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Montgomery G, Tobias JH, Paskins Z, Khera TK, Huggins CJ, Allison SJ, Abasolo D, Clark EM, Ireland A. Daily Pain Severity but Not Vertebral Fractures Is Associated With Lower Physical Activity in Postmenopausal Women With Back Pain. J Aging Phys Act 2024; 32:428-437. [PMID: 38527456 DOI: 10.1123/japa.2023-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 08/24/2023] [Accepted: 12/13/2023] [Indexed: 03/27/2024]
Abstract
Back pain lifetime incidence is 60%-70%, while 12%-20% of older women have vertebral fractures (VFs), often with back pain. We aimed to provide objective evidence, currently lacking, regarding whether back pain and VFs affect physical activity (PA). We recruited 69 women with recent back pain (age 74.5 ± 5.4 years). Low- (0.5 < g < 1.0), medium- (1.0 ≤ g < 1.5), and high-impact (g ≥ 1.5) PA and walking time were measured (100 Hz for 7 days, hip-worn accelerometer). Linear mixed-effects models assessed associations between self-reported pain and PA, and group differences (VFs from spine radiographs/no-VF) in PA. Higher daily pain was associated with reduced low (β = -0.12, 95% confidence interval, [-0.22, -0.03], p = .013) and medium-impact PA (β = -0.11, 95% confidence interval, [-0.21, -0.01], p = .041), but not high-impact PA or walking time (p > .11). VFs were not associated with PA (all p > .2). Higher daily pain levels but not VFs were associated with reduced low- and medium-impact PA, which could increase sarcopenia and falls risk in older women with back pain.
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Affiliation(s)
- Gallin Montgomery
- Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, United Kingdom
| | - Jon H Tobias
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Zoe Paskins
- School of Medicine, Keele University, Staffordshire, United Kingdom
- Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-on-Trent, Staffordshire, United Kingdom
| | - Tarnjit K Khera
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Cameron J Huggins
- Centre for Biomedical Engineering, School of Mechanical Engineering Sciences, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford, United Kingdom
| | - Sarah J Allison
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, United Kingdom
- Department of Nutrition, Food & Exercise Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Daniel Abasolo
- Centre for Biomedical Engineering, School of Mechanical Engineering Sciences, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford, United Kingdom
| | - Emma M Clark
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Alex Ireland
- Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, United Kingdom
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Skinner AM, Rowlands AV, Vlachopoulos D, Barker AR, Janz KF, Moore SA. The Influence of Accelerometer Epoch Length on Associations of Physical Activity Intensity and Volume with Bone Outcomes. J Sports Sci Med 2023; 22:117-132. [PMID: 36876186 PMCID: PMC9982530 DOI: 10.52082/jssm.2023.117] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 02/09/2023] [Indexed: 02/19/2023]
Abstract
Two accelerometer metrics (intensity-gradient and average-acceleration) can be used to determine the relative contributions of physical activity (PA) volume and intensity for health, but it is unknown whether epoch length influences the associations detected. This is important when considering bone health, as bone is particularly responsive to high intensity PA, which may be underestimated by longer epochs. This study aimed to assess the associations between average-acceleration, a proxy measure of PA volume, and intensity-gradient, reflective of PA intensity distribution, from PA data from 1-s to 60-s epochs at age 17 to 23 years with bone outcomes at age 23 years. This is a secondary analysis of 220 participants (124 females) from the Iowa Bone Development Study, a longitudinal study of bone health from childhood to early adulthood. Accelerometer-assessed PA data, captured at age 17 to 23 years, were summarised over 1-s, 5-s, 15-s, 30-s, and 60-s epochs, to generate average-acceleration and intensity-gradient from each epoch length, averaged across ages. Regression analysed associations between mutually adjusted average-acceleration and intensity-gradient with dual-energy X-ray absorptiometry assessed total-body-less-head (TBLH) bone mineral content (BMC), spine areal bone mineral density (aBMD), hip aBMD, and femoral neck cross-sectional area and section modulus at age 23 years. Intensity-gradient was positively associated with TBLH BMC in females, with spine aBMD in males, and with hip aBMD and geometry in both sexes, when a 1 to 5-s epoch was used. Average-acceleration was positively associated with TBLH BMC, spine aBMD and hip aBMD in males, generally when the adjustment for intensity-gradient was from > 1-s epochs. Intensity and volume were important for bone outcomes in both sexes and males, respectively. A 1 to 5-s epoch length was most appropriate to assess the mutually adjusted associations of intensity-gradient and average-acceleration with bone outcomes in young adults.
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Affiliation(s)
- Annie M Skinner
- Children's Health and Exercise Research Centre, University of Exeter, Exeter, UK
| | - Alex V Rowlands
- Assessment of Movement Behaviours Group (AMBer), Leicester Lifestyle and Health Research Group, Diabetes Research Centre, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, UK
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, Division of Health Sciences, University of South Australia, Adelaide, Australia
| | | | - Alan R Barker
- Children's Health and Exercise Research Centre, University of Exeter, Exeter, UK
| | - Kathleen F Janz
- Department of Health and Human Physiology, The University of Iowa, Iowa City, IA
- Department of Epidemiology, The University of Iowa, Iowa City, IA
| | - Sarah A Moore
- School of Health and Human Performance, Dalhousie University, Halifax, Canada
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Huggins CJ, Clarke R, Abasolo D, Gil-Rey E, Tobias JH, Deere K, Allison SJ. Machine Learning Models for Weight-Bearing Activity Type Recognition Based on Accelerometry in Postmenopausal Women. SENSORS (BASEL, SWITZERLAND) 2022; 22:9176. [PMID: 36501877 PMCID: PMC9740741 DOI: 10.3390/s22239176] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
Hip-worn triaxial accelerometers are widely used to assess physical activity in terms of energy expenditure. Methods for classification in terms of different types of activity of relevance to the skeleton in populations at risk of osteoporosis are not currently available. This publication aims to assess the accuracy of four machine learning models on binary (standing and walking) and tertiary (standing, walking, and jogging) classification tasks in postmenopausal women. Eighty women performed a shuttle test on an indoor track, of which thirty performed the same test on an indoor treadmill. The raw accelerometer data were pre-processed, converted into eighteen different features and then combined into nine unique feature sets. The four machine learning models were evaluated using three different validation methods. Using the leave-one-out validation method, the highest average accuracy for the binary classification model, 99.61%, was produced by a k-NN Manhattan classifier using a basic statistical feature set. For the tertiary classification model, the highest average accuracy, 94.04%, was produced by a k-NN Manhattan classifier using a feature set that included all 18 features. The methods and classifiers within this study can be applied to accelerometer data to more accurately characterize weight-bearing activity which are important to skeletal health.
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Affiliation(s)
- Cameron J. Huggins
- Centre for Biomedical Engineering, School of Mechanical Engineering Sciences, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Rebecca Clarke
- Centre for Biomedical Engineering, School of Mechanical Engineering Sciences, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Daniel Abasolo
- Centre for Biomedical Engineering, School of Mechanical Engineering Sciences, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Erreka Gil-Rey
- Faculty of Psychology and Education, University of Deusto, 20012 San Sebastián, Spain
| | - Jonathan H. Tobias
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol BS10 5NB, UK
- MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
| | - Kevin Deere
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol BS10 5NB, UK
| | - Sarah J. Allison
- School of Health and Life Sciences, Teesside University, Middlesbrough TS1 3BX, UK
- School of Bioscience and Medicine, University of Surrey, Guildford GU2 7XH, UK
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Parsons CM, Dennison EM, Fuggle N, Breasail MÓ, Deere K, Hannam K, Tobias JH, Cooper C, Ward KA. Assessment of Activity Profiles in Older Adults and Lower Limb Bone Parameters: Observations from the Hertfordshire Cohort Study. Calcif Tissue Int 2022; 111:13-20. [PMID: 35212826 PMCID: PMC9232475 DOI: 10.1007/s00223-022-00953-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 01/25/2022] [Indexed: 11/29/2022]
Abstract
As muscle strength and function decline with age the optimal high-impact physical activity (PA) required for bone remodelling is rarely achievable in older adults. This study aimed to explore the activity profiles of community-dwelling older men and women and to assess the relationship between individual PA profiles and lower limb bone parameters. Participants from the Hertfordshire Cohort Study wore triaxial accelerometers for 7 days and counts of low (0.5-1.0 g), medium (1.0-1.5 g), and high (> 1.5 g) vertical-impact activity were calculated. Two years later, participants underwent a pQCT scan of the tibia (4% and 38% sites) to obtain measures of bone mineral density and bone geometry. Linear regression was used to quantify associations between bone and PA loading profiles adjusting for age, sex, loading category, and BMI. Results are presented as β [95% confidence interval]. Bone and PA data were available for 82 participants. The mean (SD) age at follow-up was 81.4(2.7) years, 41.5% (n = 34) were women. The median low-impact PA count was 5281 (Inter-quartile range (IQR) 2516-12,977), compared with a median of only 189 (IQR 54-593) in medium, and 39 (IQR 9-105) in high-impact counts. Positive associations between high-impact PA and cortical area (mm2), polar SSI (mm3), and total area (mm2) at the 38% slice (6.21 [0.88, 11.54]; 61.94 [25.73, 98.14]; 10.09 [3.18, 16.99], respectively). No significant associations were found at distal tibia. These data suggest that maintaining high (> 1.5 g)-impact activity is difficult for older adults to achieve; however, even small amounts of high-impact PA are positively associated with selected cortical bone parameters 2 years later.
