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Garemo M, Sundh V, Mellström D, Strandvik B. Serum phospholipid fatty acids are associated with bone mass in healthy 4-years-old children. Prostaglandins Leukot Essent Fatty Acids 2024; 200:102606. [PMID: 38181601 DOI: 10.1016/j.plefa.2023.102606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/21/2023] [Accepted: 12/23/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND Fatty acids are involved in bone development but knowledge in children is limited. The aim of this study was to investigate bone mass and mineral density in healthy preschool children in relation to fatty acids. MATERIAL AND METHODS In 111 healthy 4-yrs-old children (20 % overweight) bone was analysed by dual X-ray absorptiometry and serum phospholipid fatty acid by gas chromatography. Fat intake was calculated from 7 days self-reported dietary records and food frequency questionnaire. RESULTS Total bone mass content (BMC) and mineral density (BMD) differed by sex in normal weight, but not in overweight children showing generally higher bone mass density than children with normal weight. Linoleic acid intake was strongly correlated to BMC and femoral BMD in normal weight children. Serum concentration of docosahexaenoic acid correlated positively to BMD in all children (p = 0.01), but linoleic and arachidonic acids, and monounsaturated fatty acids showed diverging associations with bone in normal weight and overweight children. CONCLUSION Serum phospholipid DHA was associated with bone density. Other fatty acids associations to bone sites differed in overweight children, analogue to the pattern in healthy 8-yrs-old.The finding need to be confirmed longitudinally and in a larger group of overweight individuals.
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Affiliation(s)
- Malin Garemo
- University of Gothenburg, Department of Pediatrics, Sahlgrenska Academy, Göteborg, Sweden
| | - Valter Sundh
- University of Gothenburg, Department of Community Medicine and Public Health, Institute of Medicine, Sahlgrenska Academy, Göteborg, Sweden
| | - Dan Mellström
- University of Gothenburg, Center for Bone and Arthritis Research, Department of Internal Medicine, Institutet of Medicine, Sahlgrenska Academy, Göteborg, Sweden
| | - Birgitta Strandvik
- Karolinska Institutet, Department of Biosciences and Nutrition, Stockholm, Sweden.
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Alghadir AH, Gabr SA, Iqbal A. Hand grip strength, vitamin D status, and diets as predictors of bone health in 6-12 years old school children. BMC Musculoskelet Disord 2023; 24:830. [PMID: 37872520 PMCID: PMC10594896 DOI: 10.1186/s12891-023-06960-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/12/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Vitamin D and calcium-rich foods, exposure to sunlight, and physical activities (PA) play a pivotal role in promoting the production of sufficient vitamin D and improving grip strength needed for better bone health among school children. PURPOSE This study aimed to determine the effects of hand grip muscle strength (HGS), vitamin D in addition to diets, and PA on bone health status among 6-12 years old schoolchildren. METHODS This study was based on a cross-sectional observational design, which was descriptive in nature. A diverse sample of 560 elementary school children aged 6-12 years old were invited to participate in this descriptive cross-sectional study. The Dual-Energy X-Ray Absorptiometry (DXA), QUS technique, and ACTi graph GT1M accelerometer were used respectively as a valid tools to identify BMD, BMC, and other parameters of bone health like c-BUA values and bone stiffness (SI), and physical activity (PA) of all individuals participated in this study. In addition, a hydraulic dynamometer was used to measure hand grip strength among the participants. Moreover, an immunoassay technique was used to measure the serum levels of vitamin 25(OH)D level, and bone metabolism markers; NTX, DPD, Ca, and sBAP in all participants. Bone loss (osteoporosis) was cross-sectionally predicted in 19.64% of the total population, most of whom were girls (14.3% vs. 5.4% for boys; P = 0.01). Compared to boys, the incidence of osteoporosis was higher and significantly correlated in girls with lower HGS, deficient vitamin D, inadequate vitamin D and Ca intake, greater adiposity, poor PA, and lower sun exposure. Also, in girls, lower vitamin 25(OH)D levels, and poor HGS were shown to be significantly associated with lower values of BMD, BMC, SI, and higher values of bone resorption markers; NTX, DPD, and sBAP and lower serum Ca than do in boys. The findings suggested that deficient vitamin D, lower HGS, adiposity, PA, and sun exposure as related risk factors to the pravelence of bone loss among school children, particularly in girls. In addition, these parameters might be considered diagnostic non-invasive predictors of bone health for clinical use in epidemiological contexts; however, more studies are required.
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Affiliation(s)
- Ahmad H Alghadir
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia
| | - Sami A Gabr
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia
| | - Amir Iqbal
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia.
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Moon RJ, Citeroni NL, Aihie RR, Harvey NC. Early Life Programming of Skeletal Health. Curr Osteoporos Rep 2023; 21:433-446. [PMID: 37335525 PMCID: PMC10393901 DOI: 10.1007/s11914-023-00800-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/02/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE OF REVIEW Increasing bone mineral accrual during childhood might delay the onset of osteoporosis. We discuss the scientific evidence for early life approaches to optimising skeletal health. RECENT FINDINGS There is an ever-growing body of evidence from observational studies suggesting associations between early life exposures, particularly during foetal development, and bone mineral density (BMD). The findings of such studies are often heterogeneous, and for some exposures, for example, maternal smoking and alcohol intake in pregnancy or age at conception, intervention studies are not feasible. The most frequently studied exposures in intervention studies are calcium or vitamin D supplementation in pregnancy, which overall suggest positive effects on offspring childhood BMD. Maternal calcium and/or vitamin D supplementation during pregnancy appear to have positive effects on offspring BMD during early childhood, but further long-term follow-up is required to demonstrate persistence of the effect into later life.
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Affiliation(s)
- Rebecca J. Moon
- MRC Lifecourse Epidemiology Centre, University of Southampton, Tremona Road, Southampton, SO16 6YD UK
- Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Natasha L. Citeroni
- MRC Lifecourse Epidemiology Centre, University of Southampton, Tremona Road, Southampton, SO16 6YD UK
| | | | - Nicholas C. Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Tremona Road, Southampton, SO16 6YD UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Casey C, Kemp BJ, Cassidy L, Patterson CC, Tully MA, Hill AJ, McCance DR. The influence of diet and physical activity on bone density of children aged 5-7 years: The Belfast HAPO family study. Bone 2023; 172:116783. [PMID: 37121559 DOI: 10.1016/j.bone.2023.116783] [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: 12/05/2022] [Revised: 04/21/2023] [Accepted: 04/25/2023] [Indexed: 05/02/2023]
Abstract
OBJECTIVE Osteoporosis is a global health issue, and modifiable behavioural factors need to be identified in childhood to reduce the risk of osteoporosis in later life. The aim of this study was to investigate the influence of diet and physical activity on bone density of children aged 5-7 years participating in the Belfast Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) Family study. DESIGN AND METHODS Pregnant women were recruited to the Belfast centre of the HAPO study at 24-32 weeks gestation. Offspring were followed up at 5-7 years as part of the Belfast HAPO Family Study. Heel bone mineral density (BMD) and bone mineral apparent density (BMAD) were measured and calculated, respectively. Physical activity in the offspring was measured by accelerometery and dietary intakes were measured using a 4-day food diary. RESULTS Results from 793 offspring were analysed. Mean age of the offspring ± standard deviation was 6.4 ± 0.5 years. A mean of 48.3 ± 22.4 min each day was spent in moderate to vigorous physical activity (MVPA). Median (interquartile range) dietary calcium and vitamin D intakes were 844 (662-1073) mg/day and 1.7 (1.1-2.5) μg/day, respectively. Neither dietary vitamin D nor calcium intakes were significantly associated with offspring heel BMD or BMAD in multiple regression. However, controlling for confounders, a 30-min greater MVPA was associated with significantly larger heel BMD (0.018 g/cm2 in boys and 0.010 g/cm2 in girls) and BMAD (0.005 g/cm3 in boys and 0.003 g/cm3 in girls). CONCLUSION Physical activity was associated with better BMD and BMAD in 5-7-year-old children. Dietary calcium and vitamin D were not predictive of BMD and BMAD.
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Affiliation(s)
- Claire Casey
- Centre for Public Health, Queen's University Belfast, Belfast BT12 6BA, Northern Ireland, UK
| | - Bridie J Kemp
- Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast BT12 6BA, Northern Ireland, UK; School of Nursing and Midwifery, Queen's University Belfast, Belfast BT12 6BA, Northern Ireland, UK
| | - Laura Cassidy
- Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast BT12 6BA, Northern Ireland, UK
| | - Chris C Patterson
- Centre for Public Health, Queen's University Belfast, Belfast BT12 6BA, Northern Ireland, UK
| | - Mark A Tully
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey BT37 0QB, Northern Ireland, UK
| | - Alyson J Hill
- Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine BT52 1SA, Northern Ireland, UK
| | - David R McCance
- Centre for Public Health, Queen's University Belfast, Belfast BT12 6BA, Northern Ireland, UK; Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast BT12 6BA, Northern Ireland, UK.
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Moldovan IA, Bragg A, Nidhiry AS, De La Cruz BA, Mitchell SE. The Physical Activity Assessment of Adults With Type 2 Diabetes Using Accelerometer-Based Cut Points: Scoping Review. Interact J Med Res 2022; 11:e34433. [PMID: 36066937 PMCID: PMC9490541 DOI: 10.2196/34433] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 04/25/2022] [Accepted: 07/11/2022] [Indexed: 11/16/2022] Open
Abstract
Background Incorporating physical activity into lifestyle routines is recommended for individuals with type 2 diabetes. Accelerometers offer a promising method for objectively measuring physical activity and for assessing interventions. However, the existing literature for accelerometer-measured physical activity among middle-aged and older adults with type 2 diabetes is lacking. Objective This study aims to identify research studies in which accelerometer-based cut points were used to classify the physical activity intensity of middle-aged to older adults with type 2 diabetes as sedentary, light, moderate, vigorous, and very vigorous, and to determine if validated accelerometer cut points specifically for this population exist. Methods We followed the Joanna Briggs Institute methodology for scoping reviews. Between June 23 and July 12, 2020, two reviewers independently screened records from four databases (PubMed, Web of Science, Embase, Engineering Village) and the ActiGraph Corp web site for eligible studies that included patients with type 2 diabetes with a sample mean age ≥50 years, used research-grade accelerometers, applied cut points to categorize objectively measured physical activity, and were available in English. We excluded studies reporting exclusively steps or step counts measured by accelerometers or pedometers and conference abstracts or other sources that did not have a full text available. Data extraction was completed using Microsoft Excel. Data for the following variables were tabulated based on frequency distributions: study design, accelerometer type, device placement, epoch length, total wear time, and cut points used. Study aims and participant demographic data were summarized. Results A total of 748 records were screened at the abstract level, and 88 full-text articles were assessed for eligibility. Ultimately, 46 articles were retained and analyzed. Participants’ mean ages ranged from 50 to 79.9 years. The ActiGraph accelerometer and the Freedson et al and Troiano et al counts-per-minute cut points were the most frequently used across the literature. Freedson et al and Troiano et al counts-per-minute cut points for light, moderate, and vigorous activity correspond to <1952, 1952-5724, and ≥5725, and 100-2019, 2020-5998, and ≥5999, respectively. The Lopes et al cut points were developed by calibrating the ActiGraph in middle-aged and older adults with overweight/obesity and type 2 diabetes. These counts-per-minute thresholds are ≥200 (light), ≥1240 (moderate), and ≥2400 (vigorous), and were applied in 1 interventional study. Conclusions An assortment of accelerometer cut points have been used by researchers to categorize physical activity intensity for middle-aged and older adults with diabetes. Only one set of cut points was validated and calibrated in our population of interest. Additional research is warranted to address the need for diabetes-specific cut points to inform public health recommendations. This includes confirmation that the Lopes et al cut points reflect clinically meaningful changes in physical activity for adults with diabetes who have comorbidities other than overweight/obesity and the development of relative intensity cut points that may be more suitable for those with suboptimal physical functioning.
