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Patel H, Woods L, Teesdale-Spittle P, Dennison E. A cross-sectional study of the relationship between recreational sporting activity and calcaneal bone density in adolescents and young adults. PHYSICIAN SPORTSMED 2022; 50:218-226. [PMID: 33724899 DOI: 10.1080/00913847.2021.1903819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Childhood and adolescence are critical periods of bone development. Sporting activity is thought to impact peak bone mass acquisition, but most studies have used dual-energy X-ray absorptiometry (DXA) to assess bone health and reported associations between bone mass and elite sporting activity. The objective of this study was instead to assess the relationship between recreational sporting activity (RSA) and another bone assessment, calcaneal quantitative ultrasound (cQUS), in adolescents and young adults. METHODS We related recreational sporting activity, assessed through a lifestyle questionnaire, to heel ultrasound bone parameters in a cohort of New Zealand students aged 16-35 years. Complete datasets with data on all relevant confounders (body mass index (BMI), pubertal timing, smoking status, and alcohol consumption) were available for 452 participants. cQUS was performed using a Lunar Achilles EX II machine to obtain bone parameters, broadband ultrasound attenuation (BUA), and speed of sound (SOS); stiffness index (SI) was derived from these measures. All descriptive statistics and statistical analyses were carried out using SPSS Statistics for Macintosh, Version 23.0 (IBM Corp., Armonk, NY, USA). Results are presented as p-values and 95% CI. RESULTS Reported lifetime sport participation declined after an individual's mid-teens. Bone cQUS parameters (SI and BUA and T-score) were all positively associated with BMI, and current physical activity (SI, SOS, BUA, T-score, and Z-score) with SI and SOS measures most strongly associated with current high impact and past recreational sporting activity (all p < 0.05). CONCLUSION Calcaneal heel ultrasound bone parameters were associated with physical activity, with SI and SOS rather than BUA more strongly related to current and past recreational sporting activity in young New Zealand adults.
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Affiliation(s)
- Hansa Patel
- School of Biological Sciences, Victoria University of Wellington, New Zealand
| | - Lisa Woods
- School of Biological Sciences, Victoria University of Wellington, New Zealand
| | | | - Elaine Dennison
- School of Biological Sciences, Victoria University of Wellington, New Zealand.,School of Biological Sciences, Victoria University of Wellington, New Zealand & MRC Lifecourse Epidemiology Unit, Southampton, UK
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Higgins S, Sokolowski CM, Vishwanathan M, Schmidt MD, Evans EM, Lewis RD. Sex-Specific Muscular Mediation of the Relationship Between Physical Activity and Cortical Bone in Young Adults. J Bone Miner Res 2020; 35:81-91. [PMID: 31499590 DOI: 10.1002/jbmr.3868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 08/06/2019] [Accepted: 08/23/2019] [Indexed: 11/07/2022]
Abstract
Muscle mass is a commonly cited mediator of the relationship between physical activity (PA) and bone, representing the mechanical forces generated during PA. However, neuromuscular properties (eg, peak force) also account for unique portions of variance in skeletal outcomes. We used serial multiple mediation to explore the intermediary role of muscle mass and force in the relationships between cortical bone and moderate-to-vigorous intensity PA (MVPA). In a cross-sectional sample of young adults (n = 147, 19.7 ± 0.7 years old, 52.4% female) cortical diaphyseal bone was assessed via peripheral quantitative computed tomography at the mid-tibia. Peak isokinetic torque in knee extension was assessed via Biodex dynamometer. Thigh fat-free soft tissue (FFST) mass, assessed via dual-energy X-ray absorptiometry, represented the muscular aspect of tibial mechanical forces. Habitual MVPA was assessed objectively over 7 days using Actigraph GT3X+ accelerometers. Participants exceeded MVPA guidelines (89.14 ± 27.29 min/day), with males performing 44.5% more vigorous-intensity activity relative to females (p < 0.05). Males had greater knee extension torque and thigh FFST mass compared to females (55.3%, and 34.2%, respectively, all p < 0.05). In combined-sex models, controlling for tibia length and age, MVPA was associated with strength strain index (pSSI) through two indirect pathways: (i) thigh FFST mass (b = 1.11 ± 0.37; 95% CI, 0.47 to 1.93), and (i) thigh FFST mass and knee extensor torque in sequence (b = 0.30 ± 0.16; 95% CI, 0.09 to 0.73). However, in sex-specific models MVPA was associated with pSSI indirectly through its relationship with knee extensor torque in males (b = 0.78 ± 0.48; 95% CI, 0.04 to 2.02) and thigh FFST mass in females (b = 1.12 ± 0.50; 95% CI, 0.37 to 2.46). Bootstrapped CIs confirmed these mediation pathways. The relationship between MVPA and cortical structure appears to be mediated by muscle in young adults, with potential sex-differences in the muscular pathway. If confirmed, these findings may highlight novel avenues for the promotion of bone strength in young adults. © 2019 American Society for Bone and Mineral Research.
