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Fausto DY, Martins JBB, Machado AC, Saraiva PS, Pelegrini A, Guimarães ACA. What is the evidence for the effect of physical exercise on bone health in menopausal women? An umbrella systematic review. Climacteric 2023; 26:550-559. [PMID: 37673101 DOI: 10.1080/13697137.2023.2249819] [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: 01/18/2023] [Revised: 08/01/2023] [Accepted: 08/12/2023] [Indexed: 09/08/2023]
Abstract
This study aimed to analyze the effects of physical exercise (PE) on bone health in menopausal women through an umbrella review and to assess the quality of systematic reviews (SRs) and meta-analyses (MAs) included. The review was registered in PROSPERO (CRD42020208130) and the Rayyan application was used. The methodological quality of the included studies was evaluated by A MeaSurement Tool to Assess Systematic Reviews (AMSTAR), and Grading of Recommendations Assessment, Development and Evaluation (GRADE) was applied to assess the level of evidence of the results. The results showed that low-intensity jumping exercises with longer sessions proved to be efficient in the hip segment. Swimming requires further investigation, as it showed high heterogeneity. Aerobic and resistance exercises showed inconsistent results, requiring further studies with these modalities of PE. Concurrent training showed improvements in the lumbar spine, femoral neck, Ward's triangle and trochanter. Finally, combined resistance exercises are effective in preserving bone mineral density (BMD) of the femoral neck and lumbar spine in postmenopausal women. In conclusion, jumping exercises were efficient in the hip, while aerobic and resistance exercises are still inconsistent. Concurrent training showed improvements in BMD of the lumbar spine, femoral neck, Ward's triangle and trochanter. Finally, combined resistance protocols are effective in preserving BMD of the femoral neck and lumbar spine in postmenopausal women.
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Affiliation(s)
- D Y Fausto
- Human Moviment Sciences, Health and Sports Sciences College, Santa Catarina State University, Florianópolis, Brazil
| | - J B B Martins
- Human Moviment Sciences, Health and Sports Sciences College, Santa Catarina State University, Florianópolis, Brazil
| | - A C Machado
- Human Moviment Sciences, Health and Sports Sciences College, Santa Catarina State University, Florianópolis, Brazil
| | - P S Saraiva
- Human Moviment Sciences, Health and Sports Sciences College, Santa Catarina State University, Florianópolis, Brazil
| | - A Pelegrini
- Human Moviment Sciences, Health and Sports Sciences College, Santa Catarina State University, Florianópolis, Brazil
| | - A C A Guimarães
- Human Moviment Sciences, Health and Sports Sciences College, Santa Catarina State University, Florianópolis, Brazil
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Sultan I, Taha I, El Tarhouny S, Mohammed RA, Allah AMA, Al Nozha O, Desouky M, Ghonimy A, Elmehallawy Y, Aldeeb N, Iskandarani YA. Determinants of Z-Score of Bone Mineral Density among Premenopausal Saudi Females in Different Age Groups: A Cross Sectional Study. Nutrients 2023; 15:4280. [PMID: 37836564 PMCID: PMC10574730 DOI: 10.3390/nu15194280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 09/30/2023] [Accepted: 10/04/2023] [Indexed: 10/15/2023] Open
Abstract
This is a comparative multicenter cross-sectional study that evaluated the potential determinants of Z-scores among premenopausal Saudi women before and after the age of peak bone density. The Study concluded that for better BMD among premenopausal women, attention should be paid to early physical activity and healthy nutrition, especially vitamin D, during the childbearing period. OBJECTIVE To explore the potential determinants of Z-scores among premenopausal Saudi females in different age groups before and after the expected age of peak bone density (PBD). METHODS This multicenter comparative cross-sectional study was conducted in Madinah and Jeddah, Saudi Arabia, between August 2021 and March 2022. We recruited 886 premenopausal females (605 (68.3%) below and 281 (31.7%) at or above the age of 30). The structured pre-coded Arabic questionnaire included sociodemographic data, a BMD questionnaire, menstrual history, an Arab Teen Lifestyle Study questionnaire, and food frequency data. Metabolic Equivalents (METs) were calculated from physical activity. Analysis of serum PTH, 25(OH) vitamin D (VD) was performed with chemiluminescent immunoassay. BMD was measured with a calcaneal qualitative ultrasound. RESULTS Most women had age-matched Z-scores, with very few (24 (2.7%)) being non-age-matched with no identified secondary causes. Significant Z-score determinants before PBD were BMI (OR: 0.167, p = 0.003) and total METs (OR: 0.160, p < 0.005). After the age of PBD, significant predictors were parity (OR: 0.340, p = 0.042), history of vitamin D deficiency (OR: 0.352, p = 0.048), and BMI (OR: 0.497, p = 0.019). CONCLUSIONS Early determinants of Z-scores among premenopausal women were the nutritional status and physical activity. After the age of PBD, parity and vitamin D status offer additional determinants. For better BMD, attention should be paid to early physical activity and healthy nutrition, especially for vitamin D, with intensification of efforts during the childbearing period.
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Affiliation(s)
- Intessar Sultan
- Ibn Sina National College for Medical Studies, Jeddah 22421, Saudi Arabia;
| | - Inass Taha
- College of Medicine, Taibah University, Medina 41477, Saudi Arabia; (I.T.); (O.A.N.); (M.D.)
| | - Shereen El Tarhouny
- Ibn Sina National College for Medical Studies, Jeddah 22421, Saudi Arabia;
- College of Medicine, Zagazig University, Zagazig 31527, Egypt
| | - Rehab A. Mohammed
- Faculty of Medicine for Girls, Al-Azhar University, Cairo 11765, Egypt;
| | - Azza M. Abdu Allah
- College of Applied Medical Sciences, Taibah University, Madinah 42353, Saudi Arabia;
- Faculty of Medicine, Menoufia University, Menoufia 32511, Egypt
| | - Omar Al Nozha
- College of Medicine, Taibah University, Medina 41477, Saudi Arabia; (I.T.); (O.A.N.); (M.D.)
| | - Maha Desouky
- College of Medicine, Taibah University, Medina 41477, Saudi Arabia; (I.T.); (O.A.N.); (M.D.)
- College of Medicine, Menia University, Menia 61519, Egypt
| | | | - Yara Elmehallawy
- College of Medicine, Al Faisal University, Riyadh 11533, Saudi Arabia;
| | - Nawaf Aldeeb
- Department of Medicine, King Salman Medical City, Medina 42316, Saudi Arabia;
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Rocha-Rangel J, Liang MTC, Tsai AHT, Auslander AT, Robles P, Kwoh YL, Arnaud SB. Bone bending strength and BMD of female athletes in volleyball, soccer, and long-distance running. Eur J Appl Physiol 2023; 123:2213-2223. [PMID: 37256294 DOI: 10.1007/s00421-023-05231-2] [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: 07/09/2022] [Accepted: 05/16/2023] [Indexed: 06/01/2023]
Abstract
PURPOSE The purpose of the study was to determine whether sports training comprised of (1) high-impact loading sport in volleyball (VOL), (2) odd impact loading sport in soccer (SOC), and (3) low impact sport in distance running (RUN) were associated with tibial bending strength and calcaneus bone mineral density (BMD), and ulnar bending strength and wrist BMD. METHOD Female athletes comprised of 13 VOL, 22 SOC, and 22 RUN participated in the study. Twenty-three female non-athletes (NA) served as the comparison group. Tibial and ulnar bending strength (EI, Nm2) were assessed using a mechanical response tissue analyzer (MRTA). Calcaneus and wrist BMD were assessed using a peripheral X-ray absorptiometry. Group means differences among the study groups were determined using ANCOVA with age, weight, height, percent body fat, ethnicity/race, and training history serving as covariates. RESULTS Tibial EI of VOL (228.3 ± 138 Nm2) and SOC (208.6 ± 115 Nm2) were greater (p < 0.05) compared to NA (101.2 ± 42 Nm2). Ulnar EI of SOC (54.9 ± 51 Nm2) was higher (p < 0.05) than NA (27.2 ± 9 Nm2). Calcaneus BMD of VOL (0.618 ± 0.12 g/cm2), SOC (0.621 ± 0.009 g/cm2), and RUN (0.572 ± 0.007 g/cm2) were higher (p < 0.05) than NA (0.501 ± 0.08 g/cm2), but not different between athletic groups. Wrist BMD of VOL (0.484 ± .06 g/cm2) and SOC (0.480 ± 0.06 g/cm2) were higher (p < 0.05) than NA (0.443 ± 0.04 g/cm2). CONCLUSIONS Female VOL athletes exhibit greater tibial bending strength than RUN and NA, but not greater than SOC. Female SOC athletes exhibit greater ulnar bending strength and wrist BMD than NA.
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Affiliation(s)
- Jose Rocha-Rangel
- Musculoskeletal Research Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University, Pomona, CA, 91768, USA
| | - Michael T C Liang
- Musculoskeletal Research Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University, Pomona, CA, 91768, USA.
| | | | - Alexandra T Auslander
- Musculoskeletal Research Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University, Pomona, CA, 91768, USA
| | - Patricia Robles
- Musculoskeletal Research Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University, Pomona, CA, 91768, USA
| | - Yuan-Lieh Kwoh
- Musculoskeletal Research Laboratory, Department of Kinesiology and Health Promotion, California State Polytechnic University, Pomona, CA, 91768, USA
| | - Sara B Arnaud
- Life Science Division, NASA Ames Research Center, Moffett Field, CA, 94035, USA
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Bone Turnover Markers and Osteokines in Adolescent Female Athletes of High- and Low-Impact Sports Compared With Nonathletic Controls. Pediatr Exerc Sci 2023; 35:41-47. [PMID: 35894972 DOI: 10.1123/pes.2022-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/14/2022] [Accepted: 05/31/2022] [Indexed: 02/01/2023]
Abstract
This study examined differences in resting concentrations of markers of bone formation and resorption, and osteokines between female adolescent (12-16 y) swimmers, soccer players, and nonathletic controls. Resting, morning blood samples were obtained after an overnight fast from 20 swimmers, 20 soccer players, and 20 nonathletic controls, matched for age. carboxyl-terminal cross-linking telopeptide of type I collagen (CTX), amino-terminal propeptide of type I collagen (P1NP), total osteocalcin (OC), sclerostin, osteoprotegerin (OPG), and receptor activator of nuclear factor kappa B ligand (RANKL) were analyzed in serum. After controlling for percent body fat, there were no significant differences between swimmers and nonathletic controls in any of the measured markers. In contrast, soccer players had significantly higher P1NP (89.5 [25.6] ng·mL-1), OC (57.6 [22.9] ng·mL-1), and OPG (1052.5 [612.6] pg·mL-1) compared with both swimmers (P1NP: 66.5 [20.9] ng·mL-1; OC: 24.9 [12.5] ng·mL-1; OPG: 275.2 [83.8] pg·mL-1) and controls (P1NP: 58.5 [16.2] ng·mL-1; OC: 23.2 [11.9] ng·mL-1; OPG: 265.4 [97.6] pg·mL-1), with no differences in CTX, sclerostin, and RANKL. These results suggest that bone formation is higher in adolescent females engaged in high-impact sports like soccer compared with swimmers and controls.