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Affiliation(s)
- Ioana A Moldovan
- Department of Family Medicine, Boston Medical Center, Boston, MA, United States
| | - Alexa Bragg
- Department of Family Medicine, Boston University School of Medicine, Boston, MA, United States
| | - Anna S Nidhiry
- Department of Family Medicine, Boston Medical Center, Boston, MA, United States
| | | | - Suzanne E Mitchell
- Department of Family Medicine, Boston Medical Center, Boston, MA, United States.,Department of Family Medicine, Boston University School of Medicine, Boston, MA, United States.,Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, MA, United States
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Curtis EM, Moon RJ, D'Angelo S, Crozier SR, Bishop NJ, Gopal‐Kothandapani JS, Kennedy SH, Papageorghiou AT, Fraser R, Gandhi SV, Schoenmakers I, Prentice A, Inskip HM, Godfrey KM, Javaid MK, Eastell R, Cooper C, Harvey NC. Pregnancy Vitamin D Supplementation and Childhood Bone Mass at Age 4 Years: Findings From the Maternal Vitamin D Osteoporosis Study (MAVIDOS) Randomized Controlled Trial. JBMR Plus 2022; 6:e10651. [PMID: 35866154 PMCID: PMC9289979 DOI: 10.1002/jbm4.10651] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/25/2022] [Accepted: 04/28/2022] [Indexed: 01/04/2023] Open
Abstract
In the Maternal Vitamin D Osteoporosis Study (MAVIDOS) randomized trial, vitamin D supplementation in pregnancy did not lead to greater neonatal bone mass across the trial as a whole, but, in a prespecified secondary analysis by season of birth, led to greater neonatal bone mass among winter-born babies. Demonstrating persistence of this effect into childhood would increase confidence in a long-term benefit of this intervention. We investigated whether antenatal vitamin D supplementation increases offspring bone mineralization in early childhood in a prespecified, single-center follow-up of a double-blinded, multicenter, randomized controlled clinical trial based in the UK (MAVIDOS). A total of 1123 women in early pregnancy with a baseline 25-hydroxyvitamin D level 25-100 nmol/L from three research centers (2008-2014) were randomized to 1000 IU/d cholecalciferol or matched placebo from 14 weeks of gestation to delivery. Offspring born at the Southampton, UK research center were assessed at age 4 years (2013-2018). Anthropometry and dual-energy X-ray absorptiometry (DXA) were performed (yielding whole body less head [WBLH] bone mineral content [BMC], areal bone mineral density [aBMD], bone area [BA], and body composition). Of 723 children, 564 (78.0%) children attended the 4-year visit, 452 of whom had a useable DXA. Maternal vitamin D supplementation led to greater WBLH aBMD in the children compared with placebo (mean [95% confidence interval {CI}]: supplemented group: 0.477 (95% CI, 0.472-0.481) g/cm2; placebo group: 0.470 (95% CI, 0.466-0.475) g/cm2, p = 0.048). Associations were consistent for BMC and lean mass, and in age- and sex-adjusted models. Effects were observed across the whole cohort irrespective of season of birth. Maternal-child interactions were observed, with a greater effect size among children with low milk intake and low levels of physical activity. Child weight, height, and body mass index (BMI) were similar by maternal randomization group. These findings suggest a sustained beneficial effect of maternal vitamin D supplementation in pregnancy on offspring aBMD at age 4 years, but will require replication in other trials. © 2022 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Elizabeth M. Curtis
- Medical Research Council (MRC) Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Rebecca J. Moon
- Medical Research Council (MRC) Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- Paediatric EndocrinologyUniversity Hospital Southampton National Health Service (NHS) Foundation TrustSouthamptonUK
| | - Stefania D'Angelo
- Medical Research Council (MRC) Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Sarah R. Crozier
- Medical Research Council (MRC) Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
| | - Nicholas J. Bishop
- Academic Unit of Child Health, Sheffield Children's HospitalUniversity of SheffieldSheffieldUK
| | | | - Stephen H. Kennedy
- Nuffield Department of Women's & Reproductive Health, John Radcliffe HospitalUniversity of OxfordOxfordUK
| | - Aris T. Papageorghiou
- Nuffield Department of Women's & Reproductive Health, John Radcliffe HospitalUniversity of OxfordOxfordUK
| | - Robert Fraser
- Department of Obstetrics and Gynaecology, Sheffield Hospitals National Health Service (NHS) TrustUniversity of SheffieldSheffieldUK
| | - Saurabh V. Gandhi
- Department of Obstetrics and Gynaecology, Sheffield Hospitals National Health Service (NHS) TrustUniversity of SheffieldSheffieldUK
| | - Inez Schoenmakers
- Department of Medicine, Faculty of Medicine and Health SciencesUniversity of East AngliaNorwichUK
| | - Ann Prentice
- Medical Research Council (MRC) Nutrition and Bone Health, Clifford Allbutt BuildingUniversity of CambridgeCambridgeUK
| | - Hazel M. Inskip
- Medical Research Council (MRC) Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- National Institute for Health Research (NIHR) Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton National Health Service (NHS) Foundation TrustSouthamptonUK
| | - Keith M. Godfrey
- Medical Research Council (MRC) Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- National Institute for Health Research (NIHR) Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton National Health Service (NHS) Foundation TrustSouthamptonUK
| | - M. Kassim Javaid
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal SciencesUniversity of OxfordOxfordUK
- National Institute for Health Research (NIHR) Oxford Biomedical Research CentreUniversity of OxfordOxfordUK
| | - Richard Eastell
- Department of Oncology and MetabolismUniversity of SheffieldSheffieldUK
| | - Cyrus Cooper
- Medical Research Council (MRC) Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- National Institute for Health Research (NIHR) Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton National Health Service (NHS) Foundation TrustSouthamptonUK
- National Institute for Health Research (NIHR) Oxford Biomedical Research CentreUniversity of OxfordOxfordUK
| | - Nicholas C. Harvey
- Medical Research Council (MRC) Lifecourse Epidemiology CentreUniversity of SouthamptonSouthamptonUK
- National Institute for Health Research (NIHR) Southampton Biomedical Research CentreUniversity of Southampton and University Hospital Southampton National Health Service (NHS) Foundation TrustSouthamptonUK
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Moon RJ, D'Angelo S, Crozier SR, Godfrey KM, Davies JH, Cooper C, Harvey NC. Is the skull responsive to bone mineralisation stimuli in children? Bone 2022; 160:116415. [PMID: 35398588 DOI: 10.1016/j.bone.2022.116415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/22/2022] [Accepted: 04/02/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Whole-body-less-head (WBLH) is the recommended skeletal region of interest (ROI) for dual-energy X-ray absorptiometry (DXA) assessment of bone mineral density (BMD) in children. Historically it has been suggested that the skull is less responsive than the rest of the skeleton to stimuli that affect BMD but there are few published data to support this notion. We compared the associations of BMD with anthropometric, body composition, diet, and activity variables across various ROI. METHODS Children from the Southampton Women's Survey (SWS) mother-offspring cohort participated at age 6-7 years, including measurement of height, weight, and whole-body and lumbar spine (LS) BMD by DXA (Hologic Discovery). Physical activity was assessed by accelerometry (Actiheart) and diet by interviewer-led questionnaire. BMD was measured in the following skeletal ROI: whole-body, skull, WBLH and lower limbs (all derived from the whole-body scan) and LS. RESULTS 1218 children participated. Height z-score, weight z-score, lean mass and milk intake were associated with skull BMD, but associations were weaker than observed for other ROI; for example, the association between lean mass and skull BMD was β (95% CI) 0.11 (0.08, 0.14) SD/kg, compared with 0.32 (0.30, 0.34), 0.38 (0.37, 0.40) and 0.23 (0.21, 0.25) SD/kg for whole body, WBLH and lumbar spine, respectively. Relationships with whole-body BMD were attenuated compared with WBLH. CONCLUSION Associations between skull BMD and anthropometry, body composition and dietary variables were weaker than for other DXA sites. These findings support, and importantly provide a quantitative basis for, the recommendation that the skull should be excluded from whole-body DXA analyses in children.
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Affiliation(s)
- Rebecca J Moon
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - Stefania D'Angelo
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, 2 Venture Road, Chilworth, Southampton SO16 7NP, UK.
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - Justin H Davies
- Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK; National Institute for Health Research (NIHR) Musculoskeletal Biomedical Research Unit, University of Oxford, UK.
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
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Constable AM, Vlachopoulos D, Barker AR, Moore SA, Soininen S, Haapala EA, Väistö J, Westgate K, Brage S, Mahonen A, Lakka TA. The independent and interactive associations of physical activity intensity and vitamin D status with bone mineral density in prepubertal children: the PANIC Study. Osteoporos Int 2021; 32:1609-1620. [PMID: 33547487 DOI: 10.1007/s00198-021-05872-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 02/01/2021] [Indexed: 01/12/2023]
Abstract
UNLABELLED It is unclear how physical activity intensity and vitamin D status are related to bone health in prepubertal children. We found positive associations between vitamin D status and moderate-to-vigorous physical activity with bone in boys and girls. This highlights the importance of lifestyle factors for skeletal health prepuberty. INTRODUCTION The sex-specific independent and interactive associations of physical activity (PA) intensity and serum 25-hydroxyvitamin D (25(OH)D) levels with areal bone mineral density (aBMD) were investigated in prepubertal children. METHODS The participants were 366 prepubertal Finnish children (190 boys, 176 girls) aged 6-8 years. Linear regression analysed the associations of sedentary time (ST), light PA (LPA), moderate PA (MPA), moderate-to-vigorous PA (MVPA) and vigorous PA (VPA) measured by accelerometery, and serum 25(OH)D with total body less head (TBLH) and lower-limb aBMD, measured by dual-energy X-ray absorptiometry. RESULTS There was no interaction between PA intensity or serum 25(OH)D and sex with aBMD. MPA and MVPA were positively associated with TBLH and lower-limb aBMD (β = 0.11, 95% CI 0.02-0.20, p = 0.01). Serum 25(OH)D was positively associated with TBLH and lower-limb aBMD (β = 0.09, 95% CI 0.01-0.18, p = 0.03). There were no interactions between PA intensity and serum 25(OH)D with aBMD. CONCLUSION Vitamin D status, MPA and MVPA levels in active prepubertal children were positively associated with aBMD. The influence of MVPA is due to the MPA component, though our findings regarding the role of VPA should be interpreted with caution, as shorter accelerometer epochs are needed to more accurately assess VPA. This study adds evidence to the promotion of MPA and behaviours to encourage optimal vitamin D status in supporting skeletal health in childhood, though these need not be used in conjunction to be beneficial, and a sex-specific approach is not necessary in prepubertal children. TRIAL REGISTRATION NUMBER NCT01803776 . Date of registration: 4/03/2013.
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Affiliation(s)
- A M Constable
- Children's Health and Exercise Research Centre, University of Exeter, Exeter, UK
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - D Vlachopoulos
- Children's Health and Exercise Research Centre, University of Exeter, Exeter, UK.
| | - A R Barker
- Children's Health and Exercise Research Centre, University of Exeter, Exeter, UK
| | - S A Moore
- School of Health and Human Performance, Dalhousie University, Halifax, Canada
| | - S Soininen
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
- Social and Health Center, Varkaus, Finland
| | - E A Haapala
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - J Väistö
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - K Westgate
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - S Brage
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - A Mahonen
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - T A Lakka
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
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The Positive Relationship between Moderate-to-Vigorous Physical Activity and Bone Mineral Content Is Not Mediated by Free Leptin Index in Prepubertal Children: The PANIC Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105365. [PMID: 34069919 PMCID: PMC8157575 DOI: 10.3390/ijerph18105365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/10/2021] [Accepted: 05/12/2021] [Indexed: 01/08/2023]
Abstract
Purpose: Moderate-to-vigorous physical activity (MVPA) positively influences bone mineral content (BMC) in prepubertal children, but it is unknown whether this relationship is partially mediated by free leptin index. The aim of this study was to examine whether the relationship between MVPA and total body less head (TBLH) BMC is mediated or moderated by free leptin index in prepubertal children. Methods: We performed a cross-sectional analysis on 401 children (194 girls) from baseline examinations of the Physical Activity and Nutrition in Childhood Study. We applied the four-way decomposition mediation analysis method to assess whether free leptin index, measured from fasted blood samples, mediated the relationship between accelerometer-measured MVPA and TBLH BMC measured by dual-energy X-ray absorptiometry. Results: MVPA had a positive controlled direct effect on TBLH BMC in girls and boys (β = 0.010 to 0.011, p < 0.05). There was no mediation or interaction between MVPA, free leptin index and TBLH BMC in girls or boys (β = −0.000 to 0.001, p > 0.05). Conclusion: Our study indicates that MVPA positively influences TBLH BMC through pathways not related to free leptin index in predominantly normal-weight prepubertal children, likely primarily through mechanical loading. The relationships between MVPA, free leptin index and TBLH BMC may be influenced by other factors such as pubertal status and adiposity, so it is unknown whether these observations extend to overweight and obese children at different stages of puberty.