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Affiliation(s)
- C M Parsons
- MRC Lifecourse Epidemiology Centre, Human Health and Development, University of Southampton, Southampton, SO16 6YD, UK
| | - E M Dennison
- MRC Lifecourse Epidemiology Centre, Human Health and Development, University of Southampton, Southampton, SO16 6YD, UK
| | - N Fuggle
- MRC Lifecourse Epidemiology Centre, Human Health and Development, University of Southampton, Southampton, SO16 6YD, UK
| | - M Ó Breasail
- MRC Nutrition and Bone Health Research Group, Cambridge, UK
| | - K Deere
- Musculoskeletal Research Unit, University of Bristol, Bristol, UK
| | - K Hannam
- Musculoskeletal Research Unit, University of Bristol, Bristol, UK
| | - J H Tobias
- Musculoskeletal Research Unit, University of Bristol, Bristol, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Centre, Human Health and Development, University of Southampton, Southampton, SO16 6YD, UK.
- National Institute for Health Research Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
- National Institute for Health Research Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK.
| | - K A Ward
- MRC Lifecourse Epidemiology Centre, Human Health and Development, University of Southampton, Southampton, SO16 6YD, UK
- MRC Nutrition and Bone Health Research Group, Cambridge, UK
- National Institute for Health Research Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Simões D, Craveiro V, Santos MP, Camões M, Pires B, Ramos E. The effect of impact exercise on bone mineral density: A longitudinal study on non-athlete adolescents. Bone 2021; 153:116151. [PMID: 34391957 DOI: 10.1016/j.bone.2021.116151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE High impact exercise is known to induce osteogenic effects in the skeleton. However, less is known about the systemic effect of exercise practice in a potential adaptive mechanism of the skeletal accrual. This research aimed to assess the effect of impact exercise on bone mineral density (BMD) in the radius throughout adolescence. METHODS This study evaluated 1137 adolescents, at 13 and 17 years old, as part of the population-based cohort EPITeen. BMD (g/cm2) was measured at the ultradistal and proximal radius of the non-dominant forearm by dual-energy X-ray absorptiometry (DXA) using a Lunar® Peripheral Instantaneous X-ray Image device. The practice of (extra-curricular) exercise was categorized as: no exercise, exercise with high impact and exercise with low impact. Regression coefficients (β) and respective 95% confidence intervals (CI95%) were used to estimate the association between exercise practice categories at 13 years old and BMD at 13 and 17 years old and BMD gain between evaluations. RESULTS In boys, at 13 years, BMD was similar between the ones not practicing exercise and those practicing exercise with low impact, and the gain of BMD was also similar in both groups. Still in boys, at 13 years, those who practiced exercise with high impact presented higher mean (standard-deviation) of BMD, comparing to the other two groups (no exercise and low impact exercise), and also significantly increased the BMD gain between 13 and 17 years (β = 0.013; CI95%0.003;0.023). In girls, no statistically significant differences on BMD were found between the categories of exercise at 13 years and BMD at 17 years of age. CONCLUSION This research shows that the practice of high impact exercise could help to increase BMD more than low impact exercise even in a nonweight-bearing bone during adolescence.
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Affiliation(s)
- Daniela Simões
- EPIUnit - Institute of Public Health, University of Porto, 4050-600, Porto, Portugal; Santa Maria Health School, 4049-024 Porto, Portugal
| | - Vanda Craveiro
- EPIUnit - Institute of Public Health, University of Porto, 4050-600, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal
| | - Maria Paula Santos
- Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal; CIAFEL - Research Centre in Physical Activity, Health and Leisure, University of Porto, 4200-450 Porto, Portugal
| | - Miguel Camões
- EPIUnit - Institute of Public Health, University of Porto, 4050-600, Porto, Portugal
| | - Bruno Pires
- EPIUnit - Institute of Public Health, University of Porto, 4050-600, Porto, Portugal
| | - Elisabete Ramos
- EPIUnit - Institute of Public Health, University of Porto, 4050-600, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health (ITR), 4050-600 Porto, Portugal; Department of Public Health and Forensic Sciences, Medical Education, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
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Savikangas T, Sipilä S, Rantalainen T. Associations of physical activity intensities, impact intensities and osteogenic index with proximal femur bone traits among sedentary older adults. Bone 2021; 143:115704. [PMID: 33099029 DOI: 10.1016/j.bone.2020.115704] [Citation(s) in RCA: 3] [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: 05/20/2020] [Revised: 10/09/2020] [Accepted: 10/17/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Dynamic high-intensity physical activity is thought to be beneficial for older adults' bone health. Traditional volume-based processing of accelerometer-measured physical activity data, quantified on a minute-per-minute basis, may average out sporadic high impact activity, whereas accelerometer data processing approaches based on identifying impacts can capture also these potentially beneficial short activity bursts. We investigated the associations between habitual physical activity and proximal femur bone traits among sedentary older adults utilizing three different numerical treatments of accelerometer-data to examine, if impact-based processing approaches are more suitable to assess bone loading than volume-based processing of physical activity data among older adults. METHODS This cross-sectional study utilized the baseline data from the PASSWORD-study (n = 284, mean ± SD age 74 ± 4 years, 57% women). Total femur bone mineral content (BMC) and bone mineral density (BMD), femoral neck BMC, BMD, section modulus and minimal width (MNW) were measured with dual energy x-ray absorptiometry. Physical activity was measured for seven consecutive days with a tri-axial accelerometer. Raw acceleration data was processed in three different ways and quantified as i) mean daily minutes in sedentary, light and moderate-to-vigorous-intensity activity, ii) mean daily number of acceleration peaks divided into low (1.5 g to 2.0 g), medium (2.0 g to 2.5 g) and high (>2.5 g) impacts, and iii) mean daily osteogenic index, which is a summary score calculated from log-transformed number of impact peaks in 32 intensity bands (≥1.3 g). Associations between physical activity measures and each bone trait were estimated with multiple linear regression adjusted with covariates (age, sex, weight, height, smoking, physical function, medication). RESULTS Participants recorded on average 10 h sedentary, 2.5 h light and 33 min moderate-to-vigorous activity, and 3937 low, 494 medium and 157 high impacts per day. Mean osteogenic index score was 173. Light physical activity was positively associated with all bone traits (beta = 0.147 to 0.182, p < 0.001 to p = 0.005) except MNW. Sedentary or moderate-to-vigorous activity, low, medium or high impacts or osteogenic index were not associated with any bone parameter. CONCLUSIONS Light physical activity may decelerate the age-related bone loss in older adults who do not meet the physical activity recommendations. In this population, the amount of high impact activity may be insufficient to stimulate bone remodelling.
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Affiliation(s)
- Tiina Savikangas
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - Sarianna Sipilä
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - Timo Rantalainen
- Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
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Kellen de Souza Cardoso C, Gondim Peixoto MDR, dos Santos Rodrigues AP, Rodrigues Mendonça C, de Oliveira C, Aparecida Silveira E. Bone Mineral Density in Severely Obese Women: Health Risk and Health Protective Risk Factors in Three Different Bone Sites. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7017. [PMID: 32992832 PMCID: PMC7579229 DOI: 10.3390/ijerph17197017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 11/21/2022]
Abstract
Factors associated with bone mineral density (BMD) are poorly known in severely obese individuals i.e., a body mass index (BMI) > 35 kg/m2. The objectives of this study were to describe the bone health profile of severely obese Brazilian women, to identify the health risk and health protective factors for BMD in this group and to assess whether these factors vary according to three different bone sites. BMD was assessed using dual-energy X-ray absorptiometry (DXA). This study analyzed baseline data from 104 women who had an average BMI of 43.7 ± 4.5 kg/m2 and presented the following BMD status: 1.283 ± 0.094 g/cm2 for total body, 1.062 ± 0.159 g/cm2 for vertebral column and 1.195 ± 0.134 g/cm2 for hip. They took part in the "Effect of nutritional intervention and olive oil in severe obesity" randomized clinical trial (DieTBra Trial). The risk factors negatively associated with lower BMD were age ≥50 years for the three bone sites i.e., total body, vertebral column and hip. Smoking for total body BMD (p = 0.045); BMI ≥ 50kg/m2 for vertebral column and hip; menopause for hip; high C-reactive protein (CRP) levels (p = 0.049), insufficient zinc (p = 0.010) and previous fracture for vertebral column (p = 0.007). The protective factors positively associated with BMD were physical activity (≥150 min/week (p = 0.001)) for hip; type 2 diabetes mellitus (DM2) (p < 0.0001) total body and adequate vitamin D levels from food consumption (p = 0.039) for vertebral column. A BMI ≥ 50 kg/m2 was a risk factor for lower BMD. The findings showed that protective and risk factors varied by bone site. The original study is registered with ClinicalTrials.gov. (protocol number: NCT02463435).
