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Rodríguez-Gómez I, Martín-García M, García-Cuartero B, González-Vergaz A, Carcavilla A, Aragonés Á, Alegre LM, Ara I. Body Composition as a Mediator between Cardiorespiratory Fitness and Bone Mass during Growth. Med Sci Sports Exerc 2020; 52:498-506. [PMID: 31939913 DOI: 10.1249/mss.0000000000002146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION AND PURPOSE To examine the effect of cardiorespiratory fitness (CRF) and muscle power output (MPO) on bone mass of prepubertal and pubertal children using lean mass (LM) and percentage of fat mass (%FM) as mediator variables. The hypothesis was that both LM and %FM would be independent mediators of the relationships during the sexual maturation period. METHODS We analyzed 200 children (88 boys and 112 girls [11.5 ± 2.0 yr]). Body composition was analyzed by bone densitometry, and indirect calorimetry and cycle ergometer were used to calculate V˙O2peak (mL·kg·min) and MPO (W) during an incremental exercise test. Sample was divided by pubertal status. RESULTS In the prepubertal group, LM and %FM acted independently as mediators in the relationship between bone mass and CRF or MPO (22%-25% for LM and 37%-50% for %FM, respectively). In pubertal children, LM acted as mediator at 37%. CONCLUSIONS Although the independent mediator role of LM and %FM in the associations between CRF or MPO and bone mass was present during the prepubertal stage, only LM remain its mediator role in these associations during the postpubertal period. Therefore, with growth and sexual maturation, the full effect of LM seems to increase, whereas the influence of %FM seems to disappear.
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Affiliation(s)
| | | | | | | | | | - Ángel Aragonés
- Endocrinology and Pediatric Service, Virgen de la Salud Hospital, SPAIN
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Kelley JC, Crabtree N, Zemel BS. Bone Density in the Obese Child: Clinical Considerations and Diagnostic Challenges. Calcif Tissue Int 2017; 100:514-527. [PMID: 28105511 PMCID: PMC5395312 DOI: 10.1007/s00223-016-0233-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 12/29/2016] [Indexed: 12/29/2022]
Abstract
The prevalence of obesity in children has reached epidemic proportions. Concern about bone health in obese children, in part, derives from the potentially increased fracture risk associated with obesity. Additional risk factors that affect bone mineral accretion, may also contribute to obesity, such as low physical activity and nutritional factors. Consequences of obesity, such as inflammation, insulin resistance, and non-alcoholic fatty liver disease, may also affect bone mineral acquisition, especially during the adolescent years when rapid increases in bone contribute to attaining peak bone mass. Further, numerous pediatric health conditions are associated with excess adiposity, altered body composition, or endocrine disturbances that can affect bone accretion. Thus, there is a multitude of reasons for considering clinical assessment of bone health in an obese child. Multiple diagnostic challenges affect the measurement of bone density and its interpretation. These include greater precision error, difficulty in positioning, and the effects of increased lean and fat tissue on bone health outcomes. Future research is required to address these issues to improve bone health assessment in obese children.
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Affiliation(s)
- Jennifer C Kelley
- Division of Endocrinology and Diabetes, Monroe Carell, Jr Children's Hospital at Vanderbilt, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA
| | - Nicola Crabtree
- Department of Endocrinology and Diabetes, Birmingham Children's Hospital, Birmingham, UK
| | - Babette S Zemel
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Room 1560, Philadelphia, PA, 19104, USA.
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Chaplais E, Thivel D, Greene D, Dutheil F, Duche P, Naughton G, Courteix D. Bone-adiposity cross-talk: implications for pediatric obesity. A narrative review of literature. J Bone Miner Metab 2015; 33:592-602. [PMID: 25796628 DOI: 10.1007/s00774-015-0654-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Accepted: 01/12/2015] [Indexed: 01/01/2023]
Abstract
The rising prevalence of overweight and obesity among pediatric populations has become a major global concern. The objective of this review is to demonstrate potential interactions between the products released by fat tissue and the hormonal production of bone tissue in obese children and adolescents. Advancing the understanding of the complex interactions between adipocyte and osteocyte activities may contribute to the mechanistic understanding of the body's responses to weight loss during adolescence. This knowledge could also reveal any side effects encountered with these interventions. Currently, the concept of bone-adiposity crosstalk has not been fully elucidated, and the mechanisms remain controversial. Understanding the local interactions between the released products by fat tissue and hormones produced in bone tissue requires further investigations.
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Affiliation(s)
- Elodie Chaplais
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), EA 3533, Clermont University, Blaise Pascal University, Clermont-Ferrand, France.
- School of Exercise Science, Australian Catholic University, Strathfield campus, Locked Bag 2002, Strathfield, NSW, 2135, Australia.
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), EA 3533, Clermont University, Blaise Pascal University, Clermont-Ferrand, France
- CRNH-Auvergne, Clermont-Ferrand, France
| | - David Greene
- School of Exercise Science, Australian Catholic University, Strathfield campus, Locked Bag 2002, Strathfield, NSW, 2135, Australia
| | - Frederic Dutheil
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), EA 3533, Clermont University, Blaise Pascal University, Clermont-Ferrand, France
- School of Exercise Science, Australian Catholic University, Strathfield campus, Locked Bag 2002, Strathfield, NSW, 2135, Australia
- Occupational Medicine, University Hospital CHU G. Montpied, 63000, Clermont-Ferrand, France
| | - Pascale Duche
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), EA 3533, Clermont University, Blaise Pascal University, Clermont-Ferrand, France
- CRNH-Auvergne, Clermont-Ferrand, France
| | - Geraldine Naughton
- School of Exercise Science, Australian Catholic University, Strathfield campus, Locked Bag 2002, Strathfield, NSW, 2135, Australia
- School of Exercise Science, Australian Catholic University, Melbourne campus, Fitzroy MDC, Locked Bag 4115, Fitzroy, VIC, 3065, Australia
| | - Daniel Courteix
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), EA 3533, Clermont University, Blaise Pascal University, Clermont-Ferrand, France
- School of Exercise Science, Australian Catholic University, Strathfield campus, Locked Bag 2002, Strathfield, NSW, 2135, Australia
- CRNH-Auvergne, Clermont-Ferrand, France
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Physical activity and bone health in schoolchildren: the mediating role of fitness and body fat. PLoS One 2015; 10:e0123797. [PMID: 25915941 PMCID: PMC4411135 DOI: 10.1371/journal.pone.0123797] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 03/06/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The relationship between physical activity (PA) and bone health is well known, although the role of percent body fat (%BF) and fitness as confounders or mediators in this relationship remains uncertain. OBJECTIVE To examine whether the association between PA and bone mineral content (BMC) is mediated by %BF and cardiorespiratory fitness (CRF). METHODS In this cross sectional study, BMC, total %BF (by DXA), vigorous PA (VPA), CRF, age and height were measured in 132 schoolchildren (62 boys, aged 8-11 years). ANCOVA was used to test differences in BMC by %BF, CRF and VPA, controlling for different sets of confounders. Simple mediation analyses and serial multiple mediation analyses were fitted to examine whether the relationship between PA and BMC is mediated by %BF and fitness. RESULTS Children with high %BF had higher total body BMC than their peers after controlling for all sets of confounders. Children with good CRF or VPA had significantly less total body BMC after controlling for age and sex but in children with good CRF this inverse relation disappeared after adjusting by %BF. %BF and CRF both act as a full mediator in the association between VPA and BMC, after inclusion of the potential confounders in the models. CONCLUSION Fitness and %BF seem to have a mediator role on the relationship between physical activity and bone mass.
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