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Effects of a Home-Based Exercise Intervention (E-Fit) on Bone Density, Muscle Function, and Quality of Life in Girls with Adolescent Idiopathic Scoliosis (AIS): A Pilot Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010899. [PMID: 34682668 PMCID: PMC8535874 DOI: 10.3390/ijerph182010899] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/24/2021] [Accepted: 10/10/2021] [Indexed: 11/16/2022]
Abstract
Background: Adolescent idiopathic scoliosis (AIS) patients have lower physical activity levels than normal adolescents, and there is an association with poorer bone and muscle health. This study evaluated the effects of a home-based exercise intervention (E-Fit) on bone mineral density (BMD), muscle function, and quality of life (QoL) in AIS-affected girls. Methods: A total of 40 AIS females aged 11 to 14 years were randomly assigned to the E-Fit or control group. The E-Fit group performed modified 7-min high-intensity interval training (HIIT) 5 days per week for 6 months. Outcome measures including BMD using dual-energy X-ray absorptiometry (DXA), muscle strength and endurance tests, physical activity levels, and QoL using self-reported questionnaires were assessed at baseline and at 6-month and 12-month follow-up. Results: In total, 14 patients in the E-Fit and 16 in the control group completed the study. The E-Fit group showed a marginally significant interaction effect in the whole body areal BMD at the 6- (p = 0.096) and 12-month follow-ups (p = 0.085). The left arm lean mass in the E-Fit group showed a statistically significant interaction effect between the 6- and 12-month follow-ups (p = 0.046). The E-Fit group showed improvements in physical activity participation, as measured by the Modified Baecke Questionnaire (MBQ), with a significant interaction effect in work index (p = 0.043), sport index (p = 0.050), and total score (p = 0.016) from baseline to the 12-month follow-up. Improvement on self-image were noted in E-Fit group across time. Conclusions: The present results provided some evidence to support the positive benefits of E-Fit for bone health and muscle function in AIS girls.
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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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Al Dahamsheh Z, Al Rashdan K, Al Hadid A, Jaradat R, Al Bakheet M, Bataineh ZS. The Impact of Aerobic Exercise on Female Bone Health Indicators. Med Arch 2019; 73:35-38. [PMID: 31097858 PMCID: PMC6445629 DOI: 10.5455/medarh.2019.73.35-38] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Introduction: Females usually suffer from bone health problems, particularly with aging. Aerobic exercise has been shown to have health benefits for females. Aim: The main objective of this study was to investigate the impact of aerobic exercise on female bone health by measuring serum trace elements and bone metabolism markers. Methods: Prospective interventional study was conducted at rehabilitation clinics in Royal Medical Services, Jordan. A total of 65 female participants were included. Participants were assigned into three groups: control group (N = 20), osteopenic group (N = 22), and osteoporotic group (N = 23). A standard aerobic exercise protocol was followed for 12 weeks. Endurance exercise protocol involved three sessions weekly for 60 minutes each. At basal level and after the experiment, the following parameters were assessed: body mass index (BMI), bone-specific alkaline phosphatase (BAP), T-score, bone mineral density (BMD), and calcium. The analysis of data was carried out using SPSS version 21. The difference in means was computed based on t-test. Significance was considered at p < 0.05. Results: Aerobic training exercise improved the levels of all parameters in all groups for both sexes significantly, including BMI, BAP, T-score, BMD, and calcium (p < 0.05). Conclusion: Aerobic training exercise improves bone health and restores the hemostasis of bone tissue by restoring bone biomarkers, including BAP and calcium.
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Bellver M, Del Rio L, Jovell E, Drobnic F, Trilla A. Bone mineral density and bone mineral content among female elite athletes. Bone 2019; 127:393-400. [PMID: 31271933 DOI: 10.1016/j.bone.2019.06.030] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 06/29/2019] [Accepted: 06/29/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Exercise is a protective factor for the appearance of osteoporosis, but not all physical activities have the same effect on bones. Low-impact sports, like swimming, may a have a negative or no effect. The aim of the present study is to evaluate bone mineral density (BMD, g/cm2) and bone mineral content (BMC, kg) among female high performance athletes from aquatic and non-aquatic sports and to assess possible differences with sedentary controls. METHODS Participants are elite female athletes over 18 years, from the Spanish Olympic teams, with at least 12-15 h of weekly training on aquatic sports: swimming (n = 19), synchronized swimming (n = 24) and water polo (n = 14), and elite female athletes from non-aquatic sports: professional football players of Futbol Club Barcelona team (n = 92), Spanish national volleyball (n = 26) and field hockey teams (n = 29) as well as sedentary controls (n = 126). Bone mineral density scans was performed using dual-energy X-ray absorptiometry for whole body, segmental analysis, proximal femur and lumbar spine. RESULTS Non-aquatic female athletes have total and segments BMC and BMD values higher than those of aquatic athletes, that in turn show similar BMD values compared to controls. BMD in lumbar spine and proximal femur was higher in non-aquatic sports compared to aquatic sports athletes and both were higher than controls. CONCLUSION BMD is not negatively compromised by the practice of aquatic sports at a highly competitive level. However, non-aquatic female athletes show a higher BMD. Time training out of the water improves BMD. Our findings suggest that swimming and synchronized swimming should be combined with weight-bearing, impact or strength activities, as they do not seem to be osteogenic sports.
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Affiliation(s)
- Montse Bellver
- Centro de Alto Rendimiento (CAR), Av. Alcalde Barnils s/n, 08173 Sant Cugat del Valles, Barcelona, Spain; Consorcio Sanitario de Terrassa, Carretera de Torrebonica s/n, 08227 Terrassa, Spain.
| | - Luis Del Rio
- CETIR Centre Medic, c/Londres, 6, 08029 Barcelona, Spain
| | - Esther Jovell
- Consorcio Sanitario de Terrassa, Carretera de Torrebonica s/n, 08227 Terrassa, Spain
| | - Franchek Drobnic
- Centro de Alto Rendimiento (CAR), Av. Alcalde Barnils s/n, 08173 Sant Cugat del Valles, Barcelona, Spain; Futbol Club Barcelona (FCB), Av. Onze de Setembre, s/n, 08970 Sant Joan Despí, Barcelona, Spain
| | - Antoni Trilla
- Hospital Clínic, University of Barcelona, c/Villarroel 170, 08036 Barcelona, (Spain)
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Effects of Zumba ® and Aquagym on Bone Mass in Inactive Middle-Aged Women. ACTA ACUST UNITED AC 2019; 55:medicina55010023. [PMID: 30669665 PMCID: PMC6358983 DOI: 10.3390/medicina55010023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 12/22/2018] [Accepted: 12/22/2018] [Indexed: 02/04/2023]
Abstract
Background and objectives: Regular exercise may stimulate bone formation and reduce the loss of bone mass in premenopausal women. This study aims to evaluate the effect of high-impact physical activity (Zumba®) and low-impact physical activity (Aquagym) on bone mass in inactive middle-aged women. Materials and methods: Fifty-five healthy inactive women (30⁻50 years old) were recruited in Spain in 2016 and were randomly allocated into one of three groups: High impact group (HIG: n = 15), low impact group (LIG: n = 12) and control group (CG: n = 28). HIG and LIG were recruited from Madrid and the CG from Toledo. HIG and LIG completed a 12-week intervention program with three 40' sessions per week of Zumba® or Aquagym; respectively. Dual energy X-ray absorptiometry (DXA) measured bone mineral content (BMC) and areal bone mineral density (aBMD) at total body less head (TBLH), lumbar spine and right hip. Results: Post-intervention adjusted data showed no significant differences in BMC between any of the groups nor in aBMD between HIG and LIG. Interestingly; significant differences for the HIG vs. CG were found in the change in total hip aBMD (1.76% vs. -0.44%), femoral neck aBMD (1.80% vs. -2.71%), and intertrochanter aBMD (2.03% vs. -0.50%). Moreover, significant differences for the LIG vs. CG were also found in the change in femoral neck aBMD (-0.54% vs. -2.71%). Conclusions: The regular practice of Zumba® and Aquagym might reduce the progressive deterioration of bone mass in inactive middle-aged women.
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Seo JY, Ha KY, Kim YH, Kim SC, Yoon EJ, Park HY. Bone Mineral Density and Osteoporotic Vertebral Fractures in Traditional, Unassisted, Free-Diving Women (Haenyeos). J Korean Med Sci 2018; 33:e316. [PMID: 30473654 PMCID: PMC6249170 DOI: 10.3346/jkms.2018.33.e316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 10/23/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Water pressure and muscle contraction may influence bone mineral density (BMD) in a positive way. However, divers experience weightlessness, which has a negative effect on BMD. The present study investigated BMD difference in normal controls and woman free-divers with vertebral fracture and with no fracture. METHODS Between January 2010 and December 2014, traditional woman divers (known as Haenyeo in Korean), and non-diving women were investigated. The study population was divided into osteoporotic vertebral fracture and non-fracture groups. The BMD of the lumbar spine and femoral neck was measured. The radiological parameters for global spinal sagittal balance were measured. RESULTS Thirty free-diving women and thirty-three non-diving women were enrolled in this study. The mean age of the divers was 72.1 ± 4.7 years and that of the controls was 72.7 ± 4.0 years (P = 0.61). There was no statistical difference in BMD between the divers and controls. In divers, cervical lordosis and pelvic tilt were significantly increased in the fracture subgroup compared to the non-fracture subgroup (P = 0.028 and P = 0.008, respectively). Sagittal vertical axis was statistically significantly correlated with cervical lordosis (Spearman's rho R = 0.41, P = 0.03), and pelvic tilt (Spearman's rho R = 0.46, P = 0.01) in divers. CONCLUSION BMD did not differ significantly between divers and controls during their postmenopausal period. When osteoporotic spinal fractures develop, compensation mechanisms, such as increased cervical lordosis and pelvic tilt, was more evident in traditional woman divers. This may be due to the superior back muscle strength and spinal mobility of this group of women.
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Affiliation(s)
- Jun-Yeong Seo
- Department of Orthopaedic Surgery, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
| | - Kee-Yong Ha
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young-Hoon Kim
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seong-Chan Kim
- Department of Orthopaedic Surgery, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
| | - Eun-Ji Yoon
- Jeju National University School of Medicine, Jeju, Korea
| | - Hyung-Youl Park
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Srinivasan S, Balsiger D, Huber P, Ausk BJ, Bain SD, Gardiner EM, Gross TS. Static Preload Inhibits Loading-Induced Bone Formation. JBMR Plus 2018; 3:e10087. [PMID: 31131340 DOI: 10.1002/jbm4.10087] [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] [Received: 09/18/2018] [Accepted: 09/20/2018] [Indexed: 12/14/2022] Open
Abstract
Nearly all exogenous loading models of bone adaptation apply dynamic loading superimposed upon a time invariant static preload (SPL) in order to ensure stable, reproducible loading of bone. Given that SPL may alter aspects of bone mechanotransduction (eg, interstitial fluid flow), we hypothesized that SPL inhibits bone formation induced by dynamic loading. As a first test of this hypothesis, we utilized a newly developed device that enables stable dynamic loading of the murine tibia with SPLs ≥ -0.01 N. We subjected the right tibias of BALB/c mice (4-month-old females) to dynamic loading (-3.8 N, 1 Hz, 50 cycles/day, 10 s rest) superimposed upon one of three SPLs: -1.5 N, -0.5 N, or -0.03 N. Mice underwent exogenous loading 3 days/week for 3 weeks. Metaphyseal trabecular bone adaptation (μCT) and midshaft cortical bone formation (dynamic histomorphometry) were assessed following euthanasia (day 22). Ipsilateral tibias of mice loaded with a -1.5-N SPL demonstrated significantly less trabecular bone volume/total volume (BV/TV) than contralateral tibias (-12.9%). In contrast, the same dynamic loading superimposed on a -0.03-N SPL significantly elevated BV/TV versus contralateral tibias (12.3%) and versus the ipsilateral tibias of the other SPL groups (-0.5 N: 46.3%, -1.5 N: 37.2%). At the midshaft, the periosteal bone formation rate (p.BFR) induced when dynamic loading was superimposed on -1.5-N and -0.5-N SPLs was significantly amplified in the -0.03-N SPL group (>200%). These data demonstrate that bone anabolism induced by dynamic loading is markedly inhibited by SPL magnitudes commonly implemented in the literature (ie, -0.5 N, -1.5 N). The inhibitory impact of SPL has not been recognized in bone adaptation models and, as such, SPLs have been neither universally reported nor standardized. Our study therefore identifies a previously unrecognized, potent inhibitor of mechanoresponsiveness that has potentially confounded studies of bone adaptation and translation of insights from our field. © 2018 The Authors. JBMR Plus Published by Wiley Periodicals, Inc. on behalf of the American Society for Bone and Mineral Research.
