UC. Sclerostin was correlated with bone mineral values and predicted areal bone mineral density in RG.
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Affiliation(s)
- Jaak Jürimäe
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, 18. Ülikooli St., 50090, Tartu, Estonia.
| | | | - Liina Remmel
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, 18. Ülikooli St., 50090, Tartu, Estonia
| | | | - Priit Purge
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, 18. Ülikooli St., 50090, Tartu, Estonia
| | | | | | - Katre Maasalu
- Institute of Clinical Medicine, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Luis Gracia-Marco
- PROFITH (PROmoting FITness and Health Through Physical Activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Vallo Tillmann
- Institute of Clinical Medicine, Faculty of Medicine, University of Tartu, Tartu, Estonia
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12
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Bland VL, Heatherington-Rauth M, Howe C, Going SB, Bea JW. Association of objectively measured physical activity and bone health in children and adolescents: a systematic review and narrative synthesis. Osteoporos Int 2020; 31:1865-1894. [PMID: 32542544 DOI: 10.1007/s00198-020-05485-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 06/01/2020] [Indexed: 12/11/2022]
Abstract
The influence of day-to-day physical activity on bone in adolescence has not been well characterized. Forty articles were identified that assessed the relationship between accelerometry-derived physical activity and bone outcomes in adolescents. Physical activity was positively associated with bone strength in peri-pubertal males, with less consistent evidence in females. Physical activity (PA) is recommended to optimize bone development in childhood and adolescence; however, the influence of day-to-day PA on bone development is not well defined. The aim of this review was to describe the current evidence for objectively measured PA on bone outcomes in healthy children and adolescents. MEDLINE, Embase, Cochrane Library, Scopus, Web of Science, CINAHL, PsycInfo, and ClinicalTrials.gov were searched for relevant articles up to April 2020. Studies assessing the relationship between accelerometry-derived PA and bone outcomes in adolescents (6-18 years old) were included. Two reviewers independently screened studies for eligibility, extracted data, and rated study quality. Forty articles met inclusion criteria (25 cross-sectional, 15 longitudinal). There was significant heterogeneity in accelerometry methodology and bone outcomes measured. Studies in males indicated a significant, positive relationship between moderate to vigorous PA (MVPA) and bone outcomes at the hip and femur, particularly during the peri-pubertal years. The results for MVPA and bone outcomes in females were mixed. There was a paucity of longitudinal studies using pQCT and a lack of data regarding how light PA and/or impact activity influences bone outcomes. The current evidence suggests that objectively measured MVPA is positively associated with bone outcomes in children and adolescents, especially in males. However, inconsistencies in methodology make it difficult to determine the amount and type of PA that leads to favorable bone outcomes. Given that the majority of research has been conducted in Caucasian adolescents, further research is needed in minority populations.
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Affiliation(s)
- V L Bland
- Department of Nutritional Sciences, University of Arizona, 1177 E 4th St, Tucson, AZ, 85721, USA.
| | - M Heatherington-Rauth
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - C Howe
- University of Arizona Health Sciences Library, University of Arizona, 1501 N Campbell Ave, Tucson, AZ, 85724, USA
| | - S B Going
- Department of Nutritional Sciences, University of Arizona, 1177 E 4th St, Tucson, AZ, 85721, USA
| | - J W Bea
- Department of Nutritional Sciences, University of Arizona, 1177 E 4th St, Tucson, AZ, 85721, USA
- University of Arizona Cancer Center, 3838 N Campbell Ave, Tucson, AZ, 85719, USA
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Min SK, Oh T, Kim SH, Cho J, Chung HY, Park DH, Kim CS. Position Statement: Exercise Guidelines to Increase Peak Bone Mass in Adolescents. J Bone Metab 2019; 26:225-239. [PMID: 31832388 PMCID: PMC6901695 DOI: 10.11005/jbm.2019.26.4.225] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 11/13/2019] [Accepted: 11/15/2019] [Indexed: 11/25/2022] Open
Abstract
Background An increase in bone mineral density during adolescence increases resistance to fractures in older age. The Korean Society for Bone and Mineral Research and the Korean Society of Exercise Physiology developed exercise guidelines to increase the peak bone mass (PBM) in adolescents based on evidence through a systematic review of previous research. Methods Articles were selected using the systematic method, and the exercise guidelines were established by selecting key questions (KQs) and defining the effects of exercises based on evidence through a literature review for selecting the final exercise method. There were 9 KQs. An online search was conducted on articles published since 2000, and 93 articles were identified. Results An increase in PBM in adolescence was effective for preventing osteoporosis and fractures in older age. Exercise programs as part of vigorous physical activity (VPA) including resistance and impact exercise at least 5 to 6 months were effective for improving PBM in adolescents. It is recommended that resistance exercise is performed 10 to 12 rep·set−1 1-2 set·region−1 and 3 days·week−1 using the large muscles. For impact exercises such as jumping, it is recommended that the exercise is performed at least 50 jumps·min−1, 10 min·day−1 and 2 days·week−1. Conclusions Exercise guidelines were successfully developed, and they recommend at least 5 to 6 months of VPA, which includes both resistance and impact exercises. With the development of exercise guidelines, the incidence of osteoporosis and fractures in the aging society can be reduced in the future, thus contributing to improved public health.
