A longitudinal study of bone density in midlife women

Lifestyle physical activity behavior among South Asian Indian immigrants

Little is known of the physical activity behavior of South Asian Indian immigrants (SAIs), though they have more than twice the risk for cardiovascular disease and diabetes than Whites. This was a cross-sectional descriptive face-to-face survey design, comparing between men and women in leisure time (LTPA), household (HPA), and occupational physical activity (OPA). Participants also wore a Lifecorder EX (NL2200) accelerometer for 7 days. Just over half (51.8 %) of the participants met the recommended PA guidelines (≥150 min moderate-intensity or ≥75 min vigorous-intensity) through LTPA. The average number of daily steps was 6,904.3, which is in the "low active" classification. Increasing lifestyle PA among SAIs is important; PA interventions appealing to gender and culture and with an aerobic component are needed.

Body mass index, physical activity, and fracture among young adults: longitudinal results from the Thai cohort study

Background

We investigated risk factors for fracture among young adults, particularly body mass index (BMI) and physical activity, which although associated with fracture in older populations have rarely been investigated in younger people.

Methods

In 2009, 4 years after initial recruitment, 58 204 Thais aged 19 to 49 years were asked to self-report fractures incident in the preceding 4 years. Conditional logistic regression was used to calculate odds ratios (ORs) and 95% CIs for associations of fracture incidence with baseline BMI and physical activity.

Results

Very obese women had a 70% increase in fracture risk (OR = 1.73, 95% CI 1.21–2.46) as compared with women with a normal BMI. Fracture risk increased by 15% with every 5-kg/m² increase in BMI. The effects were strongest for fractures of the lower limbs. Frequent purposeful physical activity was also associated with increased fracture risk among women (OR = 1.52, 95% CI 1.12–2.06 for 15 episodes/week vs none). Neither BMI nor physical activity was associated with fracture among men, although fracture risk decreased by 4% with every additional 2 hours of average sitting time per day (OR = 0.96, 95% CI 0.93–0.99).

Conclusions

The increase in obesity prevalence will likely increase fracture burden among young women but not young men. While active lifestyles have health benefits, our results highlight the importance of promoting injury prevention practices in conjunction with physical activity recommendations, particularly among women.

Long-term coffee consumption in relation to fracture risk and bone mineral density in women

High consumption of coffee has been suggested to reduce the risk of some late-onset diseases and death but also to contribute to the development of osteoporotic fractures. Results of previous fracture studies have been inconsistent, and a comprehensive study is needed. The longitudinal population-based Swedish Mammography Cohort, including 61,433 women born in 1914-1948, was followed up from 1987 through 2008. Coffee consumption was assessed with repeated food frequency questionnaires. During follow-up, 14,738 women experienced fracture of any type, and 3,871 had a hip fracture. In a subcohort (n = 5,022), bone density was measured and osteoporosis determined (n = 1,012). After multivariable adjustment, there was no evidence of a higher rate of any fracture (hazard ratio per 200 mL coffee = 0.99; 95% confidence interval: 0.98, 1.00) or hip fracture (hazard ratio per 200 mL coffee = 0.97, 95% confidence interval: 0.95, 1.00) with increasing coffee consumption. A high coffee intake (≥4 cups daily) versus a low intake (<1 cup daily) was associated with a 2%-4% lower bone density, depending on site (P < 0.001), but the odds ratio for osteoporosis was only 1.28 (95% confidence interval: 0.88, 1.87). Thus, high coffee consumption was associated with a small reduction in bone density that did not translate into an increased risk of fracture.

Physical activity during life course and bone mass: a systematic review of methods and findings from cohort studies with young adults

Background

The purpose of this paper was to review the literature of the cohort studies which evaluated the association between physical activity during the life course and bone mineral content or density in young adults.

Methods

Prospective cohort studies with bone mineral density or content measured in the whole body, lumbar spine and femoral neck by dual energy x-ray absorptiometry as outcome and physical activity as exposure were searched. Two independent reviewers selected studies retrieved from electronic databases (Medline, Lilacs, Web of Science and Scielo) and reviewed references of all selected full text articles. Downs & Black criterion was used in the quality assessment of these studies.