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Affiliation(s)
- Sundar Srinivasan
- Department of Orthopaedics and Sports Medicine University of Washington Seattle WA USA
| | - Danica Balsiger
- Department of Orthopaedics and Sports Medicine University of Washington Seattle WA USA
| | - Phillipe Huber
- Department of Orthopaedics and Sports Medicine University of Washington Seattle WA USA
| | - Brandon J Ausk
- Department of Orthopaedics and Sports Medicine University of Washington Seattle WA USA
| | - Steven D Bain
- Department of Orthopaedics and Sports Medicine University of Washington Seattle WA USA
| | - Edith M Gardiner
- Department of Orthopaedics and Sports Medicine University of Washington Seattle WA USA
| | - Ted S Gross
- Department of Orthopaedics and Sports Medicine University of Washington Seattle WA USA
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12
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Physical Education and Leisure-Time Physical Activity in Youth Are Both Important for Adulthood Activity, Physical Performance, and Health. J Phys Act Health 2018; 15:661-670. [PMID: 29706117 DOI: 10.1123/jpah.2017-0083] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The importance of youth physical activity (PA) for adulthood PA, performance, and health was retrospectively evaluated. METHODS A total of 258,146 participants (49% women), aged 19-70, with a first-time health-profile assessment between 1982 and 2015, provided self-reported data on current perceived health, PA, lifestyle, and physical education class participation, and PA outside school hours before age 20. Data on anthropometrics, blood pressure, and estimated maximal oxygen consumption (VO2max) were obtained. RESULTS Women participating in physical education class, compared with those who did not, had significantly lower OR (range: 0.81-0.87) for perceiving poor overall health, general obesity, and high diastolic blood pressure after adjustment for potential confounders, and increased OR (range: 1.17-1.23) for exercising regularly and a normal/high VO2max in adulthood. For men, the ORs were significantly lower (range: 0.66-0.86) for poor perceived overall health, general, and abdominal obesity. These associations were seen for participants up to 70 years. Increased PA outside school hours revealed even stronger beneficial associations. In joint analyses, both youth and current PA were important for lower OR of poor health and being obese in adulthood. CONCLUSIONS Physical education class participation and additional PA after school hours were both important for perceived health, PA, VO2max, and metabolic health in adulthood up to 70 years.
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13
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Olsson A, Oturai AB, Søndergaard HB, Sellebjerg F, Oturai PS. Bone microarchitecture and bone mineral density in multiple sclerosis. Acta Neurol Scand 2018; 137:363-369. [PMID: 29270986 DOI: 10.1111/ane.12884] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) patients are at increased risk of reduced bone mineral density (BMD) and fractures. The aetiology of bone loss in MS is unclear. Trabecular bone score (TBS) is a novel analytical tool that provides a measurement of the bone microarchitecture. Decreased TBS predicts increased fracture risk independently of BMD. To date, no studies have investigated TBS in MS patients. OBJECTIVES To assess bone quality in MS patients by TBS and to evaluate potential risk factors that may affect BMD and TBS in patients with MS. METHODS Two hundred sixty MS patients were included. TBS was calculated using TBS iNsight software (MediMaps® ). Multivariable regression analyses were performed with information on smoking, alcohol, glucocorticoid (GC) treatment, sun exposure, physical activity, vitamin D and BMI. RESULTS Trabecular bone score was not significantly different from an age-matched reference population. Low TBS was associated with high age (P = .014) and smoking (P = .03). Smoking and physical inactivity were associated with low BMD in spine (P = .034, P = .032). GC treatment was not associated with TBS. CONCLUSION We could not find altered TBS values among MS patients, suggesting that BMD alone, and not the bone microarchitecture, is affected in MS. However, larger studies are needed to verify these findings and to establish the role of TBS in MS. As in the background population, physical activity and non-smoking habits are associated with better bone health in MS.
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Affiliation(s)
- A. Olsson
- Department of Neurology; Danish Multiple Sclerosis Center; Rigshospitalet; University of Copenhagen; Copenhagen Denmark
| | - A. B. Oturai
- Department of Neurology; Danish Multiple Sclerosis Center; Rigshospitalet; University of Copenhagen; Copenhagen Denmark
| | - H. B. Søndergaard
- Department of Neurology; Danish Multiple Sclerosis Center; Rigshospitalet; University of Copenhagen; Copenhagen Denmark
| | - F. Sellebjerg
- Department of Neurology; Danish Multiple Sclerosis Center; Rigshospitalet; University of Copenhagen; Copenhagen Denmark
| | - P. S. Oturai
- Department of Clinical Physiology; Nuclear Medicine and PET; Rigshospitalet; Copenhagen Denmark
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14
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Seabra A, Fernandes RJ, Marques E, Moura M, Ubago-Guisado E, Hernando E, Gallardo L. Impact of Futsal and Swimming Participation on Bone Health in Young Athletes. J Hum Kinet 2018; 60:85-91. [PMID: 29339988 PMCID: PMC5765788 DOI: 10.1515/hukin-2017-0092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Physical activity plays a crucial role in bone mass acquisition during childhood and adolescence, with weightbearing and high-impact sport activities being more beneficial. This study sought to evaluate the impact of different sports activities on bone mineral density and content in male Portuguese athletes. Seventy adolescent boys (aged 12-15 years) including 28 futsal players (FG), 20 swimmers (SG) and 22 non-athletic adolescents used as control subjects (CG), participated in the current study. Areal bone mineral density (aBMD) and areal bone mineral content (aBMC) were measured by dual energy x-ray absorptiometry (DEXA). Futsal players had significantly higher aBMD (lumbar spine - FG: 0.95 ± 0.18, SG: 0.80 ± 0.13, CG: 0.79 ± 0.13 g/cm2, p = 0.001; pelvis - FG: 1.17 ± 0.21, SG: 0.91 ± 0.12, CG: 0.98 ± 0.10 g/cm2, p < 0.001; lower limbs - FG: 1.21 ± 0.19, SG: 0.97 ± 0.10, CG: 0.99 ± 0.09 g/cm2, p < 0.001) and aBMC (lumbar spine - FG: 51.07 ± 16.53, SG: 40.19 ± 12.47, CG: 40.50 ± 10.53 g, p = 0.013; pelvis - FG: 299.5 ± 110.61, SG: 170.02 ± 55.82, CG: 183.11 ± 46.78 g, p < 0.001; lower limbs - FG: 427.21 ± 117.11, SG: 300.13 ± 76.42, CG: 312.26 ± 61.86 g/cm2, p < 0.001) than swimmers and control subjects. Data suggest that futsal, as a weightbearing and high or odd-impact sport, may improve bone mass during childhood and adolescence.
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Affiliation(s)
- André Seabra
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal.,Portugal Football School - Portugal Football Federation, lisbon, Portugal
| | - Ricardo J Fernandes
- Center of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal
| | - Elisa Marques
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University Institute of Maia, Maia, ISMAI
| | - Miguel Moura
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
| | | | - Enrique Hernando
- IGOID Research Group, University of Castilla-La Mancha, Toledo, Spain
| | - Leonor Gallardo
- IGOID Research Group, University of Castilla-La Mancha, Toledo, Spain
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15
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Blagrove RC, Bruinvels G, Read P. Early Sport Specialization and Intensive Training in Adolescent Female Athletes: Risks and Recommendations. Strength Cond J 2017. [DOI: 10.1519/ssc.0000000000000315] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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16
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Lagerros YT, Hantikainen E, Michaëlsson K, Ye W, Adami HO, Bellocco R. Physical activity and the risk of hip fracture in the elderly: a prospective cohort study. Eur J Epidemiol 2017; 32:983-991. [PMID: 28940092 PMCID: PMC5684287 DOI: 10.1007/s10654-017-0312-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 09/06/2017] [Indexed: 11/26/2022]
Abstract
Physical activity has been inversely associated with the risk of hip fracture, however, few studies have been conducted on the contributions from different domains of physical activity. This study was performed to investigate the association between daily household activities, leisure time physical activity, work-related physical activity and total physical activity during a 24-h period, and the risk of hip fracture. In the Swedish National March Cohort we followed 23,881 men and women aged of 50 and over from 1997 until 2010. Information on domain-specific physical activity was collected at baseline using a questionnaire. We fitted separate multivariable adjusted Cox proportional hazard models to each domain to obtain hazard ratios (HRs) with 95% confidence intervals (CIs). Each model was mutually adjusted for the other domains of physical activity. During a mean follow-up period of 12.2 years we identified 824 incidents of hip fracture. Subjects who spent less than 1 h per week engaged in daily household activities had an 85% higher risk of hip fracture than subjects spending ≥6 h per week carrying out daily household activities (HR 1.85; 95% CI 1.01–3.38). Subjects engaged in leisure time physical activities for >3.1 MET-h/day had a 24% lower risk of hip fracture (HR 0.76; 95% CI 0.59–0.98) than subjects spending <1.1 MET-h/day performing such activities. No association was found between hip fracture and work-related or total physical activity. We conclude that daily household activities and leisure time physical activity may independently decrease the risk of hip fracture in those aged 50 and over.
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Affiliation(s)
- Ylva Trolle Lagerros
- Department of Medicine, Clinical Epidemiology Unit T2, Karolinska University Hospital, 171 76, Stockholm, Sweden.
- Department of Medicine, Clinic of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital Huddinge, C2:84, 141 86, Stockholm, Sweden.
| | - Essi Hantikainen
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Edificio U7, Via Bicocca degli Arcimboldi 8, 20126, Milan, Italy
| | - Karl Michaëlsson
- Department of Surgical Sciences, Section of Orthopedics, Uppsala Clinical Research Center, Akademiska sjukhuset ing. 61 6 tr, 751 85, Uppsala, Sweden
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, 171 77, Stockholm, Sweden
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, 171 77, Stockholm, Sweden
- Department of Epidemiology, Harvard University T H Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
- Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Sognsvannsveien 21, 0372, Oslo, Norway
| | - Rino Bellocco
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Edificio U7, Via Bicocca degli Arcimboldi 8, 20126, Milan, Italy
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, 171 77, Stockholm, Sweden
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17
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Randsborg PH, Røtterud JH. No difference in the level of physical activity between children who have or have never sustained a fracture. Scand J Med Sci Sports 2016; 27:1801-1805. [PMID: 27739115 DOI: 10.1111/sms.12787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2016] [Indexed: 11/30/2022]
Abstract
This study investigates whether children with an acute fracture have a different level of physical activity compared to children who have never sustained a fracture, as measured by the Physical Activity Questionnaire for older children (PAQ-C). The PAQ-C scores of 683 children (295 girls) aged 6-12 years (mean age 9.4 years) who presented to our institution with an acute fracture were compared to the PAQ-C scores of 151 random children (81 girls) aged 6-12 years (mean 9.1 years) in the same area who had never sustained a fracture. Multivariate regression analysis was employed, controlling for age and gender. The mean PAQ-C score of the children who presented to the institution with an acute fracture was 2.85 (95% confidence interval [CI], 2.80-2.91). For the children who had never sustained a fracture, the mean PAQ-C score was 2.78 (95% CI, 2.69-2.87). If there is a true difference in the level of physical activity between children who have or have never sustained a fracture, the PAQ-C questionnaire is not sensitive enough to identify it.