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Affiliation(s)
| | - Maria do Rosário Gondim Peixoto
- Postgraduate Program in Nutrition and Health, Faculty of Nutrition, Federal University of Goias, Goiânia 74605-220, Goiás, Brazil;
| | - Ana Paula dos Santos Rodrigues
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia 74605-220, Goiás, Brazil; (A.P.d.S.R.); (C.R.M.)
| | - Carolina Rodrigues Mendonça
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia 74605-220, Goiás, Brazil; (A.P.d.S.R.); (C.R.M.)
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London WC1E 6BT, UK;
| | - Erika Aparecida Silveira
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia 74605-220, Goiás, Brazil; (A.P.d.S.R.); (C.R.M.)
- Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London WC1E 6BT, UK;
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Abstract
IMPORTANCE Peak bone strength, which occurs in early adulthood, is an important marker of the future risk of osteoporosis. It is therefore important to identify modifiable early life factors that are associated with the attainment of peak hip strength. OBJECTIVE To investigate the association of time spent in moderate to vigorous-intensity and light-intensity physical activity throughout adolescence with peak hip strength in adulthood. DESIGN, SETTING, AND PARTICIPANTS The Avon Longitudinal Study of Parents and Children is a prospective birth cohort study that initially recruited all pregnant women residing within the catchment area of 3 health authorities in southwest England who had an expected delivery date between April 1, 1991, and December 31, 1992. In total, 15 454 eligible pregnant women were enrolled, and 15 589 infants were delivered. Of those, 14 901 infants were alive at age 1 year. The present analysis examined 2569 healthy offspring who had valid physical activity measurements obtained during a clinical assessment for at least 1 age (12, 14, 16, and/or 25 years), with up to 4 repeated accelerometer assessments performed (1 per age-associated clinical visit). Data were analyzed from June 2019 to June 2020. EXPOSURES Trajectories of accelerometer-assessed time spent in moderate to vigorous-intensity and light-intensity physical activity at ages 12, 14, 16, and 25 years (measured in minutes per day) were identified using latent trajectory modeling. Moderate to vigorous-intensity and light-intensity physical activity were determined using established thresholds of acceleration counts per minute. MAIN OUTCOMES AND MEASURES Femur neck bone mineral density (BMD; measured in g/cm2) at age 25 years assessed by dual-energy radiography absorptiometry scans of the hip. RESULTS A total of 2569 participants (1588 female participants [62%]) were included in the analysis. Male participants spent more time in moderate to vigorous-intensity activity at each age and had greater adult femur neck BMD than female participants. For each sex, 3 moderate to vigorous-intensity trajectory subgroups and 3 light-intensity trajectory subgroups were identified. With regard to the moderate to vigorous-intensity trajectories, most male participants (85%) were in the low adolescent subgroup, with only 6% and 9% in the high early-adolescent and high mid-adolescent subgroups, respectively. Moderate to vigorous-intensity trajectories in female participants were divided into low adolescent-low adult (73%), low adolescent-high adult (8%), and high adolescent (19%) subgroups. Light-intensity physical activity trajectories were classified into low nonlinear, moderate decreasing, and high decreasing subgroups for both sexes. Femur neck BMD in male participants was greater in the high early-adolescent subgroup (0.38 g/cm2; 95% CI, 0.11-0.66 g/cm2) and the high mid-adolescent subgroup (0.33 g/cm2; 95% CI, 0.07-0.60 g/cm2) compared with the low adolescent (reference) subgroup. Femur neck BMD in female participants was greater in the high adolescent subgroup (0.28 g/cm2; 95% CI, 0.15-0.41 g/cm2) but not in the low adolescent-high adult subgroup (-0.12 g/cm2; 95% CI, -0.44 to 0.20 g/cm2) compared with the low adolescent-low adult (reference) subgroup. A sensitivity analysis using a negative-outcome control variable to explore unmeasured confounding supported these findings. The light-intensity trajectories were not associated with femur neck BMD; for example, differences in femur neck BMD between the high decreasing and low nonlinear subgroups were 0.16 g/cm2 (95% CI, -0.08 to 0.40 g/cm2) in male participants and 0.20 g/cm2 (95% CI, -0.05 to 0.44 g/cm2) in female participants. CONCLUSIONS AND RELEVANCE Supporting high-intensity physical activity throughout early life may help to maximize peak hip strength and prevent osteoporosis in later life. Replication of our findings in independent studies will be important.
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Affiliation(s)
- Ahmed Elhakeem
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Jon Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Jon H. Tobias
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Deborah A. Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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Babatunde OO, Bourton AL, Hind K, Paskins Z, Forsyth JJ. Exercise Interventions for Preventing and Treating Low Bone Mass in the Forearm: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2020; 101:487-511. [DOI: 10.1016/j.apmr.2019.07.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/11/2019] [Accepted: 07/16/2019] [Indexed: 12/22/2022]
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10
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Schilperoort M, Bravenboer N, Lim J, Mletzko K, Busse B, van Ruijven L, Kroon J, Rensen PCN, Kooijman S, Winter EM. Circadian disruption by shifting the light-dark cycle negatively affects bone health in mice. FASEB J 2020; 34:1052-1064. [PMID: 31914701 DOI: 10.1096/fj.201901929r] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/16/2019] [Accepted: 11/04/2019] [Indexed: 01/31/2023]
Abstract
The past decade, it has become evident that circadian rhythms within metabolically active tissues are very important for physical health. However, although shift work has also been associated with an increased risk of fractures, circadian rhythmicity has not yet been extensively studied in bone. Here, we investigated which genes are rhythmically expressed in bone, and whether circadian disruption by shifts in light-dark cycle affects bone turnover and structure in mice. Our results demonstrate diurnal expression patterns of clock genes (Rev-erbα, Bmal1, Per1, Per2, Cry1, Clock), as well as genes involved in osteoclastogenesis, osteoclast proliferation and function (Rankl, Opg, Ctsk), and osteocyte function (c-Fos) in bone. Weekly alternating light-dark cycles disrupted rhythmic clock gene expression in bone and caused a reduction in plasma levels of procollagen type 1 amino-terminal propeptide (P1NP) and tartrate-resistant acidic phosphatase (TRAP), suggestive of a reduced bone turnover. These effects coincided with an altered trabecular bone structure and increased cortical mineralization after 15 weeks of light-dark cycles, which may negatively affect bone strength in the long term. Collectively, these results show that a physiological circadian rhythm is important to maintain bone health, which stresses the importance of further investigating the association between shift work and skeletal disorders.
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Affiliation(s)
- Maaike Schilperoort
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden, The Netherlands
| | - Nathalie Bravenboer
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Medicine, Center for Bone Quality, Leiden University Medical Center, Leiden, The Netherlands
- Department of Clinical Chemistry, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Joann Lim
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden, The Netherlands
| | - Kathrin Mletzko
- Department of Osteology and Biomechanics (IOBM), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Björn Busse
- Department of Osteology and Biomechanics (IOBM), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Leo van Ruijven
- Department of Functional Anatomy, Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Jan Kroon
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden, The Netherlands
| | - Patrick C N Rensen
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden, The Netherlands
| | - Sander Kooijman
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden, The Netherlands
| | - Elizabeth M Winter
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden, The Netherlands
- Department of Medicine, Center for Bone Quality, Leiden University Medical Center, Leiden, The Netherlands
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11
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Tanaka H, Tarumi T, Rittweger J. Aging and Physiological Lessons from Master Athletes. Compr Physiol 2019; 10:261-296. [PMID: 31853968 DOI: 10.1002/cphy.c180041] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Sedentary aging is often characterized by physical dysfunction and chronic degenerative diseases. In contrast, masters athletes demonstrate markedly greater physiological function and more favorable levels of risk factors for cardiovascular disease, osteoporosis, frailty, and cognitive dysfunction than their sedentary counterparts. In many cases, age-related deteriorations of physiological functions as well as elevations in risk factors that are typically observed in sedentary adults are substantially attenuated or even absent in masters athletes. Older masters athletes possess greater functional capacity at any given age than their sedentary peers. Impressive profiles of older athletes provide insight into what is possible in human aging and place aging back into the domain of "physiology" rather than under the jurisdiction of "clinical medicine." In addition, these exceptional aging athletes can serve as a role model for the promotion of physical activity at all ages. The study of masters athletes has provided useful insight into the positive example of successful aging. To further establish and propagate masters athletics as a role model for our aging society, future research and action are needed. © 2020 American Physiological Society. Compr Physiol 10:261-296, 2020.