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Affiliation(s)
- Seok-Ki Min
- Department of Sport Science, Korea Institute of Sport Science, Seoul, Korea
| | - Taewoong Oh
- Department of Sport Leisure, College of Sport Sciences, Yongin University, Yongin, Korea
| | - Sang Hyun Kim
- Department of Sports Science, College of Natural Science, Chonbuk National University, Jeonju, Korea
| | - Jinkyung Cho
- College of Sport Science, Sungkyunkwan University, Suwon, Korea
| | - Ho Yeon Chung
- Department of Endocrinology and Metabolism, Department of Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Dong-Ho Park
- Department of Kinesiology, Inha University, Incheon, Korea
| | - Chang-Sun Kim
- Department of Physical Education, Dongduck Women's University, Seoul, Korea
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Gou GH, Tseng FJ, Wang SH, Chen PJ, Shyu JF, Pan RY. Nutritional factors associated with femoral neck bone mineral density in children and adolescents. BMC Musculoskelet Disord 2019; 20:520. [PMID: 31699056 PMCID: PMC6839089 DOI: 10.1186/s12891-019-2901-9] [Citation(s) in RCA: 4] [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: 05/13/2019] [Accepted: 10/17/2019] [Indexed: 12/16/2022] Open
Abstract
Background Nutritional factors including vitamin D, magnesium, and fat are known to affect bone mineral accrual. This study aimed to evaluate associations between dietary nutrient intakes (both macronutrients and micronutrients) and bone mineral density (BMD) in children and adolescents. Methods Data for this cross-sectional, population-based study were derived from the National Health and Nutrition Examination Survey (NHANES). Participants aged from 8 to 19 years were included. The primary outcome was femoral neck BMD. Results Multivariate analyses revealed that for participants aged 8 to 11, daily sodium intake was significantly and positively associated with femoral neck BMD (B = 0.9 × 10− 5, p = 0.031); in particular, subgroup analyses by sex found that in male participants aged 8–11, daily total cholesterol intake (B = 5.3 × 10− 5, p = 0.030) and calcium intake (B = − 2.0 × 10− 5, p < 0.05) were significantly associated with femoral neck BMD in a positive and negative manner, respectively, but neither were observed in female participants of this age group. In contrast, daily intakes of vitamin D and magnesium were significantly and positively associated with femoral neck BMD in female participants aged 8–11 (B = 246.8 × 10− 5 and 16.3 × 10− 5, p = 0.017 and 0.033, respectively). For participants aged 16 to 19, daily total fat intake was significantly and negatively associated with femoral neck BMD (B = − 58 × 10− 5, p = 0.048); further stratification by sex found that magnesium and sodium intakes were significantly and positively associated with femoral neck BMD only in females of this age group (B = 26.9 × 10− 5 and 2.1 × 10− 5, respectively; both p < 0.05). However, no significant associations between daily nutrient intakes and femoral neck BMD were identified in participants aged 12–15 before or after subgroup stratification. Conclusion The study found that associations of specific nutrition-related variables with BMD of the femoral neck is dependent upon age and gender.