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Affiliation(s)
- P-H Randsborg
- The Department of Orthopaedic Surgery, Akershus University Hospital, Lørenskog, Norway
| | - J H Røtterud
- The Department of Orthopaedic Surgery, Akershus University Hospital, Lørenskog, Norway
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18
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Ribeiro-Dos-Santos MR, Lynch KR, Agostinete RR, Maillane-Vanegas S, Turi-Lynch B, Ito IH, Luiz-de-Marco R, Rodrigues-Junior MA, Fernandes RA. Prolonged Practice of Swimming Is Negatively Related to Bone Mineral Density Gains in Adolescents. J Bone Metab 2016; 23:149-55. [PMID: 27622179 PMCID: PMC5018608 DOI: 10.11005/jbm.2016.23.3.149] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 08/08/2016] [Accepted: 08/08/2016] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The practice of swimming in "hypogravity" conditions has potential to decrease bone formation because it decreases the time engaged in weight-bearing activities usually observed in the daily activities of adolescents. Therefore, adolescents competing in national levels would be more exposed to these deleterious effects, because they are engaged in long routines of training during most part of the year. To analyze the effect of swimming on bone mineral density (BMD) gain among adolescents engaged in national level competitions during a 9-month period. METHODS Fifty-five adolescents; the control group contained 29 adolescents and the swimming group was composed of 26 athletes. During the cohort study, BMD, body fat (BF) and fat free mass (FFM) were assessed using a dual-energy x-ray absorptiometry scanner. Body weight was measured with an electronic scale, and height was assessed using a stadiometer. RESULTS During the follow-up, swimmers presented higher gains in FFM (Control 2.35 kg vs. Swimming 5.14 kg; large effect size [eta-squared (ES-r)=0.168]) and BMD-Spine (Swimming 0.087 g/cm(2) vs. Control 0.049 g/cm(2); large effect size [ES-r=0.167]) compared to control group. Male swimmers gained more FFM (Male 10.63% vs. Female 3.39%) and BMD-Spine (Male 8.47% vs. Female 4.32%) than females. Longer participation in swimming negatively affected gains in upper limbs among males (r=-0.438 [-0.693 to -0.085]), and in spine among females (r=-0.651 [-0.908 to -0.036]). CONCLUSIONS Over a 9-month follow-up, BMD and FFM gains were more evident in male swimmers, while longer engagement in swimming negatively affected BMD gains, independently of sex.
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Affiliation(s)
- Marcelo R Ribeiro-Dos-Santos
- Department of Physical Education, Laboratory of InVestigation in Exercise (LIVE), São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Kyle R Lynch
- Department of Physical Education, Laboratory of InVestigation in Exercise (LIVE), São Paulo State University (UNESP), Presidente Prudente, Brazil.; Post-Graduation Program in Kinesiology, Institute of Biosciences, São Paulo State University (UNESP), Rio Claro, Brazil
| | - Ricardo R Agostinete
- Department of Physical Education, Laboratory of InVestigation in Exercise (LIVE), São Paulo State University (UNESP), Presidente Prudente, Brazil.; Department of Physical Therapy, Post-Graduation Program in Physical Therapy, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Santiago Maillane-Vanegas
- Department of Physical Education, Laboratory of InVestigation in Exercise (LIVE), São Paulo State University (UNESP), Presidente Prudente, Brazil.; Department of Physical Therapy, Post-Graduation Program in Physical Therapy, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Bruna Turi-Lynch
- Department of Physical Education, Laboratory of InVestigation in Exercise (LIVE), São Paulo State University (UNESP), Presidente Prudente, Brazil.; Post-Graduation Program in Kinesiology, Institute of Biosciences, São Paulo State University (UNESP), Rio Claro, Brazil
| | - Igor H Ito
- Department of Physical Education, Laboratory of InVestigation in Exercise (LIVE), São Paulo State University (UNESP), Presidente Prudente, Brazil.; Post-Graduation Program in Kinesiology, Institute of Biosciences, São Paulo State University (UNESP), Rio Claro, Brazil
| | - Rafael Luiz-de-Marco
- Department of Physical Education, Laboratory of InVestigation in Exercise (LIVE), São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Mario A Rodrigues-Junior
- Department of Physical Education, Laboratory of InVestigation in Exercise (LIVE), São Paulo State University (UNESP), Presidente Prudente, Brazil.; Post-Graduation Program in Kinesiology, Institute of Biosciences, São Paulo State University (UNESP), Rio Claro, Brazil
| | - Rômulo A Fernandes
- Department of Physical Education, Laboratory of InVestigation in Exercise (LIVE), São Paulo State University (UNESP), Presidente Prudente, Brazil.; Post-Graduation Program in Kinesiology, Institute of Biosciences, São Paulo State University (UNESP), Rio Claro, Brazil.; Department of Physical Therapy, Post-Graduation Program in Physical Therapy, São Paulo State University (UNESP), Presidente Prudente, Brazil
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19
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Jerrhag D, Englund M, Petersson I, Lempesis V, Landin L, Karlsson MK, Rosengren BE. Increasing wrist fracture rates in children may have major implications for future adult fracture burden. Acta Orthop 2016; 87:296-300. [PMID: 26905618 PMCID: PMC4900094 DOI: 10.3109/17453674.2016.1152855] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Background and purpose - Childhood fractures are associated with lower peak bone mass (a determinant of osteoporosis in old age) and higher adult fracture risk. By examining time trends in childhood fracture epidemiology, it may be possible to estimate the vector of fragility fracture risk in the future. Patients and methods - By using official inpatient and outpatient data from the county of Skåne in Sweden, 1999-2010, we ascertained distal forearm fractures in children aged ≤ 16 years and estimated overall and age- and sex-specific rates and time trends (over 2.8 million patient years) and compared the results to earlier estimations in the same region from 1950 onwards. Results - During the period 1999-2010, the distal forearm fracture rate was 634 per 10(5) patient years (750 in boys and 512 in girls). This was 50% higher than in the 1950s with a different age-rate distribution (p < 0.001) that was most evident during puberty. Also, within the period 1999-2010, there were increasing fracture rates per 10(5) and year (boys +2.0% (95% CI: 1.5-2.6), girls +2.4% (95% CI: 1.7-3.1)). Interpretation - The distal forearm fracture rate in children is currently 50% higher than in the 1950s, and it still appears to be increasing. If this higher fracture risk follows the children into old age, numbers of fragility fractures may increase sharply-as an upturn in life expectancy has also been predicted. The origin of the increase remains unknown, but it may be associated with a more sedentary lifestyle or with changes in risk behavior.
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Affiliation(s)
- Daniel Jerrhag
- Clinical and Molecular Osteoporosis Research Unit, Departments of Clinical Sciences and Orthopedics Malmö, Skåne University Hospital, Lund University,,Correspondence:
| | - Martin Englund
- Clinical Epidemiology Unit, Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden,,Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, MA, USA
| | - Ingmar Petersson
- Clinical Epidemiology Unit, Orthopedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden,
| | - Vasileios Lempesis
- Clinical and Molecular Osteoporosis Research Unit, Departments of Clinical Sciences and Orthopedics Malmö, Skåne University Hospital, Lund University,
| | - Lennart Landin
- Clinical and Molecular Osteoporosis Research Unit, Departments of Clinical Sciences and Orthopedics Malmö, Skåne University Hospital, Lund University,
| | - Magnus K Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Departments of Clinical Sciences and Orthopedics Malmö, Skåne University Hospital, Lund University,
| | - Bjorn E Rosengren
- Clinical and Molecular Osteoporosis Research Unit, Departments of Clinical Sciences and Orthopedics Malmö, Skåne University Hospital, Lund University,
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20
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Cassity EP, Redzic M, Teager CR, Thomas DT. The effect of body composition and BMI on 25(OH)D response in vitamin D-supplemented athletes. Eur J Sport Sci 2015; 16:773-9. [PMID: 26698109 DOI: 10.1080/17461391.2015.1125952] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Fat mass is inversely associated with vitamin D status, and athletes with the most adipose tissue may have the greatest risk for insufficient (25(OH)D 20-32 ng mL(-1)) or deficient (25(OH)D < 20 ng ml(-1)) status. The effects of fat and lean mass on 25(OH)D change in response to vitamin D supplementation have yet to be elucidated in athletes. In addition, vitamin D has a known role in bone health yet a link between short-term changes in 25(OH)D and bone turnover in indoor athletes have not yet been described. Thirty-two collegiate swimmers and divers (19 male, 13 female; 19 (1) years) participated in a 6-month randomized controlled trial and consumed either 4000 IU d(-1) of vitamin D3 (n = 19) or placebo (PLA; n = 13). Anthropometry and blood collection of 25(OH)D, bone-specific alkaline phosphatase (B-ALP) and N-terminal telopeptide (NTx) occurred at three time points. Dual-energy X-ray absorptiometry measured body composition analysis at baseline and endpoint. In the vitamin D group, BMI was negatively correlated with 6-month 25(OH)D change (R = -0.496; P = .03) and a stronger predictor of 25(OH)D change (P = .04) than ultraviolet B exposure and fat mass change. Athletes in the high bone turnover group showed significantly greater losses of 25(OH)D over 6-months compared to athletes in the low bone turnover group (P = .03). These results suggest athletes within the normal BMI category experience a diminished response to 4000 IU d(-1) of vitamin D3 supplementation, and periods of high bone turnover may be an additional risk factor for developing compromised vitamin D status in athletes.