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Affiliation(s)
- Hirofumi Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas, USA
| | - Takashi Tarumi
- Human Informatics Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki, Japan.,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Jörn Rittweger
- German Aerospace Center (DLR), Institute of Aerospace Medicine, Cologne, Germany.,Department of Pediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
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12
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Elhakeem A, Hannam K, Deere KC, Hartley A, Clark EM, Moss C, Edwards MH, Dennison E, Gaysin T, Kuh D, Wong A, Fox KR, Cooper C, Cooper R, Tobias JH. Correlates of high-impact physical activity measured objectively in older British adults. J Public Health (Oxf) 2019; 40:727-737. [PMID: 29237047 PMCID: PMC5877787 DOI: 10.1093/pubmed/fdx171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Indexed: 01/24/2023] Open
Abstract
Background Exposure to higher magnitude vertical impacts is thought to benefit bone health. The correlates of this high-impact physical activity (PA) in later life are unknown. Methods Participants were from the Cohort for Skeletal Health in Bristol and Avon, Hertfordshire Cohort Study and MRC National Survey of Health and Development. Associations of demographic, behavioural, physiological and psychological factors with vertical acceleration peaks ≥1.5 g (i.e. high-impact PA) from 7-day hip-worn accelerometer recordings were examined using linear regression. Results A total of 1187 participants (mean age = 72.7 years, 66.6% females) were included. Age, sex, education, active transport, self-reported higher impact PA, walking speed and self-rated health were independently associated with high-impact PA whereas BMI and sleep quality showed borderline independent associations. For example, differences in log-high-impact counts were 0.50 (P < 0.001) for men versus women and −0.56 (P < 0.001) for worst versus best self-rated health. Our final model explained 23% of between-participant variance in high impacts. Other correlates were not associated with high-impact activity after adjustment. Conclusions Besides age and sex, several factors were associated with higher impact PA in later life. Our findings help identify characteristics of older people that might benefit from interventions designed to promote osteogenic PA.
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Affiliation(s)
- Ahmed Elhakeem
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Kimberly Hannam
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Kevin C Deere
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - April Hartley
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Emma M Clark
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Charlotte Moss
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Mark H Edwards
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Tim Gaysin
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Kenneth R Fox
- Centre for Exercise Nutrition and Health Sciences, University of Bristol, Bristol, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Rachel Cooper
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Jon H Tobias
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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13
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Elhakeem A, Hannam K, Deere KC, Wong A, Gaysin T, Kuh D, Cooper R, Richards M, Tobias JH. Day-to-day physical activity producing low gravitational impacts is associated with faster visual processing speed at age 69: cross-sectional study. Eur Rev Aging Phys Act 2019; 16:9. [PMID: 31293695 PMCID: PMC6593499 DOI: 10.1186/s11556-019-0216-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 06/16/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Little is known about how different physical activity (PA) parameters relate to cognitive function in older adults. Using accelerometers calibrated to detect vertical impacts from ground reaction forces we examined the associations of low, medium and higher impact PA with processing speed, verbal memory and cognitive state in older adults. METHODS Participants were 69-year old British men and women from the Medical Research Council National Survey of Health and Development included in a vertical impacts and bone sub-study (n = 558; 48.2% female). Counts of low (0.5 < g < 1.0 g), medium (1 < g < 1.5 g), or higher (≥1.5 g) magnitude impacts were derived from vertical acceleration peaks recorded over 7 days by hip-worn accelerometers. Processing speed was assessed by a timed visual letter search task, verbal memory by a 15-word list learning test and cognitive state by the Addenbrooke's Cognitive Examination (ACE-III). Potential confounders were childhood cognitive ability, adult socioeconomic position, body mass index and depression. RESULTS In initial sex-adjusted models, low magnitude impacts were associated with better performance in all three cognitive function tests; standard deviation differences in test scores per doubling in number of low impacts: letter search speed = 0.10 (95% confidence intervals (CI): 0.03 to 0.16), word learning test = 0.05 (95% CI: 0.00 to 0.11), ACE-III scale = 0.09 (95% CI: 0.03 to 0.14). After adjustment for confounders, differences persisted for letter search speed (0.09; 95% CI: 0.02 to 0.16) but were closer to the null for the word learning test (0.02; 95% CI: - 0.04 to 0.07) and ACE-III scores (0.04; 95% CI: - 0.01 to 0.09). Low impacts remained associated with letter search speed after sensitivity analyses excluding those with functional and musculoskeletal problems, and after adjustment for impacts in higher bands. Modest positive associations between higher magnitude impacts and cognitive test scores were most likely due to chance. CONCLUSION Accelerometer-derived low impact physical activity was associated with better visual processing speed in 69-year old men and women independently of childhood cognitive ability and other measured confounders. Day-to-day low impact physical activity may therefore have the potential to benefit cognitive health in older adults.
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Affiliation(s)
- Ahmed Elhakeem
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building Level 1, Southmead Hospital, Bristol, BS10 5NB UK
- MRC Integrative Epidemiology Unit at University of Bristol, Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Kimberly Hannam
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building Level 1, Southmead Hospital, Bristol, BS10 5NB UK
| | - Kevin C. Deere
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building Level 1, Southmead Hospital, Bristol, BS10 5NB UK
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCL, WC1B 5JU, London, UK
| | - Tim Gaysin
- MRC Unit for Lifelong Health and Ageing at UCL, WC1B 5JU, London, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, WC1B 5JU, London, UK
| | - Rachel Cooper
- MRC Unit for Lifelong Health and Ageing at UCL, WC1B 5JU, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, WC1B 5JU, London, UK
| | - Jon H. Tobias
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building Level 1, Southmead Hospital, Bristol, BS10 5NB UK
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14
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Mitchell JA, Chesi A, McCormack SE, Cousminer DL, Kalkwarf HJ, Lappe JM, Gilsanz V, Oberfield SE, Shepherd JA, Kelly A, Grant SFA, Zemel BS. Physical Activity and Bone Accretion: Isotemporal Modeling and Genetic Interactions. Med Sci Sports Exerc 2019; 50:977-986. [PMID: 29465475 DOI: 10.1249/mss.0000000000001520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE This study aimed to determine if replacing time spent in high- and low-impact physical activity (PA) predicts changes in pediatric bone mineral density (BMD) and content (BMC). METHODS We analyzed data from the longitudinal Bone Mineral Density in Childhood Study (N = 2337 with up to seven visits). The participants were age 5-19 yr at baseline, 51.2% were female, and 80.6% were nonblack. Spine, total hip, and femoral neck areal BMD and total body less head (TBLH) BMC Z-scores were calculated. Hours per day spent in high- and low-impact PA were self-reported. Standard covariate-adjusted (partition model) and time allocation-sensitive isotemporal substitution modeling frameworks were applied to linear mixed models. Statistical interactions with sex, self-reported ancestry, age, and bone fragility genetic scores (percentage of areal BMD-lowering alleles carried) were tested. RESULTS In standard models, high-impact PA was positively associated with bone Z-score at all four skeletal sites (e.g., TBLH-BMC Z-score: beta = 0.05, P = 2.0 × 10), whereas low-impact PA was not associated with any of the bone Z-scores. In isotemporal substitution models, replacing 1 h·d of low- for high-impact PA was associated with higher bone Z-scores (e.g., TBLH-BMC Z-score: beta = 0.06, P = 2.9 × 10). Conversely, replacing 1 h·d of high- for low-impact PA was associated with lower bone Z-scores (e.g., TBLH-BMC Z-score: beta = -0.06, P = 2.9 × 10). The substitution associations were similar for each sex and ancestry group, and for those with higher and lower genetic scores for bone fragility (P-interactions > 0.05), but increased in strength among the older adolescents (P-age interactions < 0.05). CONCLUSIONS Time-sensitive models suggest that replacing low-impact PA for high-impact PA would be beneficial for the growing skeleton in the majority of children.
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Affiliation(s)
- Jonathan A Mitchell
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA.,Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Alessandra Chesi
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Shana E McCormack
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA.,Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Diana L Cousminer
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Heidi J Kalkwarf
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Joan M Lappe
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Vicente Gilsanz
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Sharon E Oberfield
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - John A Shepherd
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Andrea Kelly
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA.,Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Struan F A Grant
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA.,Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA.,Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Babette S Zemel
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA.,Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA
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15
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Herbert AJ, Williams AG, Hennis PJ, Erskine RM, Sale C, Day SH, Stebbings GK. The interactions of physical activity, exercise and genetics and their associations with bone mineral density: implications for injury risk in elite athletes. Eur J Appl Physiol 2019; 119:29-47. [PMID: 30377780 PMCID: PMC6342881 DOI: 10.1007/s00421-018-4007-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 10/04/2018] [Indexed: 01/30/2023]
Abstract
Low bone mineral density (BMD) is established as a primary predictor of osteoporotic risk and can also have substantial implications for athlete health and injury risk in the elite sporting environment. BMD is a highly multi-factorial phenotype influenced by diet, hormonal characteristics and physical activity. The interrelationships between such factors, and a strong genetic component, suggested to be around 50-85% at various anatomical sites, determine skeletal health throughout life. Genome-wide association studies and case-control designs have revealed many loci associated with variation in BMD. However, a number of the candidate genes identified at these loci have no known associated biological function or have yet to be replicated in subsequent investigations. Furthermore, few investigations have considered gene-environment interactions-in particular, whether specific genes may be sensitive to mechanical loading from physical activity and the outcome of such an interaction for BMD and potential injury risk. Therefore, this review considers the importance of physical activity on BMD, genetic associations with BMD and how subsequent investigation requires consideration of the interaction between these determinants. Future research using well-defined independent cohorts such as elite athletes, who experience much greater mechanical stress than most, to study such phenotypes, can provide a greater understanding of these factors as well as the biological underpinnings of such a physiologically "extreme" population. Subsequently, modification of training, exercise or rehabilitation programmes based on genetic characteristics could have substantial implications in both the sporting and public health domains once the fundamental research has been conducted successfully.