Results

Nineteen manuscripts met inclusion criteria. Lumbar spine was the skeletal site most studied (n = 15). Different questionnaires were used for physical activity evaluation. Peak strain score was also used to evaluate physical activity in 5 manuscripts. Lack of statistical power calculation was the main problem found in the quality assessment. Positive associations between physical activity and bone mass were found more in males than in females; in weight bearing anatomical sites (lumbar spine and femoral neck) than in total body and when physical activity measurements were done from adolescence to adulthood – than when evaluated in only one period. Physical activity during growth period was associated with greater bone mass in males. It was not possible to conduct pooled analyses due to the heterogeneity of the studies, considering mainly the different instruments used for physical activity measurements.

Conclusions

Physical activity seems to be important for bone mass in all periods of life, but especially the growth period should be taking into account due to its important direct effect on bone mass and its influence in physical activity practice in later life. Low participation in peak strain activities may also explain the lower number of associations found in females.

Physical activity and health during the menopausal transition

The benefits of regular physical activity are well established, but evidence for a protective effect against the adverse health consequences accompanying the menopausal transition is limited. This article reviews that evidence, concluding that more physical activity is generally associated with fewer somatic and mood symptoms. Physical activity seems to minimize weight gain and changes in body composition and fat distribution experienced at midlife and might attenuate the rapid bone density loss that occurs. Given these benefits, clinicians treating perimenopausal women should encourage their patients to follow guidelines for physical activity (≥150 minutes a week of moderate-intensity activity).

Lifestyle physical activity behavior of Korean American dry cleaner couples

OBJECTIVE

The purposes of this study were to: (1) describe and compare lifestyle physical activity (leisure-time physical activity [LTPA], household physical activity [HPA], and occupational physical activity [OPA]), using both self-report and an objective measure of step counts, in self-employed Korean American married couples working together at dry cleaners, and (2) examine the relationship between self-report and objective measures of physical activity.

DESIGN AND SAMPLE

70 couples participated in this cross-sectional, descriptive, face-to-face interview survey.

MEASURES

2 self-reports (28-item Community Healthy Activities Model Program for Seniors Physical Activity Questionnaire and Tecumseh Occupational Physical Activity Questionnaire) and 1 objective measure (New Lifestyles-800 pedometer) were used.

RESULTS

The husbands spent significantly more time than their wives in moderate- to vigorous-intensity LTPA (207 vs. 122 min/week) and OPA (2,585 vs. 1,065 min/week). Most couples (91%) met recommended levels of physical activity based on their OPA. Pedometer steps correlated significantly only with LTPA.

CONCLUSIONS

Study findings suggest that to increase physical activity in Korean American couples who work in a small business, moderate-intensity lifestyle physical activity interventions across LTPA, HPA, and OPA will be more successful than traditional leisure-time interventions. In addition, results suggest that there is a need for interventions that target both members of the married couple.

Coffee consumption and CYP1A2 genotype in relation to bone mineral density of the proximal femur in elderly men and women: a cohort study

Background

Drinking coffee has been linked to reduced calcium conservation, but it is less clear whether it leads to sustained bone mineral loss and if individual predisposition for caffeine metabolism might be important in this context. Therefore, the relation between consumption of coffee and bone mineral density (BMD) at the proximal femur in men and women was studied, taking into account, for the first time, genotypes for cytochrome P450 1A2 (CYP1A2) associated with metabolism of caffeine.

Methods

Dietary intakes of 359 men and 358 women (aged 72 years), participants of the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS), were assessed by a 7-day food diary. Two years later, BMD for total proximal femur, femoral neck and trochanteric regions of the proximal femur were measured by Dual-energy X-ray absorptiometry (DXA). Genotypes of CYP1A2 were determined. Adjusted means of BMD for each category of coffee consumption were calculated.

Results

Men consuming 4 cups of coffee or more per day had 4% lower BMD at the proximal femur (p = 0.04) compared with low or non-consumers of coffee. This difference was not observed in women. In high consumers of coffee, those with rapid metabolism of caffeine (C/C genotype) had lower BMD at the femoral neck (p = 0.01) and at the trochanter (p = 0.03) than slow metabolizers (T/T and C/T genotypes). Calcium intake did not modify the relation between coffee and BMD.