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Affiliation(s)
- Guo-Hau Gou
- Graduate Institute of Medical Sciences, National Defense Medical Center, No. 161, Sec.6 Minquan E. Rd., Neihu Dist., Taipei, 11490, Taiwan, Republic of China.,Department of Nursing, Hsin Sheng Junior College of Medical Care and Management, Taoyuan, 32544, Taiwan, Republic of China
| | - Feng-Jen Tseng
- Department of Orthopedics, Hualien Armed Force Hospital, Hualien, 971, Taiwan, Republic of China.,Department of Life Science and the Institute of Biotechnology, National Dong Hwa University, Hualien, 974, Taiwan, Republic of China
| | - Sheng-Hao Wang
- Graduate Institute of Medical Sciences, National Defense Medical Center, No. 161, Sec.6 Minquan E. Rd., Neihu Dist., Taipei, 11490, Taiwan, Republic of China.,Department of Orthopaedics, Tri-Service General Hospital, National Defense Medical Center, Taipei, 11490, Taiwan, Republic of China
| | - Pao-Ju Chen
- Department of Nursing, Hsin Sheng Junior College of Medical Care and Management, Taoyuan, 32544, Taiwan, Republic of China
| | - Jia-Fwu Shyu
- Department of Biology and Anatomy, National Defense Medical Center, Taipei, 11490, Taiwan, Republic of China
| | - Ru-Yu Pan
- Graduate Institute of Medical Sciences, National Defense Medical Center, No. 161, Sec.6 Minquan E. Rd., Neihu Dist., Taipei, 11490, Taiwan, Republic of China. .,Department of Orthopaedics, Tri-Service General Hospital, National Defense Medical Center, Taipei, 11490, Taiwan, Republic of China.
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Tamme R, Jürimäe J, Mäestu E, Remmel L, Purge P, Mengel E, Tillmann V. Physical Activity in Puberty is Associated with Total Body and Femoral Neck Bone Mineral Characteristics in Males at 18 Years of Age. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E203. [PMID: 31126164 PMCID: PMC6572272 DOI: 10.3390/medicina55050203] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 04/30/2019] [Accepted: 05/21/2019] [Indexed: 01/12/2023]
Abstract
Background and objectives: Studies indicate that genetic and lifestyle factors influence optimal bone development. Adaptations in bone mineral characteristics related to physical activity (PA) are most often observed in pre- and peri-puberty. Longitudinal associations between bone mineral accrual and objectively measured PA in puberty are poorly understood. The present study aims to investigate whether pubertal PA at different intensities is related to bone mineral characteristics in individuals at 18 years of age. Materials and Methods: Anthropometrics, pubertal stage, bone age and PA by accelerometer were measured in 88 boys at the mean age of 12.1 (T1), 13.1 (T2), 14.0 (T3) and 18.0 years (T4). Different bone mineral parameters were measured by dual-energy X-ray at T4. Stepwise multiple regression analysis was performed to determine the effect of bone age, body mass and PA characteristics on measured bone mineral parameters at 18 years of age. Results: Total PA in puberty together with mean pubertal body mass predicted 35.5% of total body (TB) bone mineral density (BMD), 43.0% of TB less head (LH) bone mineral content (BMC) and 48.1% of BMC/height in individuals at 18 years of age. Vigorous PA and body mass in puberty predicted 43.2% of femoral neck (FN) BMD; bone age at T1, vigorous PA and body mass in puberty predicted 47.3% of FN BMC at 18 years of age. No associations between pubertal PA levels and lumbar spine bone mineral characteristics in individuals at 18 years of age were found. Conclusions: Physical activity in puberty has a significant impact on bone mineral characteristics in individuals at 18 years of age, with total PA being a significant predictor of TB BMD and TB LH BMC as well as BMC/height, whereas vigorous PA is a significant predictor of FN BMD and FN BMC.
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Affiliation(s)
- Reeli Tamme
- Institute of Clinical Medicine, University of Tartu, 50406 Tartu, Estonia.
- Children's Clinic of Tartu University Hospital, 50406 Tartu, Estonia.
| | - Jaak Jürimäe
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007 Tartu, Estonia.
| | - Evelin Mäestu
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007 Tartu, Estonia.
| | - Liina Remmel
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007 Tartu, Estonia.
| | - Priit Purge
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007 Tartu, Estonia.
| | - Eva Mengel
- Children's Clinic of Tartu University Hospital, 50406 Tartu, Estonia.
| | - Vallo Tillmann
- Institute of Clinical Medicine, University of Tartu, 50406 Tartu, Estonia.
- Children's Clinic of Tartu University Hospital, 50406 Tartu, Estonia.
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