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Affiliation(s)
- Adam J. Herbert
- Department of Sport and Exercise, School of Health Sciences, Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK
| | - Alun G. Williams
- Sports Genomics Laboratory, Manchester Metropolitan University, Cheshire Campus, Crewe Green Road, Crewe, CW1 5DU UK
- Institute of Sport, Exercise and Health, University College London, Tottenham Court Road, London, W17 7HA UK
| | - Philip J. Hennis
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, Nottingham Trent University, Clifton Lane, Clifton, Nottingham, NG11 8NS UK
| | - Robert M. Erskine
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF UK
- Institute of Sport, Exercise and Health, University College London, Tottenham Court Road, London, W17 7HA UK
| | - Craig Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, Nottingham Trent University, Clifton Lane, Clifton, Nottingham, NG11 8NS UK
| | - Stephen H. Day
- Department of Biomedical Science & Physiology, School of Sciences, Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton, UK
| | - Georgina K. Stebbings
- Sports Genomics Laboratory, Manchester Metropolitan University, Cheshire Campus, Crewe Green Road, Crewe, CW1 5DU UK
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16
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A systematic review of the exercise effect on bone health: the importance of assessing mechanical loading in perimenopausal and postmenopausal women. Menopause 2018; 24:1208-1216. [PMID: 28538603 DOI: 10.1097/gme.0000000000000872] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The aims of this systematic review were to determine the general effects of exercise on areal bone mineral density (BMD) in perimenopausal and postmenopausal women, and to provide information on the most suitable bone-loading exercise regimens that may improve bone health in this population group. METHODS A computerized, systematic literature search was performed in the electronic databases PubMed, Web of Science, CINAHL, SPORTDiscus, and The Cochrane Library, from January 2005 to November 2015, to identify all randomized controlled trials related to exercise in perimenopausal and postmenopausal women. The initial search identified 915 studies, with a final yield of 10 studies. Only randomized controlled trials that examined the effects of exercise programs longer than 24 weeks in women aged 35 to 70 years were included. The 10 studies quantified at least BMD and described training variables adequately (training period, frequency, volume, intensity). RESULTS Ten studies with moderate quality evidence (6.4 ± 1.8 points, range 4-9) were included. Significant changes in lumbar and femoral neck BMD were found mainly with high-impact exercise and whole body vibration interventions. CONCLUSIONS While training effects must be interpreted with caution because of the heterogeneity of the protocols and exercises performed, this systematic review confirmed the effectiveness of impact exercises combined with other forms of training (vibration or strength training) to preserve BMD in perimenopausal and postmenopausal women. Despite the results possibly not representing a general dose-response relationship, we highlight the importance of quantifying loading intensity and frequency by means of accelerometry as these parameters are determinants for bone adaptation.
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17
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Elhakeem A, Hannam K, Deere KC, Hartley A, Clark EM, Moss C, Edwards MH, Dennison E, Gaysin T, Kuh D, Wong A, Cooper C, Cooper R, Tobias JH. Physical Activity Producing Low, but Not Medium or Higher, Vertical Impacts Is Inversely Related to BMI in Older Adults: Findings From a Multicohort Study. J Gerontol A Biol Sci Med Sci 2018; 73:643-651. [PMID: 29028919 PMCID: PMC5846734 DOI: 10.1093/gerona/glx176] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 09/16/2017] [Indexed: 01/21/2023] Open
Abstract
Background High impact physical activity (PA) is thought to improve skeletal health, but its relation to other health outcomes are unclear. We investigated associations between PA impact magnitude and body mass index (BMI) in older adults. Methods Data were taken from the Cohort for Skeletal Health in Bristol and Avon (COSHIBA), Hertfordshire Cohort Study, and MRC National Survey of Health and Development. Vertical acceleration peaks from 7-day hip-worn accelerometer recordings were used to classify PA as low (0.5 < g < 1.0g), medium (1 < g < 1.5g), or higher (≥1.5g) impact. Cohort-specific associations of low, medium, and higher impact PA with BMI were examined using linear regressions and estimates combined using random-effects meta-analysis. Results A total of 1182 participants (mean age = 72.7 years, 68% female) were included. Low, medium, and higher impact PA were inversely related to BMI in initial models. After adjustment for confounders and other impacts, low, but not medium or higher, impacts were inversely related to BMI (-0.31, p < .001: overall combined standard deviation change in BMI per doubling in the number of low impacts). In adjusted analyses of body composition measured by dual-energy X-ray absorptiometry in COSHIBA, low, but not medium or higher, impacts were inversely related to total body fat mass (-0.19, p < .001) and android:gynoid fat mass ratio (-0.16, p = .01), whereas high impact PA was weakly and positively associated with lean mass (0.05, p = .06). Conclusions Greater exposure to PA producing low magnitude vertical impacts was associated with lower BMI and fat mass at older age. Low impact PA may help reduce obesity risk in older adults.
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Affiliation(s)
- Ahmed Elhakeem
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, UK
| | - Kimberly Hannam
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, UK
| | - Kevin C Deere
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, UK
| | - April Hartley
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, UK
| | - Emma M Clark
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, UK
| | - Charlotte Moss
- MRC Lifecourse Epidemiology Unit, University of Southampton, UK
| | - Mark H Edwards
- MRC Lifecourse Epidemiology Unit, University of Southampton, UK
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, UK
| | - Tim Gaysin
- MRC Unit for Lifelong Health and Ageing, University College London, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing, University College London, UK
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing, University College London, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, UK
| | - Rachel Cooper
- MRC Unit for Lifelong Health and Ageing, University College London, UK
| | - Jon H Tobias
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, UK
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18
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Pattern of physical activity can influence its efficacy on muscle and bone health in middle-aged men and women. SPORT SCIENCES FOR HEALTH 2018; 14:503-509. [PMID: 30524508 PMCID: PMC6244540 DOI: 10.1007/s11332-018-0448-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 03/24/2018] [Indexed: 01/17/2023]
Abstract
Purpose This study aimed at investigating whether association between physical activity, and bone density and muscle strength depends on daily activity pattern. Methods Loading dose of moderate-to-vigorous physical activity (MVPA) was measured using accelerometer on 54 men (M age = 54.1 years) and 59 women (M age = 52.1 years). Pattern of MVPA was quantified as number and length of MVPA bouts, and the length of break bouts between MVPA bouts. Knee extension torque (KET) and broadband ultrasound attenuation (BUA) of the calcaneus were also measured. Regression analysis was employed to examine the moderation effect of MVPA pattern. Results Loading dose had a larger effect on BUA (b = .002, p = .035) and KET (b = .004, p = .01) with the increase of median length of MVPA bout, but had a smaller effect on KET with the increase of maximal length of break bout (b = - .015, p = .024). Conclusions This study suggests that pattern of physical activity can influence its efficacy on muscle and bone health.
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19
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Effects of Body Mass Index on Bone Loading Due to Physical Activity. J Appl Biomech 2018; 34:7-13. [PMID: 28771082 DOI: 10.1123/jab.2016-0126] [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: 11/18/2022]
Abstract
The aim of the current study was to compare bone loading due to physical activity between lean, and overweight and obese individuals. Fifteen participants (lower BMI group: BMI < 25 kg/m2, n = 7; higher BMI group: 25 kg/m2 < BMI < 36.35 kg/m2, n = 8) wore a tri-axial accelerometer on 1 day to collect data for the calculation of bone loading. The International Physical Activity Questionnaire (short form) was used to measure time spent at different physical activity levels. Daily step counts were measured using a pedometer. Differences between groups were compared using independent t-tests. Accelerometer data revealed greater loading dose at the hip in lower BMI participants at a frequency band of 0.1-2 Hz (P = .039, Cohen's d = 1.27) and 2-4 Hz (P = .044, d = 1.24). Lower BMI participants also had a significantly greater step count (P = .023, d = 1.55). This corroborated with loading intensity (d ≥ 0.93) and questionnaire (d = 0.79) effect sizes to indicate higher BMI participants tended to spend more time in very light activity, and less time in light and moderate activity. Overall, participants with a lower BMI exhibited greater bone loading due to physical activity; participants with a higher BMI may benefit from more light and moderate level activity to maintain bone health.