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10
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Hou R, Cole SA, Graff M, Wang Y, Haack K, Laston S, Mehta NR, Shypailo RJ, Gourlay ML, Comuzzie AG, North KE, Butte NF, Voruganti VS. Genetic variants and physical activity interact to affect bone density in Hispanic children. BMC Pediatr 2021; 21:79. [PMID: 33588791 PMCID: PMC7883422 DOI: 10.1186/s12887-021-02537-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 01/29/2021] [Indexed: 12/16/2022] Open
Abstract
Background Our aim was to investigate if moderate to vigorous physical activity (MVPA), calcium intake interacts with bone mineral density (BMD)-related single nucleotide polymorphisms (SNPs) to influence BMD in 750 Hispanic children (4-19y) of the cross-sectional Viva La Familia Study. Methods Physical activity and dietary intake were measured by accelerometers and multiple-pass 24 h dietary recalls, respectively. Total body and lumbar spine BMD were measured by dual energy X-ray absorptiometry. A polygenic risk score (PRS) was computed based on SNPs identified in published literature. Regression analysis was conducted with PRSs, MVPA and calcium intake with total body and lumbar spine BMD. Results We found evidence of statistically significant interaction effects between the PRS and MVPA on total body BMD and lumbar spine BMD (p < 0.05). Higher PRS was associated with a lower total body BMD (β = − 0.040 ± 0.009, p = 1.1 × 10− 5) and lumbar spine BMD (β = − 0.042 ± 0.013, p = 0.0016) in low MVPA group, as compared to high MVPA group (β = − 0.015 ± 0.006, p = 0.02; β = 0.008 ± 0.01, p = 0.4, respectively). Discussion The study indicated that calcium intake does not modify the relationship between genetic variants and BMD, while it implied physical activity interacts with genetic variants to affect BMD in Hispanic children. Due to limited sample size of our study, future research on gene by environment interaction on bone health and functional studies to provide biological insights are needed. Conclusions Bone health in Hispanic children with high genetic risk for low BMD is benefitted more by MVPA than children with low genetic risk. Our results may be useful to predict disease risk and tailor dietary and physical activity advice delivery to people, especially children. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02537-y.
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Affiliation(s)
- Ruixue Hou
- Department of Nutrition and Nutrition Research Institute, University of North Carolina at Chapel Hill, 500 Laureate Way, Kannapolis, NC, 28081, USA
| | - Shelley A Cole
- Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Mariaelisa Graff
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yujie Wang
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Karin Haack
- Texas Biomedical Research Institute, San Antonio, TX, USA
| | - Sandra Laston
- South Texas Diabetes and Obesity Institute and Department of Human Genetics, University of Texas of the Rio Grande Valley, Brownsville, TX, USA
| | - Nitesh R Mehta
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Roman J Shypailo
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Margaret L Gourlay
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Kari E North
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nancy F Butte
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Venkata Saroja Voruganti
- Department of Nutrition and Nutrition Research Institute, University of North Carolina at Chapel Hill, 500 Laureate Way, Kannapolis, NC, 28081, USA.
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Hyde NK, Duckham RL, Wark JD, Brennan-Olsen SL, Hosking SM, Holloway-Kew KL, Pasco JA. The Association Between Muscle Mass and Strength in Relation to Bone Measures in a Paediatric Population: Sex-Specific Effects. Calcif Tissue Int 2020; 107:121-125. [PMID: 32361901 DOI: 10.1007/s00223-020-00699-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 04/20/2020] [Indexed: 10/24/2022]
Abstract
Post-puberty, bone mass displays clear sex-specific patterns. However, research has suggested that a sexual dimorphism in bone mass is evident in younger children and is likely attributable to differences in lean mass. Thus, we aimed to determine whether the association with both overall muscle mass and/or muscle strength was different between the sexes in a paediatric population. Participants were recruited as part of the Vitamin D in Pregnancy Study, Australia. There were 209/402 (52.3%) children at the 11-year follow-up, and 172 had complete data. Children were assessed for bone mineral content (BMC), bone mineral density (BMD) and lean mass by DXA (Lunar). Handgrip strength (kg) was measured using a dynamometer (JAMAR). Linear regression models were adjusted for height, weight, age and pubertal stage. In adjusted models, including both muscle strength and lean mass, the observed association differed between boys and girls. At the spine in boys, BMC and BMD were associated with muscle strength (β 0.34 [95%CI 0.09-0.59] and 0.008 [95%CI 0.003-0.014]; respectively) but not total muscle mass. However, muscle mass was associated with BMC and BMD at the total body (less head). In girls, spine BMC and BMD were associated with total lean mass (β 0.95 [95%CI 0.61-1.3] and β 0.01 [95%CI 0.005-0.02], respectively), with a similar pattern of association with total body (less head) measures. Muscle mass and strength appear to have sexually dimorphic effects on bone mass in school-aged children. These findings should be replicated in longitudinal studies.
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Affiliation(s)
- Natalie K Hyde
- Faculty of Health, Deakin University, Geelong, VIC, Australia.
| | - Rachel L Duckham
- Faculty of Health, Deakin University, Geelong, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, VIC, Australia
- Department of Medicine-Western Health, University of Melbourne, St Albans, VIC, Australia
| | - John D Wark
- Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC, Australia
- Bone and Mineral Medicine, Royal Melbourne Hospital, Parkville, VIC, Australia
- Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Sharon L Brennan-Olsen
- Faculty of Health, Deakin University, Geelong, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, VIC, Australia
- Department of Medicine-Western Health, University of Melbourne, St Albans, VIC, Australia
| | - Sarah M Hosking
- Faculty of Health, Deakin University, Geelong, VIC, Australia
| | | | - Julie A Pasco
- Faculty of Health, Deakin University, Geelong, VIC, Australia
- Department of Medicine-Western Health, University of Melbourne, St Albans, VIC, Australia
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12
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Cheng L, Pohlabeln H, Ahrens W, Lauria F, Veidebaum T, Chadjigeorgiou C, Molnár D, Eiben G, Michels N, Moreno LA, Page AS, Pitsiladis Y, Hebestreit A. Cross-sectional and longitudinal associations between physical activity, sedentary behaviour and bone stiffness index across weight status in European children and adolescents. Int J Behav Nutr Phys Act 2020; 17:54. [PMID: 32345301 PMCID: PMC7189536 DOI: 10.1186/s12966-020-00956-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 04/13/2020] [Indexed: 12/15/2022] Open
Abstract
Background The associations between physical activity (PA), sedentary behaviour (SB) and bone health may be differentially affected by weight status during growth. This study aims to assess the cross-sectional and longitudinal associations between PA, SB and bone stiffness index (SI) in European children and adolescents, taking the weight status into consideration. Methods Calcaneus SI was first measured by quantitative ultrasound among children aged 2–9 years old in 2007/08. It was measured again after 2 years in the IDEFICS study and after 6 years in the I. Family study. A sample of 2008 participants with time spent at sports clubs, watching TV and playing computer/games self-reported by questionnaire, and a subsample of 1037 participants with SB, light PA (LPA) and moderate-to-vigorous PA (MVPA) objectively measured using Actigraph accelerometers were included in the analyses. Weight status was defined as thin/normal and overweight/obese according to the extended International Obesity Task Force criteria. Linear mixed-effects models were used to estimate the cross-sectional and longitudinal associations between PA, SB and SI percentiles, stratified by weight status. Results The cross-sectional association between weekly duration of watching TV and SI percentiles was negative in thin/normal weight group (β = − 0.35, p = 0.008). However, baseline weekly duration of watching TV (β = − 0.63, p = 0.021) and change after 2 years (β = − 0.63, p = 0.022) as well as the change in weekly duration of playing computer/games after 6 years (β = − 0.75, p = 0.019) were inversely associated with corresponding changes in SI percentiles in overweight/obese group. Change in time spent at sports clubs was positively associated with change in SI percentiles after 2 years (β = 1.28, p = 0.001), with comparable effect sizes across weight status. In the subsample with accelerometer data, we found a positive cross-sectional association between MVPA and SI percentiles in thin/normal weight group. Baseline MVPA predicted changes in SI percentiles after 2 and 6 years in all groups. Conclusions Our results suggested the beneficial effect of PA on SI. However, the increasing durations of screen-based SB might be risk factors for SI development, especially in overweight/obese children and adolescents.
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Affiliation(s)
- Lan Cheng
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.,Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.,Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Fabio Lauria
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | | | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Gabriele Eiben
- Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Nathalie Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, 9000, Ghent, Belgium
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, 50009, Zaragoza, Spain
| | - Angie S Page
- Centre for Exercise, Nutrition & Health Sciences, University of Bristol, Bristol, UK
| | - Yannis Pitsiladis
- Collaborating Centre of Sports Medicine, University of Brighton, Brighton, UK
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.
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13
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Laskou F, Dennison E. Interaction of Nutrition and Exercise on Bone and Muscle. EUROPEAN ENDOCRINOLOGY 2019; 15:11-12. [PMID: 31244903 PMCID: PMC6587895 DOI: 10.17925/ee.2019.15.1.11] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 02/08/2019] [Indexed: 11/24/2022]
Abstract
Physical activity and nutritional factors, such as calcium and vitamin D intake, have been shown in numerous studies to be beneficial to musculoskeletal health at different points in the lifecourse. However, the evidence that physical activity and nutrition may act synergistically for benefit is far more sparce; the best data come from studies that consider calcium, vitamin D or creatine supplementation in combination with physical activity interventions to promote better musculoskeletal health. Some observational data also suggest that a 'healthier' lifestyle, characterised by a more 'prudent' diet and higher reported levels of physical activity is also associated with better musculoskeletal health in late adulthood. Given the public health burden of osteoporosis and sarcopenia in our aging population, well designed randomised controlled trials are now timely and much needed.
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Affiliation(s)
- Faidra Laskou
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
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14
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Ireland A, Crozier SR, Heazell AEP, Ward KA, Godfrey KM, Inskip HM, Cooper C, Harvey NC. Breech presentation is associated with lower bone mass and area: findings from the Southampton Women's Survey. Osteoporos Int 2018; 29:2275-2281. [PMID: 30003305 PMCID: PMC6173302 DOI: 10.1007/s00198-018-4626-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 06/27/2018] [Indexed: 02/01/2023]
Abstract
UNLABELLED We compared bone outcomes in children with breech and cephalic presentation at delivery. Neonatal whole-body bone mineral content (BMC) and area were lower in children with breech presentation. At 4 years, no differences in whole-body or spine measures were found, but hip BMC and area were lower after breech presentation. INTRODUCTION Breech presentation is associated with altered joint shape and hip dysplasias, but effects on bone mineral content (BMC), area (BA) and density (BMD) are unknown. METHODS In the prospective Southampton Women's Survey mother-offspring cohort, whole-body bone outcomes were measured using dual-energy X-ray absorptiometry (DXA) in 1430 offspring, as neonates (mean age 6 days, n = 965, 39 with a breech presentation at birth) and/or at age 4.1 years (n = 999, 39 breech). Hip and spine bone outcomes were also measured at age 4 years. RESULTS Neonates with breech presentation had 4.2 g lower whole-body BMC (95% CI -7.4 to - 0.9 g, P = 0.012) and 5.9 cm2 lower BA (- 10.8 to - 1.0 cm2, P = 0.019), but BMD was similar between groups (mean difference - 0.007, - 0.016 to 0.002 g/cm2, P = 0.146) adjusting for sex, maternal smoking, gestational diabetes, mode of delivery, social class, parity, ethnicity, age at scan, birthweight, gestational age and crown-heel length. There were no associations between breech presentation and whole-body outcomes at age 4 years, but, in similarly adjusted models, regional DXA (not available in infants) showed that breech presentation was associated with lower hip BMC (- 0.51, - 0.98 to - 0.04 g, P = 0.034) and BA (- 0.67, - 1.28 to - 0.07 cm2, P = 0.03) but not with BMD (- 0.009, - 0.029 to 0.012 g, P = 0.408), or spine outcomes. CONCLUSIONS These results suggest that breech presentation is associated with lower neonatal whole-body BMC and BA, which may relate to altered prenatal loading in babies occupying a breech position; these differences did not persist into later childhood. Modest differences in 4-year hip BMC and BA require further investigation.