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Affiliation(s)
- Evan P Cassity
- a Division of Pulmonary, Critical Care and Sleep Medicine , University of Kentucky , Lexington , KY , USA
| | - Maja Redzic
- b Department of Pharmacology and Nutritional Sciences , University of Kentucky , Lexington , KY , USA
| | - Cassidy R Teager
- c College of Health Sciences , University of Kentucky , Lexington , KY , USA
| | - D Travis Thomas
- c College of Health Sciences , University of Kentucky , Lexington , KY , USA
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21
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Sioen I, Michels N, Polfliet C, De Smet S, D'Haese S, Roggen I, Deschepper J, Goemaere S, Valtueña J, De Henauw S. The influence of dairy consumption, sedentary behaviour and physical activity on bone mass in Flemish children: a cross-sectional study. BMC Public Health 2015. [PMID: 26216100 PMCID: PMC4517632 DOI: 10.1186/s12889-015-2077-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background This cross-sectional study aimed to look for an association in young children between whole body bone mineral content (BMC) and areal bone mineral density (aBMD) and dairy consumption as well as sedentary behaviour (SB) and physical activity (PA). Moreover, we investigated whether there was an interaction effect between dairy consumption and SB or PA on BMC and aBMD. Methods Healthy children (6-12 years) were recruited from primary schools. Body composition and whole body bone mass were measured with dual-energy X-ray absorptiometry (DXA), dairy consumption was assessed with a food frequency questionnaire (FFQ) and PA and SB with an accelerometer. In total, 272 children underwent a DXA scan. Complete FFQ data were available for 264 children and 210 children had matching data from accelerometry recordings. Regression analyses were used to study the associations between (1) BMC and aBMD and (2) dairy consumption, SB and PA, adjusting for age, gender, pubertal stage, height and body composition. Results Dairy consumption was positively associated with whole body BMC and aBMD (absolute value as well as z-score), after correction for relevant confounders. SB was negatively associated with aBMD z-score and light PA was positively associated with both BMC and aBMD z-score. No gender differences were found. Moreover, an interaction effect between vigorous PA (VPA) and dairy consumption on aBMD (z-score) and BMC z-score was found, indicating that children with both high VPA and high dairy consumption had higher values for BMC and aBMD of the whole body minus the head. Conclusion Already at young age, PA and dairy consumption positively influence whole body bone mass assessed by DXA. Moreover, this study indicates clearly that SB is negatively associated with whole body bone density. Promoting regular PA and sufficient dairy consumption in young children and limiting SB can be expected to positively influence their bone mass accumulation, which can help in the prevention of osteoporosis later in life.
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Affiliation(s)
- Isabelle Sioen
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, 4K3, De Pintelaan 185, B-9000, Ghent, Belgium. .,FWO, Research Foundation Flanders, Egmontstraat 5, 1000, Brussels, Belgium.
| | - Nathalie Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, 4K3, De Pintelaan 185, B-9000, Ghent, Belgium
| | - Carolien Polfliet
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, 4K3, De Pintelaan 185, B-9000, Ghent, Belgium
| | - Stephanie De Smet
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, 4K3, De Pintelaan 185, B-9000, Ghent, Belgium
| | - Sara D'Haese
- FWO, Research Foundation Flanders, Egmontstraat 5, 1000, Brussels, Belgium.,Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Inge Roggen
- Department of Pediatrics, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jean Deschepper
- Department of Pediatrics, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Pediatrics, Ghent University Hospital, Ghent, Belgium
| | - Stefan Goemaere
- Department of Endocrinology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium
| | - Jara Valtueña
- ImFine Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences, Universidad Politécnica de Madrid, Madrid, Spain
| | - Stefaan De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, 4K3, De Pintelaan 185, B-9000, Ghent, Belgium.,Department of Health Sciences, Vesalius, University College Ghent, Ghent, Belgium
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Volpon JB, Silva AV, Falcai MJ, Louzada MJQ, Zamarioli A, Kotake BGDS, Issa JPM. The osteogenic effects of swimming on bone mass, strength, and microarchitecture in rats with unloading-induced bone loss. Microsc Res Tech 2015; 78:784-91. [PMID: 26179081 DOI: 10.1002/jemt.22541] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 05/29/2015] [Accepted: 06/16/2015] [Indexed: 11/09/2022]
Abstract
The effect of nonweight-bearing exercise on osteoporotic bones remains controversial and inconclusive. The purpose of this study was to evaluate the effects of swimming on osteoporotic tibias of rats submitted to hindlimb suspension. Initially, 20 Wistar rats were used to confirm a significant bone loss following 21 days of unloading. Thirty rats were then divided into 3 groups and followed during 51 days: CON (nonsuspended rats), S + WB (suspended rats for 21 days and then released for regular weight-bearing) and, S + Swim (suspended rats for 21 days and then released from suspension and submitted to swimming exercise). We observed that swimming exercise was effective at fully recovering the bone deterioration caused by suspension, with significant increments in BMD, bone strength and bone volume. On the other hand, regular weight-bearing failed at fully restoring the bone loss induced by unloading. These results indicate that swimming exercise may be a potential tool to improve bone density, strength, and trabecular volume in tibias with bone loss induced by mechanical unloading in suspended rats. We conclude that this modality of activity could be beneficial in improving bone mass, strength, and architecture in osteoporotic individuals induced by disuse, such as bed rest or those exposed to microgravity, who may not be able to perform weight-bearing exercises.
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Affiliation(s)
- Jose Batista Volpon
- Department of Biomechanics, Medicine and Rehabilitation, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | - Adriana Valadares Silva
- Department of Biomechanics, Medicine and Rehabilitation, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | - Mauricio Jose Falcai
- Department of Biomechanics, Medicine and Rehabilitation, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil
| | | | - Ariane Zamarioli
- Department of Biomechanics, Medicine and Rehabilitation, School of Medicine of Ribeirão Preto, University of São Paulo, Brazil
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Soomro RR, Ahmed SI, Khan M, Ali SS. Comparing the effects of Osteoporosis Prevention Exercise Protocol (OPEP) versus walking in the prevention of osteoporosis in younger females. Pak J Med Sci 2015; 31:336-40. [PMID: 26101486 PMCID: PMC4476337 DOI: 10.12669/pjms.312.5990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Revised: 12/03/2014] [Accepted: 01/05/2015] [Indexed: 11/15/2022] Open
Abstract
Objective: The aim of this work was to evaluate the effectiveness of Osteoporosis Prevention Exercise Protocol (OPEP) in younger females. Methods: One hundred young female volunteers aged 20-30 were selected from IPM&R Dow University of Health Sciences. This was a comparative study in which 64 females participants were randomly assigned into two groups (32 in OPEP exercise group and 32 in walking group). The exercise session had three components 1) stretching 2) strengthening 3) high impact weight bearing exercises. Both interventional programs consisted of 3 sessions per week for twelve weeks under the supervision of physiotherapist. Pre and post intervention bone mass density (BMD) was measured on the lumbar spine (L1–L4), hip, femur, and distal forearm by using Dual-Energy X-ray Absorptiometry (DEXA) scan. Results: After twelve weeks of intervention BMD was found to be statistically insignificant at hip, femur, lumbar spine and wrist (p > 0.05) comparing the post results in the OPEP and exercise group. Moreover BMD at hip, femur, lumbar spine and wrist was unaltered in both groups comparing the results of pre and post intervention. Though significant changes were observed in BMI in the OPEP exercise group (p value =0.010) mean ± standard deviation pre and post found to be 20.2578 ± 3.11123 and 21.0942 ± 3.64203 but no variations in anthropometrics in walking group were found. Conclusion: The present study highlights the burden of osteopenia in younger females. The Osteoporosis Prevention Exercise Protocol formulated by author was not useful to bring any significant changes in BMD moreover it had no significant effects in comparison to walking group. However additional studies are needed to evaluate the efficacy of Osteoporosis Prevention Exercise Protocol on bone quality with long term effects.
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Affiliation(s)
- Rabail Rani Soomro
- Rabail Rani Soomro, MSPT, Institute of Physical Medicine & Rehabilitation, Dow University of Health Sciences, Karachi, Pakistan
| | - Syed Imran Ahmed
- Dr. Syed Imran Ahmed, FCPS, Institute of Physical Medicine & Rehabilitation, Dow University of Health Sciences, Karachi, Pakistan
| | - Muhammad Khan
- Muhammad Khan, MSc.PT, Institute of Physical Medicine & Rehabilitation, Dow University of Health Sciences, Karachi, Pakistan
| | - Syed Shahzad Ali
- Syed Shahzad Ali, MSPT, Institute of Physical Medicine & Rehabilitation, Dow University of Health Sciences, Karachi, Pakistan
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24
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Moreira LDF, Oliveira MLD, Lirani-Galvão AP, Marin-Mio RV, Santos RND, Lazaretti-Castro M. Physical exercise and osteoporosis: effects of different types of exercises on bone and physical function of postmenopausal women. ACTA ACUST UNITED AC 2015; 58:514-22. [PMID: 25166042 DOI: 10.1590/0004-2730000003374] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 05/28/2014] [Indexed: 11/21/2022]
Abstract
Physical exercise is an important stimulus for osteoporosis prevention and treatment. However, it is not clear yet which modality would be better to stimulate bone metabolism and enhance physical function of postmenopausal women. This review paper aims to summarize and update present knowledge on the effects of different kinds of aquatic and ground physical exercises on bone metabolism and physical function of postmenopausal women. Moderate to intense exercises, performed in a high speed during short intervals of time, in water or on the ground, can be part of a program to prevent and treat postmenopausal osteoporosis. Mechanical vibration has proven to be beneficial for bone microarchitecture, improving bone density and bone strength, as well as increasing physical function. Although impact exercises are recognized as beneficial for the stimulation of bone tissue, other variables such as muscle strength, type of muscle contraction, duration and intensity of exercises are also determinants to induce changes in bone metabolism of postmenopausal women. Not only osteoanabolic exercises should be recommended; activities aimed to develop muscle strength and body balance and improve the proprioception should be encouraged to prevent falls and fractures.
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Affiliation(s)
| | - Mônica Longo de Oliveira
- Division of Endocrinology, School of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Ana Paula Lirani-Galvão
- Division of Endocrinology, School of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Rosângela Villa Marin-Mio
- Division of Endocrinology, School of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil
| | | | - Marise Lazaretti-Castro
- Division of Endocrinology, School of Medicine, Federal University of São Paulo, São Paulo, SP, Brazil
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25
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Braun SI, Kim Y, Jetton AE, Kang M, Morgan DW. Prediction of bone mineral density and content from measures of physical activity and sedentary behavior in younger and older females. Prev Med Rep 2015; 2:300-5. [PMID: 26844085 PMCID: PMC4721477 DOI: 10.1016/j.pmedr.2015.04.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Little is known regarding the extent to which physical activity (PA) and sedentary behavior (SB) influence bone mineral content (BMC) and bone mineral density (BMD) in females across the lifespan. METHODS Data from 2232 females aged 12 years and older collected as part of the 2007-2008 National Health and Nutrition Examination Survey were analyzed. Categories of PA and SB were used to predict femoral and spinal BMD and BMC in four age groups (G1: 12-17; G2: 18-39; G3: 40-64; G4: ≥ 65 years). Self-reported PA categories included sufficient moderate-to-vigorous recreational PA (S-MVRPA) and insufficient MVRPA (I-MVRPA). RESULTS G1 females who accumulated S-MVRPA displayed greater femoral and spinal BMC and BMD compared to G1 females who displayed I-MVRPA. For G4 females, higher levels of SB were associated with lower femoral BMC and BMD. CONCLUSIONS These findings highlight the importance of engaging in sufficient moderate-to-vigorous physical activity during adolescence and reducing sedentary behavior in older adults to improve bone health in females.