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Affiliation(s)
- Simon Higgins
- Department of Kinesiology, University of Georgia, Athens, GA, USA.,Department of Exercise Science, Elon University, Elon, NC, USA
| | | | | | | | - Ellen M Evans
- Department of Kinesiology, University of Georgia, Athens, GA, USA
| | - Richard D Lewis
- Department of Foods and Nutrition, University of Georgia, Athens, GA, USA
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Zymbal V, Baptista F, Letuchy EM, Janz KF, Levy SM. Mediating Effect of Muscle on the Relationship of Physical Activity and Bone. Med Sci Sports Exerc 2019; 51:202-210. [PMID: 30157107 DOI: 10.1249/mss.0000000000001759] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE This study analyzed prospective associations between distinct trajectories of objectively measured physical activity (PA) and late adolescent bone parameters and explored the mediating effects of lean soft tissue, a surrogate of muscle mass to associations. METHODS Physical activity was measured by accelerometry starting at age 5 yr and continuing at 8, 11, 13, 15, and 17 yr in approximately 524 participants from the Iowa Bone Development Study. Sex-specific group-based trajectory modeling was used to construct developmental trajectories of moderate- and vigorous-intensity PA (MVPA) from childhood to late adolescence. At age 17 yr, proximal femur bone mineral density (aBMD) was assessed by dual X-ray energy absorptiometry, and its distribution was calculated by aBMD ratios. Specific geometric measures of the proximal femur were assessed using hip structural analysis. RESULTS A significant portion of the total effect of MVPA from age 5 to 17 yr on bone parameters at age 17 yr was explained by an increase in leg lean soft tissue in both sexes. For males and females, indirect effects were observed on the total and all regional proximal femur aBMD, and on the ratio between the inferomedial and superolateral neck aBMD. The effect on the ratio between the trochanter and the total proximal femur was specific to females, whereas the effect on the hip axis length was specific to males. Direct effects of MVPA on aBMD were identified only in males. CONCLUSIONS Using robust mediation analysis, this is the first study addressing the indirect effect (through muscle) of PA across childhood and adolescence on proximal femur bone parameters. To improve bone health at the proximal femur, the results suggest PA interventions during growth that increase muscle mass, particularly in females.