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Affiliation(s)
- A Ireland
- School of Healthcare Science, Manchester Metropolitan University, Manchester, UK
| | - S R Crozier
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - A E P Heazell
- Division of Developmental Biology and Medicine, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - K A Ward
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - K M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - H M Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - N C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
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15
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Influence of Physical Activity on Bone Mineral Content and Density in Overweight and Obese Children with Low Adherence to the Mediterranean Dietary Pattern. Nutrients 2018; 10:nu10081075. [PMID: 30103535 PMCID: PMC6116035 DOI: 10.3390/nu10081075] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/09/2018] [Accepted: 08/10/2018] [Indexed: 02/06/2023] Open
Abstract
The objective of the present cross-sectional study was to examine the associations of physical activity and the adherence to the Mediterranean dietary pattern (MDP) with bone mineral content (BMC) and density (BMD) in children with overweight and obesity. A total of 177 (n = 80 girls) children with overweight and obesity aged 8 to 12 years old participated in the study. Both BMC and BMD were assessed by Dual-Energy X-ray absorptiometry. Dietary patterns were assessed by the KIDMED questionnaire and two 24-hour recalls. Physical activity was assessed by accelerometers for 7 consecutive days (24 hours/day). Low adherence to the MDP was observed in 82.4% of participants. Higher physical activity levels (of at least moderate intensity) and lower sedentary time were significantly associated with BMC and BMD in children with low adherence to the MDP (all p < 0.05). No associations were observed between physical activity and BMC and BMD in children with high adherence to the MDP. In conclusion, engaging in moderate to vigorous physical activity and reducing the time spent in sedentary behavior might be particularly beneficial for improving bone health in overweight or obese children with poor adherence to the Mediterranean dietary pattern.
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16
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Are consumption of dairy products and physical activity independently related to bone mineral density of 6-year-old children? Longitudinal and cross-sectional analyses in a birth cohort from Brazil. Public Health Nutr 2018; 21:2654-2664. [PMID: 29766835 PMCID: PMC6141993 DOI: 10.1017/s1368980018001258] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate cross-sectional and longitudinal associations of consumption of dairy products and physical activity (PA) with bone mineral density (BMD). DESIGN Cohort study with children from the 2004 Pelotas (Brazil) Birth Cohort. SETTING Pelotas, a medium-sized Brazilian city. SUBJECTS The study started in 2004 and mothers/children were interviewed/measured periodically from birth to age 6 years. PA was measured by maternal proxy at 4 and 6 years and by accelerometry at 6 years. Consumption of dairy products was measured using 24 h food recall (at 4 years) and FFQ (at 6 years). Total-body and lumbar-spine BMD (g/cm2) were measured by dual-energy X-ray absorptiometry. RESULTS At 6 years, BMD was measured in 3444 children and 2636 children provided data on objectively measured PA by accelerometry. Consumption of dairy products at 4 years was associated with higher lumbar-spine BMD at 6 years in boys, while current consumption was positively associated with BMD in both sexes (P < 0·001). PA assessed by maternal report at 4 and 6 years of age was associated with higher BMD at 6 years in boys. PA assessed by accelerometry was positively related to total-body and lumbar-spine BMD in boys and lumbar-spine BMD in girls. We did not find evidence for an interaction between PA and consumption of dairy products on BMD. CONCLUSIONS We observed positive and independent longitudinal and cross-sectional associations between consumption of dairy products and PA with BMD in the total body and at the lumbar spine in young children.
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17
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Pregnancy-associated transient osteoporosis of the hip: results of a case-control study. Arch Osteoporos 2017; 12:11. [PMID: 28110481 DOI: 10.1007/s11657-017-0310-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 01/09/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED The etiology and underlying mechanisms of transient of osteoporosis of the hip (TOH) during pregnancy are still unclear, since no systematic analyses exist. Our results support the hypothesis that TOH is a multifactorial disease, which is associated with immobility, dental problems, and lack of exercise in childhood. INTRODUCTION Pregnancy-associated transient osteoporosis of the hip (TOH) is a rare but severe form of osteoporosis, which may affect a subgroup of women in the last trimester of pregnancy or immediately postpartum. Common symptoms include acute pain of the hip(s) due to bone marrow edema or even hip fractures. The exact underlining mechanisms of this disorder are still unknown since no published systematic analyses exist. METHODS Out of a total of 52 TOH patients, 33 TOH patients could be matched with 33 healthy controls according to age, region, and gravity. The aim of this retrospective case-control study was to evaluate the risk factors for TOH in a homogenous population of women. RESULTS The baseline characteristics of the two study groups were similar. Overall, 12.1% of the TOH patients sustained a hip fracture. Expectedly, 90.9% of the TOH patients complained about pain of the hip (p ≤ 0.001). TOH patients suffered more frequently from severe dental problems during childhood (p = 0.023) and performed less often sports before and after puberty (p ≤ 0.001), whereas the frequency of immobilization during pregnancy was threefold higher compared to the control group (p = 0.007). We found a significant increase of the TOH risk in patients with dental problems in childhood (OR 3.7; CI 1.3-10.7) as well as in patients with lack of exercise during childhood (OR 4.2; CI 1.3-12.9). CONCLUSIONS Our results support the hypothesis that pregnancy-associated TOH is a multifactorial disease, to which several individual factors may contribute. Hereby, we found significant associations with immobility, dental problems, and lack of exercise in childhood.
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18
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Carson V, Lee EY, Hewitt L, Jennings C, Hunter S, Kuzik N, Stearns JA, Unrau SP, Poitras VJ, Gray C, Adamo KB, Janssen I, Okely AD, Spence JC, Timmons BW, Sampson M, Tremblay MS. Systematic review of the relationships between physical activity and health indicators in the early years (0-4 years). BMC Public Health 2017; 17:854. [PMID: 29219090 PMCID: PMC5753397 DOI: 10.1186/s12889-017-4860-0] [Citation(s) in RCA: 317] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Given the rapid development during the early years (0-4 years), an understanding of the health implications of physical activity is needed. The purpose of this systematic review was to examine the relationships between objectively and subjectively measured physical activity and health indicators in the early years. Methods Electronic databases were originally searched in April, 2016. Included studies needed to be peer-reviewed, written in English or French, and meet a priori study criteria. The population was apparently healthy children aged 1 month to 59.99 months/4.99 years. The intervention/exposure was objectively and subjectively measured physical activity. The comparator was various volumes, durations, frequencies, patterns, types, and intensities of physical activity. The outcomes were health indicators ranked as critical (adiposity, motor development, psychosocial health, cognitive development, fitness) and important (bone and skeletal health, cardiometabolic health, and risks/harm). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework was used to assess the quality of evidence for each health indicator by each study design. Results Ninety-six studies representing 71,291 unique participants from 36 countries were included. Physical activity interventions were consistently (>60% of studies) associated with improved motor and cognitive development, and psychosocial and cardiometabolic health. Across observational studies, physical activity was consistently associated with favourable motor development, fitness, and bone and skeletal health. For intensity, light- and moderate-intensity physical activity were not consistently associated with any health indicators, whereas moderate- to vigorous-intensity, vigorous-intensity, and total physical activity were consistently favourably associated with multiple health indicators. Across study designs, consistent favourable associations with health indicators were observed for a variety of types of physical activity, including active play, aerobic, dance, prone position (infants; ≤1 year), and structured/organized. Apart from ≥30 min/day of the prone position for infants, the most favourable frequency and duration of physical activity was unclear. However, more physical activity appeared better for health. Evidence ranged from “very low” to “high” quality. Conclusions Specific types of physical activity, total physical activity, and physical activity of at least moderate- to vigorous-intensity were consistently favourably associated with multiple health indicators. The majority of evidence was in preschool-aged children (3-4 years). Findings will inform evidence-based guidelines. Electronic supplementary material The online version of this article (10.1186/s12889-017-4860-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Valerie Carson
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada.
| | - Eun-Young Lee
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada
| | - Lyndel Hewitt
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Cally Jennings
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada
| | - Stephen Hunter
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada
| | - Nicholas Kuzik
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada
| | - Jodie A Stearns
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada
| | - Stephanie Powley Unrau
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada
| | - Veronica J Poitras
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, K1H 8L1, Canada
| | - Casey Gray
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, K1H 8L1, Canada
| | - Kristi B Adamo
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, K1N 1A2, Canada
| | - Ian Janssen
- School of Kinesiology and Health Studies, and Department of Public Health Sciences, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Anthony D Okely
- Early Start Research Institute, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - John C Spence
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, T6G 2H9, Canada
| | - Brian W Timmons
- Child Health & Exercise Medicine Program, Department of Pediatrics, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | - Margaret Sampson
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, K1H 8L1, Canada.,Library and Media Services, Children's Hospital of Eastern Ontario, Ottawa, ON, K1H 8L1, Canada
| | - Mark S Tremblay
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, K1H 8L1, Canada
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Martins A, Monjardino T, Nogueira L, Canhão H, Lucas R. Do bone mineral content and density determine fracture in children? A possible threshold for physical activity. Pediatr Res 2017; 82:396-404. [PMID: 28467405 DOI: 10.1038/pr.2017.113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 04/15/2017] [Indexed: 11/09/2022]
Abstract
BackgroundRelations between bone parameters, physical exertion, and childhood fractures are complex. We aimed to estimate the associations between fracture history and bone mineral content (BMC) and areal bone mineral density (aBMD) at 7 years of age, by levels of physical activity, as a proxy for trauma frequency.MethodsWe used data collected from 2,261 children of the Generation XXI birth cohort, assembled in 2005/6 in Porto, Portugal. At the age of 7 years (2012/4), fracture history, time spent per week in active play, and sports practice were reported by parents. Subtotal and lumbar spine (LS) BMC and aBMD were measured using whole-body dual-energy X-ray absorptiometry.ResultsBoys and girls in the highest categories of time spent in sports practice or active play generally had higher BMC and aBMD. Among girls, BMC and aBMD were protective of fracture only in the highest quarter of active play (>660 min/week)-odds ratios (OR; 95% confidence interval (95% CI)) for subtotal BMC=0.27 (0.11-0.67), subtotal aBMD=0.18 (0.06-0.49), and LS aBMD=0.41 (0.22-0.75). For boys in the highest quarter of sports practice (>240 min/week), subtotal and LS BMC were protective of fracture-OR=0.39 (0.16-0.98) and 0.51 (0.27-0.96), respectively.ConclusionIn prepubertal children, BMC and aBMD predicted fracture history only in the highest levels of physical activity.
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Affiliation(s)
- Ana Martins
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Teresa Monjardino
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Luísa Nogueira
- Department of Radiology, School of Health Technology of Porto/Polytechnic Institute of Porto (ESTSP/IPP), Porto, Portugal
| | - Helena Canhão
- EpiDoC, CEDOC, Nova Medical School, NOVA University, Lisbon, Portugal
| | - Raquel Lucas
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
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Berglind D, Tynelius P. Objectively measured physical activity patterns, sedentary time and parent-reported screen-time across the day in four-year-old Swedish children. BMC Public Health 2017; 18:69. [PMID: 28764730 PMCID: PMC5540346 DOI: 10.1186/s12889-017-4600-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 07/14/2017] [Indexed: 11/29/2022] Open
Abstract
Background Physical activity (PA) improves health outcomes accumulating evidence suggests that sedentary time (ST), especially parent-reported screen-time, is associated with negative health outcomes in children. The aim of the present study is to describe levels and patterns of PA and ST across the day and week and activity pattern differences between the sexes, across all weekdays and time spent in and outside the preschool in four-year old children. Methods In total 899 four-year old Swedish children who had both complete questionnaire data on screen-time behaviors and objective activity variables and at least 4 days, including one weekend day, with more than 10 h of GT3X+ Actigraph accelerometer wear time data were included in the study. Patterns of PA and ST across the day and week and differences between sexes, weekdays vs. weekend days and time in preschool vs. time spent outside preschool were assessed. Results Children engaged in 150 min (SD 73) and 102 min (SD 60) of screen-time on weekend days and weekdays, with 97% and 86% of children exceeding the 1 h guideline for screen-time on weekend days and weekdays, respectively. Accelerometer data showed that boys are more active and less sedentary compared with girls and both sexes were more active and less sedentary on weekdays compared with weekend days, while parent-reported data showed that boys engage in more screen-time compared with girls. Children accumulated 24.8 min (SD. 19) MVPA during preschool time and 26.6 min (SD. 16) outside preschool hours on weekdays, compared with 22.4 min (SD. 18) MVPA during preschool time and 25.3 min (SD. 22) outside preschool hours on weekend days. Conclusions Four-year old Swedish children display different activity patterns across the day on weekdays compared to weekend days, with preschool hours during weekdays being the most active segments and preschool hours during weekend days being the least active segments of the day. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4600-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Daniel Berglind
- Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.