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Affiliation(s)
- Saori I Braun
- Department of Health and Human Performance, Middle Tennessee State University, 1301 E. Main St., Murfreesboro, TN 37132, USA
| | - Youngdeok Kim
- Department of Health and Human Performance, Middle Tennessee State University, 1301 E. Main St., Murfreesboro, TN 37132, USA
| | - Amy E Jetton
- Department of Biology, Middle Tennessee State University, 1301 E. Main St., Murfreesboro, TN 37132, USA
| | - Minsoo Kang
- Department of Health and Human Performance, Middle Tennessee State University, 1301 E. Main St., Murfreesboro, TN 37132, USA
| | - Don W Morgan
- Department of Health and Human Performance, Middle Tennessee State University, 1301 E. Main St., Murfreesboro, TN 37132, USA
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26
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Ubago-Guisado E, Gómez-Cabello A, Sánchez-Sánchez J, García-Unanue J, Gallardo L. Influence of different sports on bone mass in growing girls. J Sports Sci 2015; 33:1710-8. [DOI: 10.1080/02640414.2015.1004639] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Stagi S, Cavalli L, Seminara S, de Martino M, Brandi ML. The ever-expanding conundrum of primary osteoporosis: aetiopathogenesis, diagnosis, and treatment. Ital J Pediatr 2014; 40:55. [PMID: 24906390 PMCID: PMC4064514 DOI: 10.1186/1824-7288-40-55] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 05/27/2014] [Indexed: 01/07/2023] Open
Abstract
In recent years, as knowledge regarding the etiopathogenetic mechanisms of bone involvement characterizing many diseases has increased and diagnostic techniques evaluating bone health have progressively improved, the problem of low bone mass/quality in children and adolescents has attracted more and more attention, and the body evidence that there are groups of children who may be at risk of osteoporosis has grown. This interest is linked to an increased understanding that a higher peak bone mass (PBM) may be one of the most important determinants affecting the age of onset of osteoporosis in adulthood. This review provides an updated picture of bone pathophysiology and characteristics in children and adolescents with paediatric osteoporosis, taking into account the major causes of primary osteoporosis (PO) and evaluating the major aspects of bone densitometry in these patients. Finally, some options for the treatment of PO will be briefly discussed.
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Affiliation(s)
- Stefano Stagi
- Health Sciences Department, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy.
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28
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Ishikawa S, Kim Y, Kang M, Morgan DW. Effects of weight-bearing exercise on bone health in girls: a meta-analysis. Sports Med 2014; 43:875-92. [PMID: 23754172 DOI: 10.1007/s40279-013-0060-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Because growing bone possesses a greater capacity to adapt to mechanical loading than does mature bone, it is important for girls to engage in weight-bearing activities, especially since the prevalence of osteoporosis among older women is considerably higher than that of older men. In recent years, the osteogenic potential of weight-bearing activities performed by children and adolescents has received increasing attention and accumulating evidence suggests that this type of activity may improve bone health prior to adulthood and help prevent osteoporosis later in life. OBJECTIVE Because previous interventions have varied with respect to the exercise parameters studied and sometimes produced conflicting findings, this meta-analysis was undertaken to evaluate the impact of weight-bearing exercise on the bone health of female children and adolescents and quantify the influence of key moderating variables (e.g. pubertal stage, exercise mode, intervention strategy, exercise duration, frequency of exercise, programme length and study design) on skeletal development in this cohort. METHODS A comprehensive literature search was conducted using databases such as PubMed, MEDLINE, CINAHL, Web of Science, Physical Education Index, Science Direct and ProQuest. Search terms included 'bone mass', 'bone mineral', 'bone health', 'exercise' and 'physical activity'. Randomized- and non-randomized controlled trials featuring healthy prepubertal, early-pubertal and pubertal girls and measurement of areal bone mineral density (aBMD) or bone mineral content (BMC) using dual energy x-ray absorptiometry were examined. Comprehensive Meta-Analysis software was used to determine weighted mean effect sizes (ES) and conduct moderator analyses for three different regions of interest [i.e. total body, lumbar spine (LS), and femoral neck]. RESULTS From 17 included studies, 72 ES values were retrieved. Our findings revealed a small, but significant influence of weight-bearing exercise on BMC and aBMD of the LS (overall ES 0.19; 95% confidence interval (CI) 0.05, 0.33 and overall ES 0.26, 95% CI 0.09, 0.43, respectively) and BMC of the femoral neck (ES 0.23; 95% CI 0.10, 0.36). For both aBMD and BMC, overall ES was not affected by any moderator variables except frequency of exercise, such that weight-bearing activity performed for more than 3 days per week resulted in a significantly greater ES value for LS aBMD compared with programmes lasting 3 or fewer days per week [Cochran's Q statistic (Qbetween) = 4.09; p < 0.05]. CONCLUSION The impact of weight-bearing activities seems to be site specific, and a greater frequency of weight-bearing activities is related to greater aBMD of LS in growing girls. Future investigations are warranted to better understand the dose-response relationship between weight-bearing activity and bone health in girls and explore the mediating role of pubertal status in promoting skeletal development among female youth.
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Affiliation(s)
- Saori Ishikawa
- Department of Health and Human Performance, Middle Tennessee State University, P.O. Box 96, Murfreesboro, TN 37132, USA.
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29
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Warden SJ, Galley MR, Hurd AL, Richard JS, George LA, Guildenbecher EA, Barker RG, Fuchs RK. Cortical and trabecular bone benefits of mechanical loading are maintained long term in mice independent of ovariectomy. J Bone Miner Res 2014; 29:1131-40. [PMID: 24436083 PMCID: PMC3999300 DOI: 10.1002/jbmr.2143] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 10/17/2013] [Accepted: 10/21/2013] [Indexed: 11/10/2022]
Abstract
Skeletal loading enhances cortical and trabecular bone properties. How long these benefits last after loading cessation remains an unresolved, clinically relevant question. This study investigated long-term maintenance of loading-induced cortical and trabecular bone benefits in female C57BL/6 mice and the influence of a surgically induced menopause on the maintenance. Sixteen-week-old animals had their right tibia extrinsically loaded 3 days/week for 4 weeks using the mouse tibial axial compression loading model. Left tibias were not loaded and served as internal controls. Animals were subsequently detrained (restricted to cage activities) for 0, 4, 8, 26, or 52 weeks, with ovariectomy (OVX) or sham-OVX surgery being performed at 0 weeks detraining. Loading increased midshaft tibia cortical bone mass, size, and strength, and proximal tibia bone volume fraction. The cortical bone mass, area, and thickness benefits of loading were lost by 26 weeks of detraining because of heightened medullary expansion. However, loading-induced benefits on bone total area and strength were maintained at each detraining time point. Similarly, the benefits of loading on bone volume fraction persisted at all detraining time points. The long-term benefits of loading on both cortical and trabecular bone were not influenced by a surgically induced menopause because there were no interactions between loading and surgery. However, OVX had independent effects on cortical bone properties at early (4 and 8 weeks) detraining time points and trabecular bone properties at all detraining time points. These cumulative data indicate loading has long-term benefits on cortical bone size and strength (but not mass) and trabecular bone morphology, which are not influenced by a surgically induced menopause. This suggests skeletal loading associated with physical activity may provide long-term benefits by preparing the skeleton to offset both the cortical and trabecular bone changes associated with aging and menopause.
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Affiliation(s)
- Stuart J Warden
- Center for Translational Musculoskeletal Research, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, IN, USA; Department of Physical Therapy, School of Health and Rehabilitation Sciences, Indiana University, Indianapolis, IN, USA
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Kim PS, Shin YH, Noh SK, Jung HL, Lee CD, Kang HY. Beneficial effects of judo training on bone mineral density of high-school boys in Korea. Biol Sport 2013; 30:295-9. [PMID: 24744501 PMCID: PMC3944548 DOI: 10.5604/20831862.1077556] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2013] [Indexed: 11/13/2022] Open
Abstract
Bone mineralization is strongly stimulated by weight-bearing exercise during growth and development. Judo, an Olympic combat sport, is a well-known form of strenuous and weight-bearing physical activity. Therefore, the primary goal of this study was to determine the effects of Judo practice on the bone health of male high school students in Korea. The secondary goal of this study was to measure and compare the bone mineral density (BMD) of the hands of Judo players and sedentary control subjects. Thirty Judo players (JDP) and 30 sedentary high school boys (CON) voluntarily participated in the present study, and all of the sedentary control subjects were individually matched to the Judo players by body weight. BMD was determined by using dual-energy X-ray absorptiometry (Hologic, Bedford, MA, USA). The lumbar spine, femur and forearm BMD in the JDP group were significantly greater by 22.7%, 24.5%, and 18.3%, respectively, than those in the CON group. In addition, a significant difference in the CON group was observed between the dominant hand (DH) radius (0.710 ± 0.074 g/cm(2)) and the non-dominant hand (NDH) radius (0.683 ± 0.072 g/cm(2)), but this was not observed in the JDP group (DH = 0.819 ± 0.055 g/cm(2); NDH = 810 ± 0.066 g/cm(2)) (P < 0.05). Therefore, the results of this study suggest that Judo practice during the growth period significantly improves bone health in high school male students. In addition, it seems that Judo practice could eliminate the effect of increased BMD in the dominant hand.
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Affiliation(s)
- P S Kim
- Department of Physical Education, Kyungpook National University, Daegu, Korea
| | - Y H Shin
- Department of Physical Education, Kyungpook National University, Daegu, Korea
| | - S K Noh
- Department of Physical Education, Kyungpook National University, Daegu, Korea
| | - H L Jung
- Department of Physical Education, Kyungpook National University, Daegu, Korea
| | - C D Lee
- Department of Exercise and Wellness, Arizona State University, Mesa, Arizona, USA
| | - H Y Kang
- Department of Physical Education, Kyungpook National University, Daegu, Korea
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Uddenfeldt Wort U, Nordmark E, Wagner P, Düppe H, Westbom L. Fractures in children with cerebral palsy: a total population study. Dev Med Child Neurol 2013; 55:821-6. [PMID: 23750743 DOI: 10.1111/dmcn.12178] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2013] [Indexed: 11/29/2022]
Abstract
AIM To analyse factors associated with fractures in children with cerebral palsy (CP) in different levels of Gross Motor Function Classification System (GMFCS). METHOD This was an epidemiological retrospective study of a total population of 536 children (214 females, 322 males) with CP born between 1990 and 2005. CP type was unilateral spastic (n=159), bilateral spastic (n=225), ataxic (n=60), dyskinetic (n=80), and mixed type (n=12); 384 children were in Gross Motor Function Classification Scale (GMFCS) levels I-III and 152 children were in GMFCS levels IV-V. Data were collected for a 9-year period on sex, CP-type, GMFCS level, gastrostomy, height, weight, the use of a standing device, antiepileptic drug (AED) therapy, and fractures. RESULTS The risk of fracture in the total population of children with CP was similar to that for typically developing children. The risk for fractures of those in GMFCS levels I-III was not significantly associated with any of the studied risk factors. The risk of fractures for those in GMFCS levels IV-V on AED therapy was a twofold increase (p=0.004). The risk for fractures without trauma in children with stunted growth (height for age <-3 SD) and those who did not use standing devices was significantly increased: adjusted incidence rate ratio (AIRR) 4.16 (p=0.011) and 3.66 (p=0.010) respectively. Results regarding gastrostomy feeding for those in GMFCS levels IV-V were conflicting: a gastrostomy was associated with a reduced risk of fractures with trauma, but with increased risk of fractures without trauma (AIRR 0.10, p=0.003 and 4.36, p=0.012) respectively. INTERPRETATION Children in GMFCS levels I-III had a similar incidence and pattern for fractures as normally developing children. Those in GMFCS levels IV-V had stunted growth, often a sign of longstanding undernourishment, and were associated with an increased risk of fractures. Children using standing devices had a fourfold reduction of fractures without trauma. Regular loading exercises and early adequate nutritional intake could prevent fractures in severe CP.
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Affiliation(s)
- Ulrika Uddenfeldt Wort
- Department of Clinical Sciences (Malmö), Social Medicine and Global Health, Lund University, Malmö, Sweden.