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Elhakeem A, Hannam K, Deere KC, Hartley A, Clark EM, Moss C, Edwards MH, Dennison E, Gaysin T, Kuh D, Wong A, Fox KR, Cooper C, Cooper R, Tobias JH. Associations of lifetime walking and weight bearing exercise with accelerometer-measured high impact physical activity in later life. Prev Med Rep 2017; 8:183-189. [PMID: 29134173 PMCID: PMC5671612 DOI: 10.1016/j.pmedr.2017.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/06/2017] [Accepted: 10/16/2017] [Indexed: 01/10/2023] Open
Abstract
High impact physical activity (PA) is thought to benefit bone. We examined associations of lifetime walking and weight bearing exercise with accelerometer-measured high impact and overall PA in later life. Data were from 848 participants (66.2% female, mean age = 72.4 years) from the Cohort for Skeletal Health in Bristol and Avon, Hertfordshire Cohort Study and MRC National Survey of Health and Development. Acceleration peaks from seven-day hip-worn accelerometer recordings were used to derive counts of high impact and overall PA. Walking and weight bearing exercise up to age 18, between 18-29, 30-49 and since age 50 were recalled using questionnaires. Responses in each age category were dichotomised and cumulative scores derived. Linear regression was used for analysis. Greater lifetime walking was related to higher overall, but not high impact PA, whereas greater lifetime weight bearing exercise was related to higher overall and high impact PA. For example, fully-adjusted differences in log-overall and log-high impact PA respectively for highest versus lowest lifetime scores were: walking [0.224 (0.087, 0.362) and 0.239 (- 0.058, 0.536)], and weight bearing exercise [0.754 (0.432, 1.076) and 0.587 (0.270, 0.904)]. For both walking and weight bearing exercise, associations were strongest in the 'since age 50' category. Those reporting the most walking and weight bearing exercise since age 50 had highest overall and high impact PA, e.g. fully-adjusted difference in log-high impact PA versus least walking and weight bearing exercise = 0.588 (0.226, 0.951). Promoting walking and weight bearing exercise from midlife may help increase potentially osteogenic PA levels in later life.
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Affiliation(s)
- Ahmed Elhakeem
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Kimberly Hannam
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Kevin C. Deere
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, UK
| | - April Hartley
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Emma M. Clark
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Charlotte Moss
- MRC Lifecourse Epidemiology Unit, University of Southampton, UK
| | - Mark H. Edwards
- MRC Lifecourse Epidemiology Unit, University of Southampton, UK
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, UK
| | - Tim Gaysin
- MRC Unit for Lifelong Health and Ageing at UCL, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, UK
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCL, UK
| | - Kenneth R. Fox
- Centre for Exercise Nutrition and Health Sciences, University of Bristol, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, UK
| | | | - Jon H. Tobias
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, UK
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McMillan LB, Zengin A, Ebeling PR, Scott D. Prescribing Physical Activity for the Prevention and Treatment of Osteoporosis in Older Adults. Healthcare (Basel) 2017; 5:healthcare5040085. [PMID: 29113119 PMCID: PMC5746719 DOI: 10.3390/healthcare5040085] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 10/11/2017] [Accepted: 10/31/2017] [Indexed: 12/24/2022] Open
Abstract
Osteoporosis is an age-related disease, characterised by low bone mineral density (BMD) and compromised bone geometry and microarchitecture, leading to reduced bone strength. Physical activity (PA) has potential as a therapy for osteoporosis, yet different modalities of PA have varying influences on bone health. This review explores current evidence for the benefits of PA, and targeted exercise regimes for the prevention and treatment of osteoporosis in older adults. In particular, the outcomes of interventions involving resistance training, low- and high-impact weight bearing activities, and whole-body vibration therapy are discussed. Finally, we present recommendations for future research that may maximise the potential of exercise in primary and secondary prevention of osteoporosis in the ageing population.
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Affiliation(s)
- Lachlan B McMillan
- School of Clinical Sciences at Monash Health, Monash Medical Centre, Monash University, Clayton, VIC 3168, Australia.
| | - Ayse Zengin
- School of Clinical Sciences at Monash Health, Monash Medical Centre, Monash University, Clayton, VIC 3168, Australia.
| | - Peter R Ebeling
- School of Clinical Sciences at Monash Health, Monash Medical Centre, Monash University, Clayton, VIC 3168, Australia.
| | - David Scott
- School of Clinical Sciences at Monash Health, Monash Medical Centre, Monash University, Clayton, VIC 3168, Australia.
- Department of Medicine, Melbourne Medical School (Western Campus), The University of Melbourne, St Albans, Melbourne, VIC 3021, Australia.
- Australian Institute for Musculoskeletal Science (AIMSS), Sunshine Hospital, St Albans, Melbourne, VIC 3021, Australia.
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Structural Strength Benefits Observed at the Hip of Premenarcheal Gymnasts Are Maintained Into Young Adulthood 10 Years After Retirement From the Sport. Pediatr Exerc Sci 2017; 29:476-485. [PMID: 28661717 DOI: 10.1123/pes.2017-0039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE Premenarcheal female gymnasts have been consistently found to have greater bone mass and structural advantages. However, little is known about whether these structural advantages are maintained after the loading stimulus is removed. Therefore, the purpose of this study was to investigate the structural properties at the hip after long-term retirement from gymnastics. METHODS Structural properties were derived from dual-energy X-ray absorptiometry scans using the hip structural analysis program for the same 24 gymnasts and 21 nongymnasts both in adolescence (8-15 y) and adulthood (22-30 y). Structural measures were obtained at the narrow neck, intertrochanter, and femoral shaft and included cross-sectional area, section modulus, and buckling ratio. Multivariate analysis of covariance was used to assess differences between groups in bone measures while controlling for size, age, maturity, and physical activity. RESULTS Gymnasts were found to have structural advantages at the narrow neck in adolescence (16% greater cross-sectional area, 17% greater section modulus, and 25% lower buckling ratio) and 14 years later (13% greater cross-sectional area and 26% lower buckling ratio). Benefits were also found at the intertrochanter and femoral shaft sites in adolescence and adulthood. CONCLUSION Ten years after retirement from gymnastics, former gymnasts' maintained significantly better hip bone structure than females who did not participate in gymnastics during growth.
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Bone Turnover Markers and Lean Mass in Pubescent Boys: Comparison Between Elite Soccer Players and Controls. Pediatr Exerc Sci 2017; 29:513-519. [PMID: 28872422 DOI: 10.1123/pes.2017-0090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of this study was to examine the relationship between bone mass and bone turnover markers with lean mass (LM) in pubescent soccer players. Two groups participated in this study, which included 65 elite young soccer players who trained for 6-8 hours per week and 60 controls. Bone mineral density; bone mineral content in the whole body, lower limbs, lumbar spine, and femoral neck; biochemical markers of osteocalcin; bone-specific alkaline phosphatase; C-telopeptide type I collagen; and total LM were assessed. Young soccer players showed higher bone mineral density and bone mineral content in the whole body and weight-bearing sites (P < .001). Indeed, the total LM correlated with whole-body bone mineral density and bone mineral content (P < .001). There were significant differences within the bone formation markers and osteocalcin (formation)/C-telopeptide type I collagen (resorption) ratio between young soccer players compared with the control group, but no significant difference in C-telopeptide type I collagen was observed between the 2 groups. This study showed a significant positive correlation among bone-specific alkaline phosphatase, osteocalcin, and total LM (r = .29; r = .31; P < .05) only for the young soccer players. Findings of this study highlight the importance of soccer practice for bone mineral parameters and bone turnover markers during the puberty stage.
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Abstract
Wearable sensors, in particular inertial measurement units (IMUs) allow the objective, valid, discriminative and responsive assessment of physical function during functional tests such as gait, stair climbing or sit-to-stand. Applied to various body segments, precise capture of time-to-task achievement, spatiotemporal gait and kinematic parameters of demanding tests or specific to an affected limb are the most used measures. In activity monitoring (AM), accelerometry has mainly been used to derive energy expenditure or general health related parameters such as total step counts. In orthopaedics and the elderly, counting specific events such as stairs or high intensity activities were clinimetrically most powerful; as were qualitative parameters at the ‘micro-level’ of activity such as step frequency or sit-stand duration. Low cost and ease of use allow routine clinical application but with many options for sensors, algorithms, test and parameter definitions, choice and comparability remain difficult, calling for consensus or standardisation.
Cite this article: Grimm B, Bolink S. Evaluating physical function and activity in the elderly patient using wearable motion sensors. EFORT Open Rev 2016;1:112–120. DOI: 10.1302/2058-5241.1.160022.