| | - Per Tynelius
- Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden
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VLACHOPOULOS DIMITRIS, UBAGO-GUISADO ESTHER, BARKER ALANR, METCALF BRADS, FATOUROS IOANNISG, AVLONITI ALEXANDRA, KNAPP KARENM, MORENO LUISA, WILLIAMS CRAIGA, GRACIA-MARCO LUIS. Determinants of Bone Outcomes in Adolescent Athletes at Baseline. Med Sci Sports Exerc 2017; 49:1389-1396. [DOI: 10.1249/mss.0000000000001233] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Bell JM, Shields MD, Watters J, Hamilton A, Beringer T, Elliott M, Quinlivan R, Tirupathi S, Blackwood B. Interventions to prevent and treat corticosteroid-induced osteoporosis and prevent osteoporotic fractures in Duchenne muscular dystrophy. Cochrane Database Syst Rev 2017; 1:CD010899. [PMID: 28117876 PMCID: PMC6464928 DOI: 10.1002/14651858.cd010899.pub2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Corticosteroid treatment is considered the 'gold standard' for Duchenne muscular dystrophy (DMD); however, it is also known to induce osteoporosis and thus increase the risk of vertebral fragility fractures. Good practice in the care of those with DMD requires prevention of these adverse effects. Treatments to increase bone mineral density include bisphosphonates and vitamin D and calcium supplements, and in adolescents with pubertal delay, testosterone. Bone health management is an important part of lifelong care for patients with DMD. OBJECTIVES To assess the effects of interventions to prevent or treat osteoporosis in children and adults with DMD taking long-term corticosteroids; to assess the effects of these interventions on the frequency of vertebral fragility fractures and long-bone fractures, and on quality of life; and to assess adverse events. SEARCH METHODS On 12 September 2016, we searched the Cochrane Neuromuscular Specialised Register, CENTRAL, MEDLINE, Embase, and CINAHL Plus to identify potentially eligible trials. We also searched the Web of Science ISI Proceedings (2001 to September 2016) and three clinical trials registries to identify unpublished studies and ongoing trials. We contacted correspondence authors of the included studies in the review to obtain information on unpublished studies or work in progress. SELECTION CRITERIA We considered for inclusion in the review randomised controlled trials (RCTs) and quasi-RCTs involving any bone health intervention for corticosteroid-induced osteoporosis and fragility fractures in children, adolescents, and adults with a confirmed diagnosis of DMD. The interventions might have included oral and intravenous bisphosphonates, vitamin D supplements, calcium supplements, dietary calcium, testosterone, and weight-bearing activity. DATA COLLECTION AND ANALYSIS Two review authors independently assessed reports and selected potential studies for inclusion, following standard Cochrane methodology. We contacted study authors to obtain further information for clarification on published work, unpublished studies, and work in progress. MAIN RESULTS We identified 18 potential studies, of which two, currently reported only as abstracts, met the inclusion criteria for this review. Too little information was available for us to present full results or adequately assess risk of bias. The participants were children aged five to 15 years with DMD, ambulant and non-ambulant. The interventions were risedronate versus no treatment in one trial (13 participants) and whole-body vibration versus a placebo device in the second (21 participants). Both studies reported improved bone mineral density with the active treatments, with no improvement in the control groups, but the abstracts did not compare treatment and control conditions. All children tolerated whole-body vibration treatment. No study provided information on adverse events. Two studies are ongoing: one investigating whole-body vibration, the other investigating zoledronic acid. AUTHORS' CONCLUSIONS We know of no high-quality evidence from RCTs to guide use of treatments to prevent or treat corticosteroid-induced osteoporosis and reduce the risk of fragility fractures in children and adults with DMD; only limited results from two trials reported in abstracts were available. We await formal trial reports. Findings from two ongoing relevant studies and two trials, for which only abstracts are available, will be important in future updates of this review.
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Affiliation(s)
- Jennifer M Bell
- Queen's University BelfastCentre for Experimental Medicine, School of Medicine, Dentistry and Biomedical SciencesRoom 02.041, 2nd FloorMulhouse, Grosvenor RoadBelfastNorthern IrelandUKBT12 6BJ
| | - Michael D Shields
- Queen's University BelfastCentre for Experimental Medicine, School of Medicine, Dentistry and Biomedical SciencesRoom 02.041, 2nd FloorMulhouse, Grosvenor RoadBelfastNorthern IrelandUKBT12 6BJ
| | - Janet Watters
- Belfast Health and Social Care TrustGP Out of Hours ServiceBelfastNorthern IrelandUK
| | - Alistair Hamilton
- Belfast Health and Social Care TrustWithers Orthopaedic CentreMusgrave Park Hospital, Royal Group of Hospitals,Stockman's LaneBelfastNorthern IrelandUK
| | - Timothy Beringer
- Belfast Health and Social Care TrustDepartment of Care for the ElderyFlorence Elliot CentreRoyal Victoria HospitalBelfastNorthern IrelandUKBT12 6BA
| | - Mark Elliott
- Musgrave Park Hospital, Belfast Health and Social Care TrustBelfastUK
| | - Rosaline Quinlivan
- UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery and Great Ormond StreetMRC Centre for Neuromuscular Diseases and Dubowitz Neuromuscular CentrePO Box 114LondonUKWC1B 3BN
| | - Sandya Tirupathi
- Royal Belfast Hospital for Sick ChildrenPaediatric Neurology180 Falls RoadBelfastUKBT12 6BE
| | - Bronagh Blackwood
- Queen's University BelfastCentre for Experimental Medicine, School of Medicine, Dentistry and Biomedical SciencesRoom 02.041, 2nd FloorMulhouse, Grosvenor RoadBelfastNorthern IrelandUKBT12 6BJ
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Funck KL, Laugesen E, Høyem P, Fleischer J, Cichosz SL, Christiansen JS, Hansen TK, Poulsen PL. Low Physical Activity Is Associated With Increased Arterial Stiffness in Patients Recently Diagnosed With Type 2 Diabetes. Am J Hypertens 2016; 29:882-8. [PMID: 26714500 DOI: 10.1093/ajh/hpv197] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 12/05/2015] [Indexed: 01/01/2023] Open
Abstract
AIMS Several studies have indicated that low physical activity is associated with increased risk of cardiovascular disease (CVD) and all-cause mortality among patients with diabetes. The association between physical activity and subclinical cardiovascular changes preceding clinical events remains to be elucidated. We investigated the relationship between physical activity and arterial stiffness, an independent predictor of CVD, in patients with type 2 diabetes and controls. METHODS We included 100 patients with type 2 diabetes and 100 sex- and age-matched controls in a cross-sectional study. Arterial stiffness (carotid-femoral pulse wave velocity, cfPWV) was measured using the SphygmoCor device (AtCor Medical, Sydney, Australia). Physical activity was assessed by an accelerometer (counts per minute (cpm), Actiheart (CamNtech, Cambridge, UK)) worn by the participants for up to 6 days. High vs. low levels of physical activity was defined according to the median level of activity (cpm = 31). RESULTS Sixty-five patients and 65 controls were included in the final analysis (median age 59 years, 55% men, median diabetes duration 1.9 years). Participants with low physical activity had higher cfPWV compared to participants with high physical activity: (i) Patients and controls combined: 9.3±1.7 m/s vs. 7.8±1.5 m/s, P < 0.001; (ii) Patients with diabetes: 9.5±1.8 m/s vs. 8.3±1.6 m/s, P = 0.02 and C) Controls: 9.0±1.4 m/s vs. 7.7±1.4 m/s, P < 0.01). The difference remained significant after adjustment for other determinants of cfPWV including whole body fat percentage (P < 0.01). No significant interaction between diabetes and the effect of low activity was seen. CONCLUSIONS Low physical activity is associated with increased arterial stiffness in patients recently diagnosed with type 2 diabetes and in healthy controls. CLINICAL TRIALS REGISTRATION Trial Number NCT00674271.
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Affiliation(s)
- Kristian L Funck
- Department of Endocrinology and Internal Medicine and Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark;
| | - Esben Laugesen
- Department of Endocrinology and Internal Medicine and Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; The Danish Diabetes Academy, Odense University Hospital, Odense, Denmark
| | - Pernille Høyem
- Department of Endocrinology and Internal Medicine and Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark
| | - Jesper Fleischer
- Department of Endocrinology and Internal Medicine and Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark
| | - Simon L Cichosz
- Department of Endocrinology and Internal Medicine and Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark
| | - Jens S Christiansen
- Department of Endocrinology and Internal Medicine and Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark
| | - Troels K Hansen
- Department of Endocrinology and Internal Medicine and Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark
| | - Per L Poulsen
- Department of Endocrinology and Internal Medicine and Medical Research Laboratories, Aarhus University Hospital, Aarhus, Denmark
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Hesketh KR, Griffin SJ, van Sluijs EMF. UK Preschool-aged children's physical activity levels in childcare and at home: a cross-sectional exploration. Int J Behav Nutr Phys Act 2015; 12:123. [PMID: 26410252 PMCID: PMC4583748 DOI: 10.1186/s12966-015-0286-1] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 09/17/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Young children are thought to be inactive in childcare, but little is known about location-specific activity levels. This observational study sought to describe the in-care and out-of-care activity patterns of preschool-aged children and explore differences in physical activity level by childcare attendance. METHODS Three to four-year-old children were recruited from 30 preschool and nursery 'settings' in Cambridgeshire, UK. Average minutes per hour (min/h) spent sedentary (SED), in light physical activity (LPA) and in moderate-to-vigorous PA (MVPA) were measured by accelerometry for up to 7 days (mean: 6.7 ± 1.1). Weekly childcare attendance patterns were reported by parents. The within-child association between childcare attendance and outcomes was assessed using two- and three-level hierarchical regression; sex by care (in/out) interactions were considered. RESULTS Two hundred and two children (51% female) had valid activity data for ≥2 days. Children, and particularly boys, were less sedentary and more active when in care compared to at home (SED: Boys: β (SE): -6.4 (0.5) min/h, Girls: -4.8 (0.5); LPA: Boys: 0.6 (0.4), Girls: 1.8 (0.4); MVPA: Boys: 5.7 (0.5); Girls: 3.0 (0.4)). Differences between in-care and at-home activity were largest in the (early) mornings and early evenings for boys; no compensation in at-home activity occurred later in the day. On days when children were in care part-time (1-5 h) or full-time (>5 h), they were significantly less sedentary and more active compared with non-care days. CONCLUSIONS Young children, and particularly boys, accumulate more MVPA in care compared to at home. Future research should identify factors accounting for this difference and consider targeting non-care time in intervention efforts to increase higher-intensity activity and decrease sedentary time in preschoolers.
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Affiliation(s)
- Kathryn R Hesketh
- MRC Epidemiology Unit & Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
- UCL Institute of Child Health, 30 Guilford Street, London, WC1N1EH, UK.
| | - Simon J Griffin
- MRC Epidemiology Unit & Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
- Primary Care Unit, Cambridge Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, CB2 0SR, UK
| | - Esther M F van Sluijs
- MRC Epidemiology Unit & Centre for Diet and Activity Research (CEDAR), University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
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Herrmann D, Buck C, Sioen I, Kouride Y, Marild S, Molnár D, Mouratidou T, Pitsiladis Y, Russo P, Veidebaum T, Ahrens W. Impact of physical activity, sedentary behaviour and muscle strength on bone stiffness in 2-10-year-old children-cross-sectional results from the IDEFICS study. Int J Behav Nutr Phys Act 2015; 12:112. [PMID: 26377674 PMCID: PMC4574210 DOI: 10.1186/s12966-015-0273-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 08/29/2015] [Indexed: 11/17/2022] Open
Abstract
Background Physical activity (PA), weight-bearing exercises (WBE) and muscle strength contribute to skeletal development, while sedentary behaviour (SB) adversely affects bone health. Previous studies examined the isolated effect of PA, SB or muscle strength on bone health, which was usually assessed by x-ray methods, in children. Little is known about the combined effects of these factors on bone stiffness (SI) assessed by quantitative ultrasound. We investigated the joint association of PA, SB and muscle strength on SI in children. Methods In 1512 preschool (2- < 6 years) and 2953 school children (6–10 years), data on calcaneal SI as well as on accelerometer-based sedentary time (SED), light (LPA), moderate (MPA) and vigorous PA (VPA) were available. Parents reported sports (WBE versus no WBE), leisure time PA and screen time of their children. Jumping distance and handgrip strength served as indicators for muscle strength. The association of PA, SB and muscle strength with SI was estimated by multivariate linear regression, stratified by age group. Models were adjusted for age, sex, country, fat-free mass, daylight duration, consumption of dairy products and PA, or respectively SB. Results Mean SI was similar in preschool (79.5 ± 15.0) and school children (81.3 ± 12.1). In both age groups, an additional 10 min/day in MPA or VPA increased the SI on average by 1 or 2 %, respectively (p ≤ .05). The negative association of SED with SI decreased after controlling for MVPA. LPA was not associated with SI. Furthermore, participation in WBE led to a 3 and 2 % higher SI in preschool (p = 0.003) and school children (p < .001), respectively. Although muscle strength significantly contributed to SI, it did not affect the associations of PA with SI. In contrast to objectively assessed PA, reported leisure time PA and screen time showed no remarkable association with SI. Conclusion This study suggests that already an additional 10 min/day of MPA or VPA or the participation in WBE may result in a relevant increase in SI in children, taking muscle strength and SB into account. Our results support the importance of assessing accelerometer-based PA in large-scale studies. This may be important when deriving dose–response relationships between PA and bone health in children.