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Affiliation(s)
- Vera Zymbal
- Department of Sport and Health, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, PORTUGAL
| | - Fátima Baptista
- Department of Sport and Health, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, PORTUGAL
| | - Elena M Letuchy
- Department of Epidemiology, The University of Iowa, Iowa City, IA
| | - Kathleen F Janz
- Department of Epidemiology, The University of Iowa, Iowa City, IA.,Department of Health and Human Physiology, The University of Iowa, Iowa City, IA
| | - Steven M Levy
- Department of Epidemiology, The University of Iowa, Iowa City, IA.,Department of Preventive and Community Dentistry, College of Dentistry, The University of Iowa, Iowa City, IA
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Luiz-de-Marco R, Kemper H, Agostinete RR, Werneck AO, Maillane-Vanegas S, Faustino-da-Silva YDS, Exupério I, Fernandes RA. Sports participation and muscle mass affect sex-related differences in bone mineral density between male and female adolescents: A longitudinal study. SAO PAULO MED J 2019; 137:75-81. [PMID: 31116275 PMCID: PMC9721219 DOI: 10.1590/1516-3180.2018.031040119] [Citation(s) in RCA: 5] [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: 12/06/2018] [Accepted: 01/04/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Sports participation plays an important role in bone gain during childhood and adolescence. The aim here was to identify sex-related determinants of bone mineral density (BMD) differences between male and female adolescents, with emphasis on the role of sports participation. DESIGN AND SETTING Longitudinal study conducted in a public university in Presidente Prudente, Brazil. METHODS The sample comprised 48 adolescents aged 11-17 years, of both sexes, who were matched according to sex, age and sports participation. BMD was the main outcome, while muscle mass, sports participation, calendar age and biological maturation were treated as covariates. Participants were followed up after nine months. RESULTS At baseline, BMD values were similar between the sexes. However, adjustment for covariates showed that BMD was higher among girls at all sites, with a contribution from lean soft tissue (LST) in the model (partial eta-squared, ES-r = 0.619 in upper limbs; 0.643 in lower limbs; 0.699 in spine; and 0.599 in whole body). Sports participation only explained the upper-limb variance (ES-r = 0.99). At the follow-up, the results resembled the baseline except in the lower limbs (P = 0.109), in which BMD was similar between the groups. BMD gain over time was similar between girls and boys in all segments, and baseline LST affected upper-limb and whole-body BMD accrual (ES-r = 0.396 and 0.107, respectively). CONCLUSION Whole-body and specific-site BMD differed between baseline and follow-up. However,BMD accrual was similar between the sexes, given that muscle mass constituted the most relevant determinant of the difference between them.
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Affiliation(s)
- Rafael Luiz-de-Marco
- Master's Student and Researcher of Physical Education, Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Universidade Estadual Paulista (UNESP), and Postgraduate Student, Postgraduate Program on Physical Therapy, Department of Physical Therapy, UNESP, Presidente Prudente (SP), Brazil
| | - Han Kemper
- PhD. Emeritus Professor, Amsterdam UMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Ricardo Ribeiro Agostinete
- MSc. Researcher, Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil
| | - André Oliveira Werneck
- Master's Student and Researcher, Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil
| | - Santiago Maillane-Vanegas
- MSc. Researcher,Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Universidade Estadual Paulista (UNESP), and Doctoral Student, Postgraduate Program on Physical Therapy, Department of Physical Therapy, UNESP, Presidente Prudente (SP), Brazil
| | - Yuri da Silva Faustino-da-Silva
- Master's Student and Researcher of Physical Education, Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Universidade Estadual Paulista (UNESP), and Postgraduate Student, Postgraduate Program on Physical Therapy, Department of Physical Therapy, UNESP, Presidente Prudente (SP), Brazil
| | - Isabella Exupério
- Master's Student and Researcher of Physical Education, Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Universidade Estadual Paulista (UNESP), and Postgraduate Student, Postgraduate Program on Physical Therapy, Department of Physical Therapy, UNESP, Presidente Prudente (SP), Brazil
| | - Rômulo Araújo Fernandes
- PhD. Associate Professor, Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Universidade Estadual Paulista (UNESP); Associate Professor, Postgraduate Program on Physical Therapy, Department of Physical Therapy, UNESP; and Associate Professor, Postgraduate Program on Movement Sciences, Department of Physical Education, UNESP, Presidente Prudente (SP), Brazil
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