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SIU WINGSUM, KO CHUNHAY, HUNG LEUNGKIM, LAU CHINGPO, LAU CLARABIKSAN, FUNG KWOKPUI, LEUNG PINGCHUNG. Effect of anti-osteoporotic agents on the prevention of bone loss in unloaded bone. Mol Med Rep 2013; 8:1188-94. [DOI: 10.3892/mmr.2013.1647] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 06/20/2013] [Indexed: 11/05/2022] Open
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Gómez-Bruton A, Gónzalez-Agüero A, Gómez-Cabello A, Casajús JA, Vicente-Rodríguez G. Is bone tissue really affected by swimming? A systematic review. PLoS One 2013; 8:e70119. [PMID: 23950908 PMCID: PMC3737199 DOI: 10.1371/journal.pone.0070119] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 06/14/2013] [Indexed: 11/18/2022] Open
Abstract
Background Swimming, a sport practiced in hypogravity, has sometimes been associated with decreased bone mass. Aim This systematic review aims to summarize and update present knowledge about the effects of swimming on bone mass, structure and metabolism in order to ascertain the effects of this sport on bone tissue. Methods A literature search was conducted up to April 2013. A total of 64 studies focusing on swimmers bone mass, structure and metabolism met the inclusion criteria and were included in the review. Results It has been generally observed that swimmers present lower bone mineral density than athletes who practise high impact sports and similar values when compared to sedentary controls. However, swimmers have a higher bone turnover than controls resulting in a different structure which in turn results in higher resistance to fracture indexes. Nevertheless, swimming may become highly beneficial regarding bone mass in later stages of life. Conclusion Swimming does not seem to negatively affect bone mass, although it may not be one of the best sports to be practised in order to increase this parameter, due to the hypogravity and lack of impact characteristic of this sport. Most of the studies included in this review showed similar bone mineral density values in swimmers and sedentary controls. However, swimmers present a higher bone turnover than sedentary controls that may result in a stronger structure and consequently in a stronger bone.
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Affiliation(s)
- Alejandro Gómez-Bruton
- GENUD “Growth, Exercise, NUtrition and Development” Research Group, Universidad de Zaragoza, Zaragoza, Spain
| | - Alejandro Gónzalez-Agüero
- GENUD “Growth, Exercise, NUtrition and Development” Research Group, Universidad de Zaragoza, Zaragoza, Spain
- Department of Sport and Exercise Science, Aberystwyth University, Aberystwyth, United Kingdom
| | - Alba Gómez-Cabello
- GENUD “Growth, Exercise, NUtrition and Development” Research Group, Universidad de Zaragoza, Zaragoza, Spain
| | - José A. Casajús
- GENUD “Growth, Exercise, NUtrition and Development” Research Group, Universidad de Zaragoza, Zaragoza, Spain
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, Huesca, Spain
| | - Germán Vicente-Rodríguez
- GENUD “Growth, Exercise, NUtrition and Development” Research Group, Universidad de Zaragoza, Zaragoza, Spain
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, Universidad de Zaragoza, Huesca, Spain
- * E-mail:
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Jackman SR, Scott S, Randers MB, Ørntoft C, Blackwell J, Zar A, Helge EW, Mohr M, Krustrup P. Musculoskeletal health profile for elite female footballers versus untrained young women before and after 16 weeks of football training. J Sports Sci 2013; 31:1468-74. [DOI: 10.1080/02640414.2013.796066] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Sarah R. Jackman
- a Sport and Health Sciences, College of Life and Environmental Sciences , University of Exeter , Exeter , UK
| | - Suzanne Scott
- a Sport and Health Sciences, College of Life and Environmental Sciences , University of Exeter , Exeter , UK
| | - Morten Bredsgaard Randers
- b Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health , University of Copenhagen , Denmark
| | - Christina Ørntoft
- b Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health , University of Copenhagen , Denmark
| | - Jamie Blackwell
- a Sport and Health Sciences, College of Life and Environmental Sciences , University of Exeter , Exeter , UK
| | - Abdossaleh Zar
- c Department of Physical Education & Sport Science , University of Jahrom , Islamic Republic of Iran
| | - Eva Wulff Helge
- b Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health , University of Copenhagen , Denmark
| | - Magni Mohr
- a Sport and Health Sciences, College of Life and Environmental Sciences , University of Exeter , Exeter , UK
| | - Peter Krustrup
- a Sport and Health Sciences, College of Life and Environmental Sciences , University of Exeter , Exeter , UK
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Rietsch K, Eccard JA, Scheffler C. Decreased external skeletal robustness due to reduced physical activity? Am J Hum Biol 2013; 25:404-10. [DOI: 10.1002/ajhb.22389] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 02/20/2013] [Accepted: 02/22/2013] [Indexed: 11/05/2022] Open
Affiliation(s)
- Katrin Rietsch
- Human Biology, Institute of Biochemistry and Biology; University of Potsdam; Potsdam; Germany
| | - Jana A. Eccard
- Human Biology, Institute of Biochemistry and Biology; University of Potsdam; Potsdam; Germany
| | - Christiane Scheffler
- Human Biology, Institute of Biochemistry and Biology; University of Potsdam; Potsdam; Germany
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Nor Aini J, Poh BK, Chee WSS. Validity of a children's physical activity questionnaire (cPAQ) for the study of bone health. Pediatr Int 2013; 55:223-8. [PMID: 23253297 DOI: 10.1111/ped.12035] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Revised: 10/31/2012] [Accepted: 11/30/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND The aim of this cross-sectional study was to examine the ability of a children's physical activity questionnaire (cPAQ) to assess physical activity levels and bone health status of school children. METHODS Subjects consisted of 90 pre-pubertal and early pubertal children aged 9-10 years. Components of physical activity were assessed using metabolic intensity (METPA) scores and mechanical bone strain (MECHPA) scores. An Actical accelerometer was used to validate METPA scores among a sub-sample of 57 children. Reliability was assessed by test-retesting all children after a 7 day interval. Whole body bone mineral content (BMC) was measured using dual-energy X-ray absorptiometry. RESULTS The reliability of cPAQ for assessment of various categories of physical activity was moderate to high (r ranged from 0.55 to 0.68, P < 0.001). Agreement was fair for repeated use of the cPAQ (Cohen's kappa = 0.32, P < 0.001). Bland-Altman plots show cPAQ had fair agreement only for moderate activity (mean difference 35.4 min/week; 95% limits of agreement -434.0 to +504.9 min/week). Approximately 69.6% of children were correctly classified (into the same or adjacent quartiles) according to the quartiles of BMC for METPA score, and 58.7% were correctly classified according to MECHPA score. Only 10.9% and 12.0% of children were grossly misclassified as compared to METPA and MECHPA scores, respectively. CONCLUSIONS The cPAQ has reasonable validity in assessing moderate physical activity, and it demonstrates good ability to accurately classify children according to BMC. It fails, however, to assess other activity levels, suggesting that objective measurement is still a better method of assessment of physical activity among primary school children.
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Affiliation(s)
- Jamil Nor Aini
- School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Leisure time physical activity and risk of non-vertebral fracture in men and women aged 55 years and older: the Tromsø Study. Eur J Epidemiol 2012; 27:463-71. [DOI: 10.1007/s10654-012-9665-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2011] [Accepted: 02/15/2012] [Indexed: 01/25/2023]
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Long-term effect of exercise on bone mineral density and body composition in post-menopausal ex-elite athletes: a retrospective study. Eur J Clin Nutr 2011; 66:69-74. [PMID: 21673718 DOI: 10.1038/ejcn.2011.104] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The aim of this retrospective study was to determine the long-term effect of exercise on bone mineral density (BMD), bone mineral content (BMC) and body composition (BC) in post-menopausal women who were elite athletes during their youth compared with sedentary controls. SUBJECTS/METHODS It is a retrospective study and carried out in an outpatient clinic. A total of 48 post-menopausal women (54-73 years of age) were enrolled. Ex-elite athletes with long-term (>20 years) histories of significant training and performance were divided into two groups: weight-bearing sports (runners, n=12) and non-weight-bearing sports (swimmers, n=12). The athletes were age matched with sedentary controls (n=24). BMD, BMC and BC were measured using dual-energy X-ray absorptiometry. Healthcare and sport activity histories were evaluated using a questionnaire. RESULTS No significant differences were found with regard to body weight, height, body mass index and hours of activity between the two groups of athletes. There were no significant differences in activity levels between athletes and controls at the time of this study. BMD and BMC were not significantly different between athletes; they were significantly higher in athletes than in controls (P<0.001). Although the ex-athletes did not significantly differ in BC, left and right lean arm mass and arm BMD were significantly higher in swimmers than in runners (P<0.0001). CONCLUSIONS The high level of physical activity observed in female athletes is associated with improved muscle mass, BMD and BMC, and physical activity during youth seems to have a beneficial effect on bone mass and helps to prevent bone loss due to aging.
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Scuba diving does not affect bone mineral density or bone mineral content. Joint Bone Spine 2011; 78:616-8. [PMID: 21441055 DOI: 10.1016/j.jbspin.2011.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Accepted: 02/03/2011] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Scuba diving is a very specialized, physically demanding activity. The bones of divers are subjected to stress from water pressure, from the forces generated when their muscles resist water pressure, and from weightlessness. Notably, few studies have addressed the effects of diving on bone mineral density (BMD) and bone mineral content (BMC), and the results have been controversial. The goal of the study was to assess BMD and BMC in a group of professional scuba divers. METHODS The study group (diving group [D]) included 16 male professional scuba divers who also worked as firemen. The control group included 14 firemen who did not scuba dive (non-diving group [ND]). The groups were matched by age, weight, and height. The BMD and BMC of the whole skeleton, L1-L4, total hip, and femoral neck were assessed by dual-energy X-ray absorptiometry. RESULTS There were no differences in BMD or in BMC in the two groups, and the BMD and BMC values were within one standard deviation in terms of Z- and T-scores. There was no correlation between total diving time (hours) and BMD in the D group. CONCLUSION Scuba diving does not negatively influence bone turnover.
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Maurel DB, Boisseau N, Ingrand I, Dolleans E, Benhamou CL, Jaffre C. Combined effects of chronic alcohol consumption and physical activity on bone health: study in a rat model. Eur J Appl Physiol 2011; 111:2931-40. [PMID: 21437605 DOI: 10.1007/s00421-011-1916-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Accepted: 03/08/2011] [Indexed: 11/28/2022]
Abstract
Chronic alcohol consumption may be deleterious for bone tissue depending on the amount of ethanol consumed, whereas physical activity has positive effects on bone. This study was designed to analyze the effects of moderate alcohol consumption on bone in trained rats. 48 male Wistar rats were divided into four groups: control (C), alcohol (A), exercise (E) and alcohol + exercise (AE). A and AE groups drank a solution composed of water and ethanol. E and AE groups were trained for 2 months (treadmill: 40 min/day, 5 times/week). Body composition and bone mineral density (BMD) were assessed by dual X-ray absorptiometry and microarchitectural parameters using micro-computed tomography. Serum osteocalcin and CTx were determined by ELISA assays. The body weight and lean mass gain were lower in group A, while the fat mass gain was lower in exercised groups. BMD and BMC were higher with alcohol after body weight adjustment. Trabecular thickness was significantly higher in AE and A groups compared to C and E; cross-sectional area was larger in A and C groups compared to AE and E. CTx levels were higher in A compared to C and in AE and E versus C and A. Osteocalcin levels were significantly greater in AE and E groups versus C and A. In conclusion, the light to moderate alcohol consumption over a short period increased the trabecular thickness, BMC and BMD in A and AE groups. However, we observed alterations in bone remodeling and body composition with alcohol, at the end of the protocol, which did not appear when alcohol was combined to exercise.