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Affiliation(s)
- Diana Herrmann
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359, Bremen, Germany.
| | - Christoph Buck
- Department of Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359, Bremen, Germany.
| | - Isabelle Sioen
- Department of Public Health, Ghent University, 4K3, De Pintelaan 185, 9000, Ghent, Belgium.
| | - Yiannis Kouride
- Research and Education Institute of Child Health, 138 Limassol Ave, #205, 2015, Strovolos, Cyprus.
| | - Staffan Marild
- Department of Paediatrics, Queen Silvia Children's Hospital, University of Gothenburg, Rondvägen 15, 41685, Gothenburg, Sweden.
| | - Dénes Molnár
- Department of Pediatrics, Medical Faculty, University of Pecs, Jozsef A. u. 7, 7623, Pecs, Hungary.
| | - Theodora Mouratidou
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, C/Domingo Miral s/n, 50009, Zaragoza, Spain.
| | - Yannis Pitsiladis
- Centre for Sport and Exercise Science and Medicine (SESAME), University of Brighton, Welkin House, 30 Carlisle Road, Eastbourne, BN20 7SN, UK.
| | - Paola Russo
- Institute of Food Sciences, National Research Council, Via Roma 64, 83100, Avellino, Italy.
| | - Toomas Veidebaum
- Department of Chronic Diseases, Centre of Behavioural and Health Sciences, National Institute for Health Development, Hiiu 42, 11619, Tallinn, Estonia.
| | - Wolfgang Ahrens
- Department of Epidemiological Methods and Etiological Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359, Bremen, Germany. .,Faculty of Mathematics and Computer Science, Bremen University, Bibliothekstraße 1, 28359, Bremen, Germany.
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Moon RJ, Harvey NC, Davies JH, Cooper C. Vitamin D and bone development. Osteoporos Int 2015; 26:1449-51. [PMID: 25448839 DOI: 10.1007/s00198-014-2976-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Accepted: 11/19/2014] [Indexed: 12/17/2022]
Affiliation(s)
- R J Moon
- MRC Lifecourse Epidemiology Unit, University of Southampton, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK
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Muniz LC, Menezes AMB, Assunção MCF, Martínez-Mesa J, Wehrmeister FC, Howe LD, Hallal PC, Gonçalves H, Barros FC. Body mass index at 11 years and bone mass at age 18: path analysis within the 1993 Pelotas (Brazil) birth cohort study. BMC Musculoskelet Disord 2015; 16:71. [PMID: 25887330 PMCID: PMC4391135 DOI: 10.1186/s12891-015-0529-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 03/13/2015] [Indexed: 11/24/2022] Open
Abstract
Background We investigated whether Body Mass Index (BMI) at 11 years old has a direct effect on bone mass at age 18 operating through alterations to bone growth and development, or whether the association is mediated by concurrent BMI, fat mass (FM), and fat free mass (FFM). Methods Path analysis was used to explore the association between BMI at age 11 and whole-body bone mineral content (BMC) and bone mineral density (BMD) assessed by dual-energy x-ray absorptiometry (DXA) at age 18 in a prospective birth cohort study comprising 3,307 adolescents; we also evaluated the degree to which this association was mediated by BMI, FM (kg) and FFM (kg) assessed by plethysmography (BOD POD) at age 18. Results We found a positive association between BMI at age 11 and BMC (males [β = 179.7 g, 95% CI 161.4; 198.0]; females [β = 179.9 g, 95% CI 165.3; 194.6]) and BMD (males [β = 0.030 g/cm2, 95% CI 0.024; 0.035]; females [β = 0.029 g/cm2, 95% CI 0.025; 0.033]) at age 18. This association was largely mediated by BMI and FFM at age 18 in both female and male adolescents. FM at age 18 was not an important mediator. Conclusions Concurrent BMI and FFM were the main mediators of the association between BMC/BMD in late adolescence and BMI in early adolescence. Electronic supplementary material The online version of this article (doi:10.1186/s12891-015-0529-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ludmila Correa Muniz
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rua: Marechal Deodoro 1160 (3° andar). CEP, Pelotas, Rio Grande do Sul, 96020-220, Brasil.
| | - Ana Maria Baptista Menezes
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rua: Marechal Deodoro 1160 (3° andar). CEP, Pelotas, Rio Grande do Sul, 96020-220, Brasil.
| | - Maria Cecília Formoso Assunção
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rua: Marechal Deodoro 1160 (3° andar). CEP, Pelotas, Rio Grande do Sul, 96020-220, Brasil.
| | - Jeovany Martínez-Mesa
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rua: Marechal Deodoro 1160 (3° andar). CEP, Pelotas, Rio Grande do Sul, 96020-220, Brasil.
| | - Fernando Cesar Wehrmeister
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rua: Marechal Deodoro 1160 (3° andar). CEP, Pelotas, Rio Grande do Sul, 96020-220, Brasil.
| | - Laura D Howe
- MRC Integrative Epidemiology Unit at the University of Bristol, School of Social and Community Medicine, University of Bristol, Bristol, UK.
| | - Pedro Curi Hallal
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rua: Marechal Deodoro 1160 (3° andar). CEP, Pelotas, Rio Grande do Sul, 96020-220, Brasil.
| | - Helen Gonçalves
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rua: Marechal Deodoro 1160 (3° andar). CEP, Pelotas, Rio Grande do Sul, 96020-220, Brasil.
| | - Fernando C Barros
- Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rua: Marechal Deodoro 1160 (3° andar). CEP, Pelotas, Rio Grande do Sul, 96020-220, Brasil.
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Robinson SM, Crozier SR, Harvey NC, Barton BD, Law CM, Godfrey KM, Cooper C, Inskip HM. Modifiable early-life risk factors for childhood adiposity and overweight: an analysis of their combined impact and potential for prevention. Am J Clin Nutr 2015; 101:368-75. [PMID: 25646335 PMCID: PMC4307207 DOI: 10.3945/ajcn.114.094268] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Early life may be a "critical period" when appetite and regulation of energy balance are programmed, with lifelong consequences for obesity risk. Insight into the potential impact of modifying early-life risk factors on later obesity can be gained by evaluating their combined effects. OBJECTIVE The objective was to examine the relation between the number of early-life risk factors and obesity outcomes among children in a prospective birth cohort (Southampton Women's Survey). DESIGN Five risk factors were defined: maternal obesity [prepregnant body mass index (BMI; in kg/m(2)) >30], excess gestational weight gain (Institute of Medicine, 2009), smoking during pregnancy, low maternal vitamin D status (<64 nmol/L), and short duration of breastfeeding (none or <1 mo). Obesity outcomes examined when the children were aged 4 and 6 y were BMI, dual-energy X-ray absorptiometry-assessed fat mass, overweight, or obesity (International Obesity Task Force). Data were available for 991 mother-child pairs, with children born between 1998 and 2003. RESULTS Of the children, 148 (15%) had no early-life risk factors, 330 (33%) had 1, 296 (30%) had 2, 160 (16%) had 3, and 57 (6%) had 4 or 5. At both 4 and 6 y, there were positive graded associations between number of early-life risk factors and each obesity outcome (all P < 0.001). After taking account of confounders, the relative risk of being overweight or obese for children who had 4 or 5 risk factors was 3.99 (95% CI: 1.83, 8.67) at 4 y and 4.65 (95% CI: 2.29, 9.43) at 6 y compared with children who had none (both P < 0.001). CONCLUSIONS Having a greater number of early-life risk factors was associated with large differences in adiposity and risk of overweight and obesity in later childhood. These findings suggest that early intervention to change these modifiable risk factors could make a significant contribution to the prevention of childhood obesity.
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Affiliation(s)
- Siân M Robinson
- From the Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom (SMR, SRC, NCH, BDB, KMG, CC, and HMI); the National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and Southampton University Hospitals NHS Trust, Southampton, United Kingdom (SMR, NCH, KMG, and CC); NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopaedic Centre, Oxford, United Kingdom (CC); and UCL Institute of Child Health, London, United Kingdom (CML)
| | - Sarah R Crozier
- From the Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom (SMR, SRC, NCH, BDB, KMG, CC, and HMI); the National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and Southampton University Hospitals NHS Trust, Southampton, United Kingdom (SMR, NCH, KMG, and CC); NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopaedic Centre, Oxford, United Kingdom (CC); and UCL Institute of Child Health, London, United Kingdom (CML)
| | - Nicholas C Harvey
- From the Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom (SMR, SRC, NCH, BDB, KMG, CC, and HMI); the National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and Southampton University Hospitals NHS Trust, Southampton, United Kingdom (SMR, NCH, KMG, and CC); NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopaedic Centre, Oxford, United Kingdom (CC); and UCL Institute of Child Health, London, United Kingdom (CML)
| | - Benjamin D Barton
- From the Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom (SMR, SRC, NCH, BDB, KMG, CC, and HMI); the National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and Southampton University Hospitals NHS Trust, Southampton, United Kingdom (SMR, NCH, KMG, and CC); NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopaedic Centre, Oxford, United Kingdom (CC); and UCL Institute of Child Health, London, United Kingdom (CML)
| | - Catherine M Law
- From the Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom (SMR, SRC, NCH, BDB, KMG, CC, and HMI); the National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and Southampton University Hospitals NHS Trust, Southampton, United Kingdom (SMR, NCH, KMG, and CC); NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopaedic Centre, Oxford, United Kingdom (CC); and UCL Institute of Child Health, London, United Kingdom (CML)
| | - Keith M Godfrey
- From the Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom (SMR, SRC, NCH, BDB, KMG, CC, and HMI); the National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and Southampton University Hospitals NHS Trust, Southampton, United Kingdom (SMR, NCH, KMG, and CC); NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopaedic Centre, Oxford, United Kingdom (CC); and UCL Institute of Child Health, London, United Kingdom (CML)
| | - Cyrus Cooper
- From the Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom (SMR, SRC, NCH, BDB, KMG, CC, and HMI); the National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and Southampton University Hospitals NHS Trust, Southampton, United Kingdom (SMR, NCH, KMG, and CC); NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopaedic Centre, Oxford, United Kingdom (CC); and UCL Institute of Child Health, London, United Kingdom (CML)
| | - Hazel M Inskip
- From the Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom (SMR, SRC, NCH, BDB, KMG, CC, and HMI); the National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and Southampton University Hospitals NHS Trust, Southampton, United Kingdom (SMR, NCH, KMG, and CC); NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopaedic Centre, Oxford, United Kingdom (CC); and UCL Institute of Child Health, London, United Kingdom (CML)
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Hesketh KR, Goodfellow L, Ekelund U, McMinn AM, Godfrey KM, Inskip HM, Cooper C, Harvey NC, van Sluijs EMF. Activity levels in mothers and their preschool children. Pediatrics 2014; 133:e973-80. [PMID: 24664097 DOI: 10.1542/peds.2013-3153] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To investigate the association between objectively measured maternal and preschool-aged children's physical activity, determine how this association differs by demographic and temporal factors, and identify factors associated with maternal activity levels. METHODS In the UK Southampton Women's Survey, physical activity levels of 554 4-year-olds and their mothers were measured concurrently by using accelerometry for ≤7 days. Two-level mixed-effects linear regression was used to model the association between maternal and children's minutes spent sedentary, in light (LPA) and moderate-to-vigorous physical activity (MVPA). Linear regression was used to investigate correlates of maternal activity. RESULTS Mother-child daily activity levels were positively associated at all activity intensities (sedentary, LPA, and MVPA; all P < .001). The association for sedentary time was stronger for normal-weight children (versus those who were overweight/obese), and those attending preschool part-time (versus full-time). The mother-child association for LPA differed by maternal education and was stronger at the weekend (versus weekdays). The opposite was true for MVPA. Sedentary time and MVPA were most strongly associated in mornings, with LPA most strongly associated in the evenings. Maternal BMI, age leaving school, number and age of children at home, and working hours were independently associated with maternal daily sedentary time and LPA. CONCLUSIONS Physical activity levels in mothers and their 4-year-old children are directly associated, with associations at different activity intensities influenced by temporal and demographic factors. Influences on maternal physical activity levels also differ by activity intensity. Providing targeted interventions for mothers of young children may increase both groups' activity.