Conclusion

High consumption of coffee seems to contribute to a reduction in BMD of the proximal femur in elderly men, but not in women. BMD was lower in high consumers of coffee with rapid metabolism of caffeine, suggesting that rapid metabolizers of caffeine may constitute a risk group for bone loss induced by coffee.

Risk factors for low bone mass in healthy 40-60 year old women: a systematic review of the literature

Based on a systematic review of the literature, only low body weight and menopausal status can be considered with confidence, as important risk factors for low BMD in healthy 40-60 year old women. The use of body weight to identify high risk women may reduce unnecessary BMD testing in this age group.

INTRODUCTION

BMD testing of perimenopausal women is increasing but may be unnecessary as fracture risk is low. Appropriate assessment among younger women requires identification of risk factors for low BMD specific to this population.

METHODS

We conducted a systematic literature review of risk factors for low BMD in healthy women aged 40-60 years. Articles were retrieved from six databases and reviewed for eligibility and methodological quality. A grade for overall strength of evidence for each risk factor was assigned.

RESULTS

There was good evidence that low body weight and post-menopausal status are risk factors for low BMD. There was good or fair evidence that alcohol and caffeine intake, and reproductive history are not risk factors. There was inconsistent or insufficient evidence for the effect of calcium intake, physical activity, smoking, age at menarche, history of amenorrhea, family history of OP, race and current age on BMD.

CONCLUSIONS

Based on current evidence in Caucasians, we suggest that, in healthy women aged 40-60 years, only those with a low body weight (< 70 kg) be selected for BMD testing. Further research is necessary to determine optimal race-specific discriminatory weight cut-offs and to evaluate the risk factors for which there was inconclusive evidence.

Gender Differences in Smoking and Self Reported Indicators of Health

Health Issue

Smoking among Canadian women is a serious public health issue. Using the 1998–99 National Population Health Survey, this study examined underlying factors contributing to differences in prevalence of smoking among subgroups of women and men, and its effects on self-reported indicators of health.

Key Findings

In Canada, 26.4% of women and 29.2% of men were classified as current smokers. Higher levels of education and income were associated with decreased odds of current smoking. Adjusting for all other factors, being an ethnic minority decreased the odds of current smoking for both men and women (OR:0.35, 99%CI:0.23–0.54; OR:0.13, 99%CI: 0.09–0.20 respectively). Single mothers had the highest odds of smoking (OR: 2.12, 99%CI: 1.28–3.51) when compared to married mothers with children under 25 years of age. Current women smokers and current and former men smokers were less likely to report very good or excellent health compared with never smokers (OR: 0.83, 99%CI: 0.70–0.98; OR: 0.49, 99%CI: 0.41–0.60; OR: 0.75, 99%CI: 0.63–0.90 respectively). Women who were current smokers had increased odds of needing health care and not receiving it (OR: 1.50, 99%CI: 1.10–2.05).

Data Gaps and Recommendations

Key issues for Canadian women include an increased prevalence of smoking among young girls and the strong association between smoking and social and economic disadvantage. Tobacco control policies and programs must target high-risk groups more effectively. Of particular importance is the development of programs and policies that do not serve to reinforce existing inequities, but rather, contribute to their amelioration.

The use of quantitative ultrasound in assessing bone status in newborn preterm infants

OBJECTIVE

Quantitative ultrasound is increasingly used to assess bone status in adults and children; however, few studies have been carried out in neonates. Our objective was to determine if tibial bone speed of sound (SOS) correlates with gestational age and birth anthropometrics, and if bone SOS is related to maternal factors.

STUDY DESIGN

We prospectively studied 95 preterm infants to assess factors related to bone status as measured by quantitative ultrasound.

RESULTS

We found significant (p< or =0.001) positive correlations between SOS and gestational age, birth weight, length, head circumference and tibial length. There was no significant relationship between SOS and prenatal steroid use, gestational diabetes, pre-eclampsia, race or parity.

CONCLUSIONS

Quantitative ultrasound is an easy to use and inexpensive tool for assessing bone status in preterm neonates. Tibial SOS correlated with gestational age and birth anthropometrics, and was not related by few maternal factors.