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Affiliation(s)
- Delphine B Maurel
- INSERM Unit 658, Caractérisation du Tissu Osseux par Imagerie, Techniques et Applications, Hôpital Porte Madeleine, 1 rue Porte Madeleine, BP 2439, 45032, Orléans Cedex 01, France
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Viljakainen HT, Pekkinen M, Saarnio E, Karp H, Lamberg-Allardt C, Mäkitie O. Dual effect of adipose tissue on bone health during growth. Bone 2011; 48:212-7. [PMID: 20858556 DOI: 10.1016/j.bone.2010.09.022] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Revised: 09/05/2010] [Accepted: 09/15/2010] [Indexed: 11/26/2022]
Abstract
Recent studies suggest association between body fat and childhood bone health, although conflicting findings have also been reported. The aim of the present study was to examine the association between body fat content and areal BMD, volumetric BMD, bone turnover markers, and calcitropic factors in apparently healthy children and adolescents. The study was carried out as a school based cross-sectional cohort study with 186 subjects (61% girls) aged from 7 to 19 years. Background characteristics, including medical history and lifestyle factors, were collected. Anthropometry, BMD and body composition measurements with DXA and pQCT, a fasting blood sample and a second morning void urine sample were obtained. The subjects were divided into three groups, representing low, intermediate and high adiposity, based on age and gender specific fat percentage Z-scores. Multivariate analysis was performed to all bone variables using lean body mass, pubertal development, dietary intake of calcium and intensity of physical activity as covariates. In pQCT, a significant difference between the groups was observed in cortical BMD (MANOVA; p=0.02) in proximal radius, the intermediate group having the highest values. Similarly, DXA-derived LS and WB BMD Z-scores differed significantly between the groups (MANOVA; p=0.026 and p=0.036, respectively), with highest values in the intermediate group. High body fat content associated also with low bone turnover markers, low PTH, high S-Ca and high urinary calcium excretion. The differences in biochemical markers explain our and others' findings of bone health in children and adolescents with different body fat content. These findings suggest that normal body fat content is beneficial for bone health in growing children and adolescents while both low and high body fat content have adverse skeletal effects.
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Affiliation(s)
- Heli T Viljakainen
- Hospital for Children and Adolescents, Helsinki University Central Hospital, Biomedicum Helsinki 2, Tukholmankatu 8 C, PO Box 705, 00029 HUS, Helsinki, Finland.
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Kawalilak CE, Baxter-Jones ADG, Faulkner RA, Bailey DA, Kontulainen SA. Does childhood and adolescence fracture influence bone mineral content in young adulthood? Appl Physiol Nutr Metab 2010; 35:235-43. [PMID: 20555366 DOI: 10.1139/h10-011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Previous fracture may predispose an individual to bone fragility because of impaired bone mineral accrual. The primary objective of the study was to investigate the influence of fractures sustained during childhood and (or) adolescence on total body (TB), lumbar spine (LS), femoral neck (FN), and total hip (TH) bone mineral content (BMC) in young adulthood. It was hypothesized that there would be lower TB, LS, FN, and TH BMC in participants who had sustained a pediatric fracture. Participant anthropometrics, physical activity, and BMC (measured with dual energy X-ray absorptiometry) were assessed longitudinally during childhood and adolescence (from 1991 to 1997), and again in young adulthood (2002 to 2006). Sex, adult height, adult lean mass, adult physical activity, and adolescent BMC adjusted TB, LS, FN, and TH BMC in young adulthood, for those who reported 1 or more fractures (n = 42), were compared with those who reported no fractures (n = 101). There were no significant differences (p > 0.05) in adjusted BMC between fracture and nonfracture groups at the TB, LS, FN, and TH sites in young adulthood. These results suggest that fractures sustained during childhood and adolescence may not interfere with bone mass in young adulthood at clinically relevant bone sites.
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Affiliation(s)
- Chantal E Kawalilak
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK S7N 5B2, Canada
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Ohtani J, Hernandez RAM, Sunagawa H, Fujita T, Kawata T, Kaku M, Motokawa M, Tsuka N, Koseki H, Matsuda Y, Hayashi H, Abedini S, Tanne K. A newly developed snack effective for enhancing bone volume. Nutr J 2009; 8:30. [PMID: 19573248 PMCID: PMC2711110 DOI: 10.1186/1475-2891-8-30] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2009] [Accepted: 07/03/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The incidence of primary osteoporosis is higher in Japan than in USA and European countries. Recently, the importance of preventive medicine has been gradually recognized in the field of orthopaedic surgery with a concept that peak bone mass should be increased in childhood as much as possible for the prevention of osteoporosis. Under such background, we have developed a new bean snack with an aim to improve bone volume loss. In this study, we examined the effects of a newly developed snack on bone volume and density in osteoporosis model mice. METHODS Orchiectomy (ORX) and ovariectomy (OVX) were performed for C57BL/6J mice of twelve-week-old (Jackson Laboratory, Bar Harbar, ME, USA) were used in this experiment. We prepared and given three types of powder diet e.g.: normal calcium diet (NCD, Ca: 0.9%, Clea Japan Co., Tokyo, Japan), low calcium diet (LCD, Ca: 0.63%, Clea Japan Co.,) and special diet (SCD, Ca: 0.9%). Eighteen weeks after surgery, all the animals were sacrified and prepared for histomorphometric analysis to quantify bone density and bone mineral content. RESULTS As a result of histomorphometric examination, SCD was revealed to enhance bone volume irrespective of age and sex. The bone density was increased significantly in osteoporosis model mice fed the newly developmental snack as compared with the control mice. The bone mineral content was also enhanced significantly. These phenomena were revealed in both sexes. CONCLUSION It is shown that the newly developed bean snack is highly effective for the improvement of bone volume loss irrespective of sex. We demonstrated that newly developmental snack supplements may be a useful preventive measure for Japanese whose bone mineral density values are less than the ideal condition.
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Affiliation(s)
- Junji Ohtani
- Department of Orthodontics and Craniofacial Developmental Biology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima-city, Hiroshima, Japan
| | - Rene Arturo Marquez Hernandez
- Department of Orthodontics and Craniofacial Developmental Biology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima-city, Hiroshima, Japan
| | - Hiroko Sunagawa
- Department of Orthodontics and Craniofacial Developmental Biology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima-city, Hiroshima, Japan
| | - Tadashi Fujita
- Department of Orthodontics and Craniofacial Developmental Biology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima-city, Hiroshima, Japan
| | - Toshitsugu Kawata
- Department of Orthodontics and Craniofacial Developmental Biology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima-city, Hiroshima, Japan
| | - Masato Kaku
- Department of Orthodontics and Craniofacial Developmental Biology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima-city, Hiroshima, Japan
| | - Masahide Motokawa
- Department of Orthodontics and Craniofacial Developmental Biology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima-city, Hiroshima, Japan
| | - Natsumi Tsuka
- Department of Orthodontics and Craniofacial Developmental Biology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima-city, Hiroshima, Japan
| | - Hiroyuki Koseki
- Department of Orthodontics and Craniofacial Developmental Biology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima-city, Hiroshima, Japan
| | - Yayoi Matsuda
- Department of Orthodontics and Craniofacial Developmental Biology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima-city, Hiroshima, Japan
| | - Hidetaka Hayashi
- Department of Orthodontics and Craniofacial Developmental Biology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima-city, Hiroshima, Japan
| | - Sara Abedini
- Department of Orthodontics and Craniofacial Developmental Biology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima-city, Hiroshima, Japan
| | - Kazuo Tanne
- Department of Orthodontics and Craniofacial Developmental Biology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima-city, Hiroshima, Japan
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Karlsson MK, Nordqvist A, Karlsson C. Sustainability of exercise-induced increases in bone density and skeletal structure. Food Nutr Res 2008; 52:1872. [PMID: 19109651 PMCID: PMC2596739 DOI: 10.3402/fnr.v52i0.1872] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2008] [Revised: 07/22/2008] [Accepted: 08/10/2008] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The prevalence of osteoporosis with related fragility fractures has increased during the last decades. As physical activity influences the skeleton in a beneficial way, exercise may hypothetically be used as a prophylactic tool against osteoporosis. OBJECTIVE This review evaluates if exercise-induced skeletal benefits achieved during growth remain in a long-term perspective. DESIGN PUBLICATIONS WITHIN THE FIELD WERE SEARCHED THROUGH MEDLINE (PUBMED) USING THE SEARCH WORDS: exercise, physical activity, bone mass, bone mineral content (BMC), bone mineral density (BMD) and skeletal structure. We based our inferences on publications with the highest level of evidence, particularly randomised controlled trials (RCT). RESULTS Benefits in BMD achieved by exercise during growth seem to be eroded at retirement, but benefits in skeletal structure may possibly be retained in a longer perspective. Recreational exercise seems to at least partially maintain exercise-induced skeletal benefits achieved during growth. CONCLUSIONS Exercise during growth may be followed by long-term beneficial skeletal effects, which could possibly reduce the incidence of fractures. Exercise during adulthood seems to partly preserve these benefits and reduce the age-related bone loss.
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Affiliation(s)
- Magnus K Karlsson
- Clinical and Osteoporosis Research Unit, Department of Clinical Sciences and Department of Orthopaedics, Malmö University Hospital, Lund University, Malmö, Sweden
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Karlsson MK, Nordqvist A, Karlsson C. Physical activity increases bone mass during growth. Food Nutr Res 2008; 52:1871. [PMID: 19109652 PMCID: PMC2596740 DOI: 10.3402/fnr.v52i0.1871] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2008] [Revised: 07/22/2008] [Accepted: 08/10/2008] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The incidence of fragility fractures has increased during the last half of the 1990's. One important determinant of fractures is the bone mineral content (BMC) or bone mineral density (BMD), the amount of mineralised bone. If we could increase peak bone mass (the highest value of BMC reached during life) and/or decrease the age-related bone loss, we could possibly improve the skeletal resistance to fracture. OBJECTIVE This review evaluates the importance of exercise as a strategy to improve peak bone mass, including some aspects of nutrition. DESIGN PUBLICATIONS WITHIN THE FIELD WERE SEARCHED THROUGH MEDLINE (PUBMED) USING THE SEARCH WORDS: exercise, physical activity, bone mass, bone mineral content, bone mineral density, BMC, BMD, skeletal structure and nutrition. We included studies dealing with exercise during growth and young adolescence. We preferably based our inferences on randomised controlled trials (RCT), which provide the highest level of evidence. RESULTS Exercise during growth increases peak bone mass. Moderate intensity exercise intervention programs are beneficial for the skeletal development during growth. Adequate nutrition must accompany the exercise to achieve the most beneficial skeletal effects by exercise. CONCLUSION Exercise during growth seems to enhance the building of a stronger skeleton through a higher peak bone mass and a larger bone size.
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Affiliation(s)
- Magnus K. Karlsson
- Clinical and Osteoporosis Research Unit, Department of Clinical Sciences and Department of Orthopaedics, Malmö University Hospital, Lund University, Malmö, Sweden
| | - Anders Nordqvist
- Clinical and Osteoporosis Research Unit, Department of Clinical Sciences and Department of Orthopaedics, Malmö University Hospital, Lund University, Malmö, Sweden
| | - Caroline Karlsson
- Clinical and Osteoporosis Research Unit, Department of Clinical Sciences and Department of Orthopaedics, Malmö University Hospital, Lund University, Malmö, Sweden
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