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Affiliation(s)
- Kathryn R Hesketh
- UK Clinical Research Collaboration Centre of Excellence for Diet and Activity Research, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
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Abstract
PURPOSE OF REVIEW To review the recent publications describing the link between pediatric nephrolithiasis and bone metabolism. RECENT FINDINGS Nephrolithiasis incidence is increasing in children and is associated with low bone mineral density (BMD). Affected children are conceptually at risk for fractures and osteoporosis. In addition to abnormal calcium metabolism, inflammation, genetic makeup and dietary habits are being recognized as important factors in the pathophysiology of nephrolithiasis and low bone density. Findings from retrospective reviews suggest that low BMD in children may be improved with citrate or thiazide treatment. SUMMARY The healthcare burden from low BMD with subsequent osteoporosis and fracture risk is immense with potential far-reaching effects in patient quality of life and healthcare expense. Bone mass is acquired in the pediatric age range, thus it is important to identify and treat at-risk children. Retrospective reviews in pediatric patients indicate that citrate or thiazide diuretic treatment may improve BMD. We now understand that a relationship exists between nephrolithiasis and low BMD. To improve healthcare for our current patients as well as protect their future health it is important to identify low BMD and initiate strategies to improve BMD in 'at-risk' children.
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Bell JM, Blackwood B, Shields MD, Watters J, Hamilton A, Beringer T, Elliott M, Quinlivan R, Tirupathi S. Interventions to prevent steroid-induced osteoporosis and osteoporotic fractures in Duchenne muscular dystrophy. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2014. [DOI: 10.1002/14651858.cd010899] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Hesketh KR, McMinn AM, Ekelund U, Sharp SJ, Collings PJ, Harvey NC, Godfrey KM, Inskip HM, Cooper C, van Sluijs EMF. Objectively measured physical activity in four-year-old British children: a cross-sectional analysis of activity patterns segmented across the day. Int J Behav Nutr Phys Act 2014; 11:1. [PMID: 24405936 PMCID: PMC3896827 DOI: 10.1186/1479-5868-11-1] [Citation(s) in RCA: 121] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 12/20/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Little is known about preschool-aged children's levels of physical activity (PA) over the course of the day. Using time-stamped data, we describe the levels and patterns of PA in a population-based sample of four-year-old British children. METHODS Within the Southampton Women's Survey the PA levels of 593 4-year-old children (51% female) were measured using (Actiheart) accelerometry for up to 7 days. Three outcome measures: minutes spent sedentary (<20 cpm); in light (LPA: ≥20-399 cpm) and in moderate-to-vigorous activity (MVPA: ≥400 cpm) were derived. Average daily activity levels were calculated and then segmented across the day (morning, afternoon and evening). MVPA was log-transformed. Two-level random intercept models were used to analyse associations between activity level and temporal and demographic factors. RESULTS Children were active for 67% (mean 568.5 SD 79.5 minutes) of their daily registered time on average, with 88% of active time spent in LPA. All children met current UK guidelines of 180 minutes of daily activity. There were no differences in children's average daily levels of sedentary activity and LPA by temporal and demographic factors: differences did emerge when activity was segmented across the day. Sex differences were largest in the morning, with girls being more sedentary, spending fewer minutes in LPA and 18% less time in MVPA than boys. Children were more sedentary and less active (LPA and MVPA) in the morning if they attended childcare full-time compared to part-time, and on weekend mornings compared to weekdays. The reverse was true for weekend afternoons and evenings. Children with more educated mothers were less active in the evenings. Children were less sedentary and did more MVPA on summer evenings compared to winter evenings. CONCLUSIONS Preschool-aged children meet current physical activity guidelines, but with the majority of their active time spent in LPA, investigation of the importance of activity intensity in younger children is needed. Activity levels over the day differed by demographic and temporal factors, highlighting the need to consider temporality in future interventions. Increasing girls' morning activity and providing opportunities for daytime activity in winter months may be worthwhile.
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Affiliation(s)
- Kathryn R Hesketh
- UKCRC Centre of Excellence for Diet and Activity Research (CEDAR), Box 296, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Alison M McMinn
- UKCRC Centre of Excellence for Diet and Activity Research (CEDAR), Box 296, Institute of Public Health, University of Cambridge, Cambridge, UK
- MRC Epidemiology Unit, Institute of Metabolic Science, Box 285, Addenbrooke's Hospital, Cambridge, UK
| | - Ulf Ekelund
- MRC Epidemiology Unit, Institute of Metabolic Science, Box 285, Addenbrooke's Hospital, Cambridge, UK
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Stephen J Sharp
- MRC Epidemiology Unit, Institute of Metabolic Science, Box 285, Addenbrooke's Hospital, Cambridge, UK
| | - Paul J Collings
- MRC Epidemiology Unit, Institute of Metabolic Science, Box 285, Addenbrooke's Hospital, Cambridge, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Hazel M Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Esther MF van Sluijs
- UKCRC Centre of Excellence for Diet and Activity Research (CEDAR), Box 296, Institute of Public Health, University of Cambridge, Cambridge, UK
- MRC Epidemiology Unit, Institute of Metabolic Science, Box 285, Addenbrooke's Hospital, Cambridge, UK
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Harvey NC, Moon RJ, Sayer AA, Ntani G, Davies JH, Javaid MK, Robinson SM, Godfrey KM, Inskip HM, Cooper C. Maternal antenatal vitamin D status and offspring muscle development: findings from the Southampton Women's Survey. J Clin Endocrinol Metab 2014; 99:330-7. [PMID: 24178796 PMCID: PMC3880861 DOI: 10.1210/jc.2013-3241] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
CONTEXT Maternal 25-hydroxyvitamin D [25(OH)D] status in pregnancy has been associated with offspring bone development and adiposity. Vitamin D has also been implicated in postnatal muscle function, but little is known about a role for antenatal 25(OH)D exposure in programming muscle development. OBJECTIVE We investigated the associations between maternal plasma 25(OH)D status at 34 weeks of gestation and offspring lean mass and muscle strength at 4 years of age. DESIGN AND SETTING We studied a prospective UK population-based mother-offspring cohort: the Southampton Women's Survey (SWS). PARTICIPANTS Initially, 12,583 nonpregnant women were recruited into the SWS, of whom 3159 had singleton pregnancies; 678 mother-child pairs were included in this analysis. MAIN OUTCOMES MEASURED At 4 years of age, offspring assessments included hand grip strength and whole-body dual-energy x-ray absorptiometry, yielding lean mass and percent lean mass. Physical activity was assessed by 7-day accelerometry in a subset of children (n=326). RESULTS The maternal serum 25(OH)D concentration in pregnancy was positively associated with offspring height-adjusted hand grip strength (β=0.10 SD/SD, P=.013), which persisted after adjustment for maternal confounding factors, duration of breastfeeding, and child's physical activity at 4 years (β=0.13 SD/SD, P=.014). Maternal 25(OH)D was also positively associated with offspring percent lean mass (β=0.11 SD/SD, P=.006), but not total lean mass (β=0.06 SD/SD, P=.15). However, this association did not persist after adjustment for confounding factors (β=0.09 SD/SD, P=.11). CONCLUSIONS This observational study suggests that intrauterine exposure to 25(OH)D during late pregnancy might influence offspring muscle development through an effect primarily on muscle strength rather than on muscle mass.
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Affiliation(s)
- Nicholas C. Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD UK
| | - Rebecca J. Moon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK
- Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK
| | - Avan Aihie Sayer
- MRC Lifecourse Epidemiology Unit, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK
| | - Georgia Ntani
- MRC Lifecourse Epidemiology Unit, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK
| | - Justin H. Davies
- Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK
| | - M Kassim Javaid
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopedic Centre, Headington, Oxford, OX3 7HE
| | - Sian M. Robinson
- MRC Lifecourse Epidemiology Unit, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD UK
| | - Hazel M. Inskip
- MRC Lifecourse Epidemiology Unit, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD UK
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopedic Centre, Headington, Oxford, OX3 7HE
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Hesketh KR, McMinn AM, Griffin SJ, Harvey NC, Godfrey KM, Inskip HM, Cooper C, van Sluijs EMF. Maternal awareness of young children's physical activity: levels and cross-sectional correlates of overestimation. BMC Public Health 2013; 13:924. [PMID: 24090173 PMCID: PMC3852941 DOI: 10.1186/1471-2458-13-924] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 09/11/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Factors associated with parental awareness of children's physical activity (PA) levels have not been explored in preschool-aged children. This paper investigates maternal awareness of preschool-aged children's PA levels and determined correlates associated with maternal overestimation of PA. METHODS Data from the Southampton Women's Survey, a UK population-based study, were collected March 2006 through June 2009. Daily minutes of moderate-to-vigorous PA (MVPA) were derived using accelerometry in 478 4-year-old children. Mothers who were realistic or overestimated their child's PA were identified. Log-binomial regression was used to analyse correlates of maternal overestimation of PA levels in children whose mothers perceived them to be active (n = 438). RESULTS 40.8% of children were classified as inactive: 89.7% of these were perceived to be active by their mothers (over-estimators). These mothers were more likely to think their child sometimes lacked skills required to be physically active (RR (95% CI) = 1.29(1.03-1.63)) and their child was more likely to attend nursery full-time (RR = 1.53(1.14-2.04)). They were less likely to have older children at home (RR = 0.71(0.56-0.90)). CONCLUSIONS Almost 90% of mothers of inactive preschool-aged children perceive their child to be active. Nursery-school attendance and having older siblings at home may be important to consider when designing behavioural interventions to increase PA in preschool children.
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Affiliation(s)
- Kathryn R Hesketh
- UKCRC Centre for Diet and Activity Research, Institute of Public Health, University of Cambridge, Cambridge, UK.
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Nakatsuka H, Shimbo S, Watanabe T, Yaginuma-Sakurai K, Ikeda M. Applicability of food composition tables as a tool to estimate mineral and trace element intake of pre-school children in Japan: a validation study. J Trace Elem Med Biol 2013; 27:339-45. [PMID: 23583343 DOI: 10.1016/j.jtemb.2013.02.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 01/07/2013] [Accepted: 02/19/2013] [Indexed: 11/17/2022]
Abstract
Because dietary intakes of some minerals (including trace elements), especially iron (Fe), are insufficient for the needs of the general Japanese population, accurate estimation of mineral intake is important. This capability is especially necessary to preserve the health of Japanese children. Therefore, the current version of food composition tables (FCT) in Japan was evaluated for validity as tools to estimate dietary intake of minerals for children. For this purpose, 24h food duplicate samples were collected from 292 pre-school children in Miyagi prefecture, Japan. From the weights of items and food codes, intakes of nine minerals were estimated taking advantage of the FCT. In parallel, amounts of minerals in each duplicate samples were instrumentally measured by ICP-AES for Ca, Cu, Fe, Mg, Mn, P and Zn, and by flame AAS for K and Na, both after wet-ashing. The distributions of the mineral amounts were essentially normal. The comparison of the FCT-based estimates (E) and instrumental measures (M) showed that the E/M ratio was close to 1 for Ca, K, Mn, P and Zn, suggesting that E may be a surrogate of M for Ca, K, Mn, P and Zn on a group basis. The ratio being larger than 1.2 for Cu, Fe, Mg and Na indicates that a risk of over-estimation exists when E is relied upon in place of M. On an individual basis, significant differences were detected for all 9 minerals suggesting that the use of E as a surrogate for M should be practiced with care for the estimation of mineral intake.