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Affiliation(s)
- Bernd Grimm
- AHORSE Research Foundation, Zuyderland Medical Center, Heerlen, The Netherlands
| | - Stijn Bolink
- AHORSE Research Foundation, Zuyderland Medical Center, Heerlen, The Netherlands
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Relationship between Social Isolation and Indoor and Outdoor Physical Activity in Community-Dwelling Older Adults in Germany: Findings from the ActiFE Study. J Aging Phys Act 2016; 25:387-394. [PMID: 26421605 PMCID: PMC4857800 DOI: 10.1123/japa.2016-0060] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The purpose of this study was to establish the feasibility of using an aerobics class to produce potentially bone protective vertical impacts of ≥ 4g in older adults and to determine whether impacts can be predicted by physical function. Participants recruited from older adult exercise classes completed an SF-12 questionnaire, short physical performance battery, and an aerobics class with seven different components, performed at low and high intensity. Maximum g and jerk values were identified for each activity. Forty-one participants (mean 69 years) were included. Mean maximal values approached or exceeded the 4g threshold for four of the seven exercises. In multivariate analyses, age (–0.53; –0.77, –0.28) (standardized beta coefficient; 95% CI) and 4-m walk time (–0.39; –0.63, –0.16) were inversely related to maximum g. Aerobics classes can be used to produce relatively high vertical accelerations in older individuals, although the outcome is strongly dependent on age and physical function.
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26
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Owens S, Galloway R, Gutin B. The Case for Vigorous Physical Activity in Youth. Am J Lifestyle Med 2016; 11:96-115. [PMID: 30202319 DOI: 10.1177/1559827615594585] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 06/04/2015] [Accepted: 06/15/2015] [Indexed: 12/21/2022] Open
Abstract
Although it is widely recognized that regular physical activity is associated with a variety of health-related benefits in youths, the extent to which vigorous physical activity, as opposed to moderate or light physical activity, may be especially beneficial for youths is not completely understood. This review will examine the evidence for the efficacy of vigorous physical activity for promoting the well-being of youths as indicated by body composition, physical fitness, cardiometabolic biomarkers, and cognitive function. Potential caveats associated with the promotion of vigorous physical activity among youths will also be discussed, as will the inclusion of vigorous physical activity in current recommendations by national organizations for physical activity among youths.
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Affiliation(s)
- Scott Owens
- University of Mississippi, University, Mississippi (SO, RG).,Teachers College, Columbia University, New York (BG).,Medical College of Georgia, Augusta, Georgia (BG)
| | - Riley Galloway
- University of Mississippi, University, Mississippi (SO, RG).,Teachers College, Columbia University, New York (BG).,Medical College of Georgia, Augusta, Georgia (BG)
| | - Bernard Gutin
- University of Mississippi, University, Mississippi (SO, RG).,Teachers College, Columbia University, New York (BG).,Medical College of Georgia, Augusta, Georgia (BG)
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27
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Aparicio VA, Ruiz-Cabello P, Borges-Cosic M, Andrade A, Coll-Risco I, Acosta-Manzano P, Soriano-Maldonado A. Association of physical fitness, body composition, cardiometabolic markers and adherence to the Mediterranean diet with bone mineral density in perimenopausal women. The FLAMENCO project. J Sports Sci 2016; 35:880-887. [PMID: 27310097 DOI: 10.1080/02640414.2016.1196825] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
This study aimed to analyse the association of different components of physical fitness, body composition, cardiometabolic markers and the Mediterranean diet with bone mineral density (BMD) in perimenopausal women, and to test which of these components are independently associated with BMD. The sample comprised 197 perimenopausal women (52.6 ± 4.5 years). Physical fitness was assessed with the "Senior Fitness Test" battery and the handgrip strength and Bruce tests. Fat and lean mass and BMD were measured using dual-energy X-ray absorptiometry. We analysed the markers of metabolic syndrome, C-reactive protein, and components of the Mediterranean diet. Handgrip muscle strength (β = 0.212, P = 0.005), body weight (β = 0.244, P = 0.001), BMI (β = 0.180, P = 0.011) and lean mass (β = 0.379, P < 0.001) were positively associated with BMD. No associations were observed between cardiometabolic markers or the Mediterranean diet with BMD (all P > 0.05). When all relevant indicators of BMD were simultaneously considered, lean mass was the only 1 showing an independent association with BMD (β = 0.392, P < 0.001), explaining 14% of the BMD variability. In conclusion, muscle strength might be a marker of BMD in perimenopausal women. However, lean mass was the only factor independently associated with BMD. Future research to determine whether increasing lean mass through specific exercise-based interventions contributes to increasing BMD is warranted.
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Affiliation(s)
- Virginia A Aparicio
- a Department of Physiology, Faculty of Pharmacy, Faculty of Sport Sciences, and Institute of Nutrition and Food Technology , University of Granada , Granada , Spain.,b Department of Public and Occupational Health , VU University and EMGO+ Institute for Health and Care Research , Amsterdam , The Netherlands
| | - Pilar Ruiz-Cabello
- a Department of Physiology, Faculty of Pharmacy, Faculty of Sport Sciences, and Institute of Nutrition and Food Technology , University of Granada , Granada , Spain
| | - Milkana Borges-Cosic
- c Department of Physical Education and Sport, Faculty of Sport Sciences , University of Granada , Granada , Spain
| | - Ana Andrade
- a Department of Physiology, Faculty of Pharmacy, Faculty of Sport Sciences, and Institute of Nutrition and Food Technology , University of Granada , Granada , Spain
| | - Irene Coll-Risco
- a Department of Physiology, Faculty of Pharmacy, Faculty of Sport Sciences, and Institute of Nutrition and Food Technology , University of Granada , Granada , Spain
| | - Pedro Acosta-Manzano
- c Department of Physical Education and Sport, Faculty of Sport Sciences , University of Granada , Granada , Spain
| | - Alberto Soriano-Maldonado
- c Department of Physical Education and Sport, Faculty of Sport Sciences , University of Granada , Granada , Spain
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28
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Kim MH, Lee HJ. Osteoporosis, vitamin C intake, and physical activity in Korean adults aged 50 years and over. J Phys Ther Sci 2016; 28:725-30. [PMID: 27134348 PMCID: PMC4842429 DOI: 10.1589/jpts.28.725] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 11/19/2015] [Indexed: 01/26/2023] Open
Abstract
[Purpose] To investigate associations between vitamin C intake, physical activity, and osteoporosis among Korean adults aged 50 and over. [Subjects and Methods] This study was based on bone mineral density measurement data from the 2008 to 2011 Korean National Health and Nutritional Examination Survey. The study sample comprised 3,047 subjects. The normal group was defined as T-score ≥ -1.0, and the osteoporosis group as T-score ≤ -2.5. The odds ratios for osteoporosis were assessed by logistic regression of each vitamin C intake quartile. [Results] Compared to the lowest quartile of vitamin C intake, the other quartiles showed a lower likelihood of osteoporosis after adjusting for age and gender. In the multi-variate model, the odds ratio for the likelihood of developing osteoporosis in the non-physical activity group significantly decreased to 0.66, 0.57, and 0.46 (p for trend = 0.0046). However, there was no significant decrease (0.98, 1.00, and 0.97) in the physical activity group. [Conclusion] Higher vitamin C intake levels were associated with a lower risk of osteoporosis in Korean adults aged over 50 with low levels of physical activity. However, no association was seen between vitamin C intake and osteoporosis risk in those with high physical activity levels.
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Affiliation(s)
- Min Hee Kim
- Department of Physical Therapy, College of Health Science, Eulji University, Republic of Korea
| | - Hae-Jeung Lee
- Department of Food and Nutrition, College of Bionano Technology, Gachon University: 1342 Seongnam-daero, Sujeong-gu, Seongnam-si, Gyeonggi-do 461-701, Republic of Korea
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Johansson J, Nordström A, Nordström P. Objectively measured physical activity is associated with parameters of bone in 70-year-old men and women. Bone 2015; 81:72-79. [PMID: 26151120 DOI: 10.1016/j.bone.2015.07.001] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 06/25/2015] [Accepted: 07/01/2015] [Indexed: 11/22/2022]
Abstract
As the world's population ages, the occurrence of osteoporosis-related fractures is projected to increase. Low areal bone mineral density (aBMD), a well-known risk factor for fractures, may be influenced by physical activity (PA). In this cross-sectional study, we aimed to investigate potential associations between objective measures of PA and bone properties, in a population-based cohort of 1228 70-year-old men and women. We measured volumetric BMD (vBMD, mg/cm(3)) together with cross-sectional area (CSA, mm(2)) by peripheral quantitative computed tomography at sites located 4% and 66% in the distal-proximal trajectory at the tibia and radius. We also measured aBMD (g/cm(2)) by dual energy X-ray absorptiometry at the femoral neck, lumbar spine (L1-L4) and radius. Participants wore triaxial accelerometers for 7 consecutive days to obtain objective estimates of PA. The intensity of the objective PA was divided into light (100-1951 counts/min [CPM]), moderate (1952-5724 cpm) and vigorous (≥ 5725 cpm). Maximal accelerations for the anterior-posterior (z), medio-lateral (x), and vertical (y) axes were also separately assessed. Associations were investigated using bivariate correlations and multiple linear regression, adjusted for height, weight and sex. Vigorous PA showed the strongest association with femoral neck aBMD (β=0.09, p<0.001), while both moderate and vigorous PAs were associated with cortical area and trabecular vBMD in the weight-bearing tibia (all p<0.05). Peak vertical accelerations were associated significantly with cortical area (β=0.09, p<0.001) and trabecular vBMD (β=0.09, p=0.001) of the tibia, whereas peak anterior-posterior accelerations showed no correlation with these properties. No positive association was found between objectively measured PA and bone parameters of the radius. In conclusion, vertical accelerations and moderate to vigorous PA independently predict bone properties, especially in the weight-bearing tibia, in 70-year-old men and women.