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Affiliation(s)
- Haruo Nakatsuka
- Department of Nursing, Miyagi University, Miyagi 981-3298, Japan
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van Sluijs EMF, McMinn AM, Inskip HM, Ekelund U, Godfrey KM, Harvey NC, Griffin SJ. Correlates of light and moderate-to-vigorous objectively measured physical activity in four-year-old children. PLoS One 2013; 8:e74934. [PMID: 24040365 PMCID: PMC3764204 DOI: 10.1371/journal.pone.0074934] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 08/07/2013] [Indexed: 12/31/2022] Open
Abstract
Background Correlates of physical activity (PA) are hypothesized to be context and behaviour specific, but there is limited evidence of this in young children. The aim of the current study is to investigate associations between personal, social and environmental factors and objectively measured light and moderate-to-vigorous PA (LPA and MVPA, respectively) in four-year-old children. Methods Cross-sectional data were used from the Southampton Women’s Survey, a UK population-based longitudinal study. Four-year old children (n = 487, 47.0% male) had valid PA data assessed using accelerometry (Actiheart) and exposure data collected with a validated maternal questionnaire (including data on child personality, family demographics, maternal behaviour, rules and restrictions, and perceived local environment). Linear regression modelling was used to analyse associations with LPA and MVPA separately, interactions with sex were explored. Results LPA minutes were greater in children whose mothers reported more PA (vs. inactive: regression coefficient±standard error: 6.70±2.94 minutes), and without other children in the neighbourhood to play with (−6.33±2.44). MVPA minutes were greater in children with older siblings (vs. none: 5.81±2.80) and those whose mothers used active transport for short trips (vs. inactive: 6.24±2.95). Children accumulated more MVPA in spring (vs. winter: 9.50±4.03) and, in boys only, less MVPA with availability of other children in the neighbourhood (−3.98±1.70). Discussion Young children’s LPA and MVPA have differing associations with a number of social and environmental variables. Interventions targeting PA promotion in young children outside of formal care settings should consider including intensity specific factors.
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Affiliation(s)
- Esther M. F. van Sluijs
- Medical Research Council Epidemiology Unit, Cambridge, United Kingdom
- UKCRC Centre for Diet and Activity Research (CEDAR), Cambridge, United Kingdom
- * E-mail:
| | - Alison M. McMinn
- Medical Research Council Epidemiology Unit, Cambridge, United Kingdom
- UKCRC Centre for Diet and Activity Research (CEDAR), Cambridge, United Kingdom
| | - Hazel M. Inskip
- Medical Research Council Lifecourse Epidemiology Unit, Southampton, United Kingdom
| | - Ulf Ekelund
- Medical Research Council Epidemiology Unit, Cambridge, United Kingdom
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Keith M. Godfrey
- Medical Research Council Lifecourse Epidemiology Unit, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Nicholas C. Harvey
- Medical Research Council Lifecourse Epidemiology Unit, Southampton, United Kingdom
| | - Simon J. Griffin
- Medical Research Council Epidemiology Unit, Cambridge, United Kingdom
- UKCRC Centre for Diet and Activity Research (CEDAR), Cambridge, United Kingdom
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Machado M, Fernandes P, Cardadeiro G, Baptista F. Femoral neck bone adaptation to weight-bearing physical activity by computational analysis. J Biomech 2013; 46:2179-85. [DOI: 10.1016/j.jbiomech.2013.06.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 06/28/2013] [Accepted: 06/30/2013] [Indexed: 11/25/2022]
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Cichosz SL, Fleischer J, Hoeyem P, Laugesen E, Poulsen PL, Christiansen JS, Ejskjær N, Hansen TK. Objective measurements of activity patterns in people with newly diagnosed Type 2 diabetes demonstrate a sedentary lifestyle. Diabet Med 2013; 30:1063-6. [PMID: 23600518 DOI: 10.1111/dme.12199] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 01/04/2013] [Accepted: 03/15/2013] [Indexed: 02/05/2023]
Abstract
AIMS To evaluate physical activity in people with newly diagnosed Type 2 diabetes using objective measures. METHODS We analysed data from a study aimed at assessing carotid femoral pulse wave velocity in which a piezoelectric accelerometer was worn by 100 people with newly diagnosed Type 2 diabetes and by 100 age- and sex-matched control subjects. Differences in physical activity patterns were investigated. RESULTS Compared with the control group, the people with Type 2 diabetes spent significantly more time engaged in sedentary or lower level activities during the day, with a mean (sd) time of 926 (44) vs 898 (70) min, P < 0.001). This difference remained significant after correction for differences in BMI between the two groups. CONCLUSIONS Using objective measurements, our findings demonstrate that people with newly diagnosed Type 2 diabetes have a more sedentary lifestyle compared with well-matched controls.
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Affiliation(s)
- S L Cichosz
- Department of Endocrinology, Internal Medicine and Medical Research Laboratories, Aarhus University Hospital, Denmark.
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Collings PJ, Brage S, Ridgway CL, Harvey NC, Godfrey KM, Inskip HM, Cooper C, Wareham NJ, Ekelund U. Physical activity intensity, sedentary time, and body composition in preschoolers. Am J Clin Nutr 2013; 97:1020-8. [PMID: 23553158 PMCID: PMC3785144 DOI: 10.3945/ajcn.112.045088] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Detailed associations between physical activity (PA) subcomponents, sedentary time, and body composition in preschoolers remain unclear. OBJECTIVE We examined the magnitude of associations between objectively measured PA subcomponents and sedentary time with body composition in 4-y-old children. DESIGN We conducted a cross-sectional study in 398 preschool children recruited from the Southampton Women's Survey. PA was measured by using accelerometry, and body composition was measured by using dual-energy X-ray absorptiometry. Associations between light physical activity, moderate physical activity (MPA), vigorous physical activity (VPA), and moderate-to-vigorous physical activity (MVPA) intensity; sedentary time; and body composition were analyzed by using repeated-measures linear regression with adjustment for age, sex, birth weight, maternal education, maternal BMI, smoking during pregnancy, and sleep duration. Sedentary time and PA were also mutually adjusted for one another to determine whether they were independently related to adiposity. RESULTS VPA was the only intensity of PA to exhibit strong inverse associations with both total adiposity [P < 0.001 for percentage of body fat and fat mass index (FMI)] and abdominal adiposity (P = 0.002 for trunk FMI). MVPA was inversely associated with total adiposity (P = 0.018 for percentage of body fat; P = 0.022 for FMI) but only because of the contribution of VPA, because MPA was unrelated to fatness (P ≥ 0.077). No associations were shown between the time spent sedentary and body composition (P ≥ 0.11). CONCLUSIONS In preschoolers, the time spent in VPA is strongly and independently associated with lower adiposity. In contrast, the time spent sedentary and in low-to-moderate-intensity PA was unrelated to adiposity. These results indicate that efforts to challenge pediatric obesity may benefit from prioritizing VPA.
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Affiliation(s)
- Paul J Collings
- Medical Research Council Epidemiology Unit, Institute of Metabolic Science, Cambridge, United Kingdom
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Heidemann M, Mølgaard C, Husby S, Schou AJ, Klakk H, Møller NC, Holst R, Wedderkopp N. The intensity of physical activity influences bone mineral accrual in childhood: the childhood health, activity and motor performance school (the CHAMPS) study, Denmark. BMC Pediatr 2013; 13:32. [PMID: 23452342 PMCID: PMC3599700 DOI: 10.1186/1471-2431-13-32] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Accepted: 02/25/2013] [Indexed: 11/30/2022] Open
Abstract
Background Studies indicate genetic and lifestyle factors can contribute to optimal bone development. In particular, the intensity level of physical activity may have an impact on bone health. This study aims to assess the relationship between physical activity at different intensities and Bone Mineral Content (BMC), Bone Mineral Density (BMD) and Bone Area (BA) accretion. Methods This longitudinal study is a part of The CHAMPS study-DK. Whole-body DXA scans were performed at baseline and after two years follows up. BMC, BMD, and BA were measured. The total body less head (TBLH) values were used. Physical activity (PA) was recorded by accelerometers (ActiGraph, model GT3X). Percentages of different PA intensity levels were calculated and log odds of two intensity levels of activity relative to the third level were calculated. Multilevel regression analyses were used to assess the relationship between the categories of physical activity and bone traits. Results Of 800 invited children, 742 (93%) accepted to participate. Of these, 682/742 (92%) participated at follow up. Complete datasets were obtained in 602/742 (81%) children. Mean (range) of age was 11.5 years (9.7-13.9). PA at different intensity levels was for boys and girls respectively, sedentary 62% and 64%, low 29% for both genders and moderate to high 9% and 7% of the total time. Mean (range) BMC, BMD, and BA was 1179 g (563–2326), 0.84 g/cm2 (0.64-1.15) and 1393 cm2 (851–2164), respectively. Valid accelerometer data were obtained for a mean of 6.1 days, 13 hours per day. Conclusions There 7was a positive relationship between the log odds of moderate to high-level PA versus low level activity and BMC, BMD and BA. Children with an increased proportion of time in moderate to high-level activity as opposed to sedentary and low-level activity achieved positive effects on BMC, BMD and BA.
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Affiliation(s)
- Malene Heidemann
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Sdr, Boulevard 29, Odense C DK-5000, Denmark.
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Tuck SP. Distal forearm fractures and inheritance of bone mass. J Clin Densitom 2013; 16:79-80. [PMID: 23146255 DOI: 10.1016/j.jocd.2012.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 09/04/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Stephen Paul Tuck
- Department of Rheumatology, The James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, United Kingdom.
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Bibliography Current World Literature. CURRENT ORTHOPAEDIC PRACTICE 2012. [DOI: 10.1097/bco.0b013e31826b35c1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Deere K, Sayers A, Davey Smith G, Rittweger J, Tobias JH. High impact activity is related to lean but not fat mass: findings from a population-based study in adolescents. Int J Epidemiol 2012; 41:1124-31. [PMID: 22576953 PMCID: PMC3429873 DOI: 10.1093/ije/dys073] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Objective measures of physical activity calibrated against energy expenditure may have limited utility in studying relationships with musculoskeletal phenotypes. We wished to assess an alternative approach using an accelerometer calibrated according to impact loading. Methods Of the 17-year olds from the Avon Longitudinal Study of Parents and Children (ALSPAC), 732 wore Newtest accelerometers while performing day-to-day activities for a mean of 5.8 days. Outputs were categorized as light, moderate, high and very high impact, based on the thresholds identified in 22 adolescents during graded activities. In subsequent regression analyses, activity data and fat mass were normalized by log transformation. Results The number of counts relating to high impact activity was ∼2% that of light impact activity, and 33% greater in boys when compared with girls. High impact activity was more strongly related to lean mass [light: 0.033 (95% CI −0.023 to 0.089), moderate: 0.035 (95% CI −0.010 to 0.080) and high: 0.044 (95% CI 0.010 to 0.078)] (β = SD change in outcome per doubling in activity, height adjusted, boys and girls combined). In contrast, lower impact activity was more strongly related to fat mass [light: −0.069 (95% CI −0.127 to −0.011), moderate: −0.060 (95% CI −0.107 to −0.014) and high: −0.033 (95% CI −0.069 to 0.003)]. In a more fully adjusted model including other activity types and fat/lean mass, lean mass was related to only high activity (boys and girls combined), whereas fat mass was related to only moderate activity (girls only). Conclusions Using an accelerometer calibrated according to impact loading revealed that high impact activity is related to lean but not fat mass.
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Affiliation(s)
- Kevin Deere
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol, UK
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Holroyd C, Harvey N, Dennison E, Cooper C. Epigenetic influences in the developmental origins of osteoporosis. Osteoporos Int 2012; 23:401-10. [PMID: 21656266 DOI: 10.1007/s00198-011-1671-5] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Accepted: 05/10/2011] [Indexed: 12/01/2022]
Abstract
Osteoporosis is a major public health problem due to consequent fragility fractures; data from the UK suggest that up to 50% of women and 20% men aged 50 years will have an osteoporosis-related fracture in their remaining lifetime. Skeletal size and density increase from early embryogenesis through intrauterine, infant, childhood and adult life to reach a peak in the third to fourth decade. The peak bone mass achieved is a strong predictor of later osteoporosis risk. Epidemiological studies have demonstrated a positive relationship between early growth and later bone mass, both at peak and in later life, and also with reduced risk of hip fracture. Mother-offspring cohorts have allowed the elucidation of some of the specific factors in early life, such as maternal body build, lifestyle and 25(OH)-vitamin D status, which might be important. Most recently, the phenomenon of developmental plasticity, whereby a single genotype may give rise to different phenotypes depending on the prevailing environment, and the science of epigenetics have presented novel molecular mechanisms which may underlie previous observations. This review will give an overview of these latter developments in the context of the burden of osteoporosis and the wider data supporting the link between the early environment and bone health in later life.
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Affiliation(s)
- C Holroyd
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
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