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Affiliation(s)
- Jonas Johansson
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden; Department of Community Medicine and Rehabilitation, Sports Medicine, Umeå University, Umeå, Sweden
| | - Anna Nordström
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Peter Nordström
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
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Characterization of Vertical Accelerations Experienced by Older People Attending an Aerobics Class Designed to Produce High Impacts. J Aging Phys Act 2015; 24:268-74. [PMID: 26421605 DOI: 10.1123/japa.2015-0060] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The purpose of this study was to establish the feasibility of using an aerobics class to produce potentially bone protective vertical impacts of ≥ 4g in older adults and to determine whether impacts can be predicted by physical function. Participants recruited from older adult exercise classes completed an SF-12 questionnaire, short physical performance battery, and an aerobics class with seven different components, performed at low and high intensity. Maximum g and jerk values were identified for each activity. Forty-one participants (mean 69 years) were included. Mean maximal values approached or exceeded the 4g threshold for four of the seven exercises. In multivariate analyses, age (-0.53; -0.77, -0.28) (standardized beta coefficient; 95% CI) and 4-m walk time (-0.39; -0.63, -0.16) were inversely related to maximum g. Aerobics classes can be used to produce relatively high vertical accelerations in older individuals, although the outcome is strongly dependent on age and physical function.
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31
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Quantifying Habitual Levels of Physical Activity According to Impact in Older People: Accelerometry Protocol for the VIBE Study. J Aging Phys Act 2015; 24:290-5. [PMID: 26372670 PMCID: PMC4856876 DOI: 10.1123/japa.2015-0066] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Physical activity (PA) may need to produce high impacts to be osteogenic. The aim of this study was to identify threshold(s) for defining high impact PA for future analyses in the VIBE (Vertical Impact and Bone in the Elderly) study, based on home recordings with triaxial accelerometers. Recordings were obtained from 19 Master Athlete Cohort (MAC; mean 67.6 years) and 15 Hertfordshire Cohort Study (HCS; mean 77.7 years) participants. Data cleaning protocols were developed to exclude artifacts. Accelerations expressed in g units were categorized into three bands selected from the distribution of positive Y-axis peak accelerations. Data were available for 6.6 and 4.4 days from MAC and HCS participants respectively, with approximately 14 hr recording daily. Three-fold more 0.5-1.0g impacts were observed in MAC versus HCS, 20-fold more 1.0-1.5g impacts, and 140-fold more impacts ≥ 1.5g. Our analysis protocol successfully distinguishes PA levels in active and sedentary older individuals.
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32
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Grosprêtre S, Lepers R. Performance characteristics of Parkour practitioners: Who are the traceurs? Eur J Sport Sci 2015; 16:526-35. [DOI: 10.1080/17461391.2015.1060263] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Verlaan L, Bolink SAAN, Van Laarhoven SN, Lipperts M, Heyligers IC, Grimm B, Senden R. Accelerometer-based Physical Activity Monitoring in Patients with Knee Osteoarthritis: Objective and Ambulatory Assessment of Actual Physical Activity During Daily Life Circumstances. Open Biomed Eng J 2015; 9:157-63. [PMID: 26312077 PMCID: PMC4541405 DOI: 10.2174/1874120701509010157] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 11/21/2014] [Accepted: 12/19/2014] [Indexed: 12/27/2022] Open
Abstract
Background: It is important to assess physical activity objectively during daily life circumstances, to understand the association between physical activity and diseases and to determine the effectiveness of interventions. Accelerometer-based physical activity monitoring seems a promising method and could potentially capture all four FITT (i.e. Frequency, Intensity, Time, Type) components of physical activity considered by the World Health Organization (WHO). Aim: To assess the four FITT components of physical activity with an accelerometer during daily life circumstances and compare with self-reported levels of physical activity in patients with knee osteoarthritis (OA) and a healthy control group. Methods: Patients (n=30) with end-stage knee OA and age-matched healthy subjects (n=30) were measured. An ambulant tri-axial accelerometer was placed onto the lateral side of the upper leg. Physical activity was measured during four consecutive days. Using algorithm-based peak detection methods in Matlab, parameters covering the four FITT components were assessed. Self-reported physical activity was assessed using the Short questionnaire to assess health enhancing physical activity (SQUASH). Results: Knee OA patients demonstrated fewer walking bouts (154 ±79 versus 215 ±65 resp.; p=0.002), step counts (4402 ±2960 steps/day versus 6943 ±2581 steps/day; p=0.001) and sit-to-stand (STS) transfers (37 ±14 versus 44 ±12; p=0.031) compared to controls. Knee OA patients demonstrated more time sitting (65 ±15% versus 57 ±10% resp.; p=0.029), less time walking (8 ±4% versus 11 ±4% resp.; p=0.014) and lower walking cadence (87 ±11steps/min versus 99 ± 8steps/min resp.; p<0.001). Accelerometer-based parameters of physical activity were moderately-strong (Pearsons’s r= 0.28-0.49) correlated to self-reported SQUASH scores. Conclusion: A single ambulant accelerometer-based physical activity monitor feasibly captures the four FITT components of physical activity and provides more insight into the actual physical activity behavior and limitations of knee OA patients in their daily life.
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Affiliation(s)
- L Verlaan
- AHORSE Foundation, Department of Orthopaedics, Atrium Medical Center Heerlen, The Netherlands
| | - S A A N Bolink
- AHORSE Foundation, Department of Orthopaedics, Atrium Medical Center Heerlen, The Netherlands
| | - S N Van Laarhoven
- AHORSE Foundation, Department of Orthopaedics, Atrium Medical Center Heerlen, The Netherlands
| | - M Lipperts
- AHORSE Foundation, Department of Orthopaedics, Atrium Medical Center Heerlen, The Netherlands
| | - I C Heyligers
- AHORSE Foundation, Department of Orthopaedics, Atrium Medical Center Heerlen, The Netherlands
| | - B Grimm
- AHORSE Foundation, Department of Orthopaedics, Atrium Medical Center Heerlen, The Netherlands
| | - R Senden
- AHORSE Foundation, Department of Orthopaedics, Atrium Medical Center Heerlen, The Netherlands
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Chahal J, Lee R, Luo J. Loading dose of physical activity is related to muscle strength and bone density in middle-aged women. Bone 2014; 67:41-5. [PMID: 24999224 DOI: 10.1016/j.bone.2014.06.029] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 06/11/2014] [Accepted: 06/24/2014] [Indexed: 11/26/2022]
Abstract
The aim of the current study was to investigate the association between loading dose of physical activity, muscle strength and bone density in middle-aged women. Thirty four healthy women (mean age=49.8±7.5years) were recruited. They were requested to wear an accelerometer for a period of 10h (from 9am to 7pm) on a day to record the acceleration. On a separate day their knee extension torque (KET) was measured using an isokinetic dynamometer and broadband ultrasound attenuation (BUA) at the heel by an ultrasound bone scanner. The loading dose of physical activity was calculated at four intensity categories - very light, light, moderate, and vigorous (intensities of <5BW/s, 5-10BW/s, 10-15BW/s and >15BW/s) and for three frequency bands - 0.1-2Hz, 2-4Hz, and 4-6Hz. Correlation analysis was used to examine the association between loading dose and age, KET, and BUA. With the increase of age, there tended to be a decrease in the loading dose of vigorous activity in 2-4 and 4-6Hz frequency bands (Kendall's tau=-.22, p<.1). The increase of loading dose in all three frequency bands in moderate or vigorous activity was associated with higher BUA (Kendall's tau=.27-.41, p<.05). The increase of loading dose in all frequency bands in light, moderate, or vigorous activity was associated with higher KET (Kendall's tau=.30-.45, p<.05). It is concluded that physical activity, especially that at high intensity level and high frequency range, may have beneficial effect on muscle strength and bone density in middle-aged women.
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Affiliation(s)
- Jaswinder Chahal
- Department of Life Sciences, University of Roehampton, London, UK
| | - Raymond Lee
- Department of Life Sciences, University of Roehampton, London, UK
| | - Jin Luo
- Department of Life Sciences, University of Roehampton, London, UK.
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