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      A Cross-Sectional Study of the Relationship between Cortical Bone and High-Impact Activity in Young Adult Males and Females

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          Abstract

          Context:

          The factors that govern skeletal responses to physical activity remain poorly understood.

          Objective:

          The aim of this study was to investigate whether gender or fat mass influences relationships between cortical bone and physical activity, after partitioning accelerometer outputs into low (0.5–2.1 g), medium (2.1–4.2 g), or high (>4.2 g) impacts, where g represents gravitational force.

          Design/Setting:

          We conducted a cross-sectional analysis in participants from the Avon Longitudinal Study of Parents and Children.

          Participants:

          We studied 675 adolescents (272 boys; mean age, 17.7 yr).

          Outcome Measures:

          We measured cortical bone parameters from peripheral quantitative computed tomography scans of the mid-tibia, adjusted for height, fat mass, and lean mass.

          Results:

          High-impact activity was positively associated with periosteal circumference (PC) in males but not females [coefficients (95% confidence intervals), 0.054 (0.007, 0.100) and 0.07 (−0.028, 0.041), respectively; showing sd change per doubling in activity]. There was also weak evidence that medium impacts were positively related to PC in males but not females ( P = 0.03 for gender interaction). On stratifying by fat mass, the positive relationship between high-impact activity and PC was greatest in those with the highest fat mass [high impact vs. PC in males, 0.01 (−0.064, 0.085), 0.045 (−0.040, 0.131), 0.098 (0.012, 0.185), for lower, middle, and upper fat tertiles, respectively; high impact vs. PC in females, −0.041 (−0.101, 0.020), −0.028 (−0.077, 0.022), 0.082 (0.015, 0.148), P = 0.01 for fat mass interaction]. Similar findings were observed for strength parameters, cross-sectional moment of inertia, and strength-strain index.

          Conclusions:

          In late adolescence, associations between high-impact activity and PC are attenuated by female gender and low body fat, suggesting that the skeletal response to high-impact activity is particularly reduced in young women with low fat mass.

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          Most cited references23

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          ALSPAC--the Avon Longitudinal Study of Parents and Children. I. Study methodology.

          ALSPAC (The Avon Longitudinal Study of Parents and Children, formerly the Avon Longitudinal Study of Pregnancy and Childhood) was specifically designed to determine ways in which the individual's genotype combines with environmental pressures to influence health and development. To date, there are comprehensive data on approximately 10,000 children and their parents, from early pregnancy until the children are aged between 8 and 9. The study aims to continue to collect detailed data on the children as they go through puberty noting, in particular, changes in anthropometry, attitudes and behaviour, fitness and other cardiovascular risk factors, bone mineralisation, allergic symptoms and mental health. The study started early during pregnancy and collected very detailed data from the mother and her partner before the child was born. This not only provided accurate data on concurrent features, especially medication, symptoms, diet and lifestyle, attitudes and behaviour, social and environmental features, but was unbiased by parental knowledge of any problems that the child might develop. From the time of the child's birth many different aspects of the child's environment have been monitored and a wide range of phenotypic data collected. By virtue of being based in one geographic area, linkage to medical and educational records is relatively simple, and hands-on assessments of children and parents using local facilities has the advantage of high quality control. The comprehensiveness of the ALSPAC approach with a total population sample unselected by disease status, and the availability of parental genotypes, provides an adequate sample for statistical analysis and for avoiding spurious results. The study has an open policy in regard to collaboration within strict confidentiality rules.
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            Weight-bearing exercise and bone mineral accrual in children and adolescents: a review of controlled trials.

            Osteoporosis is a serious skeletal disease and as there is currently no cure, there is a large emphasis on its prevention, including the optimisation of peak bone mass. There is increasing evidence that regular weight-bearing exercise is an effective strategy for enhancing bone status during growth. This systematic review evaluates randomised and non-randomised controlled trials to date, on the effects of exercise on bone mineral accrual in children and adolescents. An online search of Medline and the Cochrane database enabled the identification of studies. Those that met the inclusion criteria were included in the review and graded according to risk for bias. Twenty-two trials were reviewed. Nine were conducted in prepubertal children (Tanner I), 8 in early pubertal (Tanner II-III) and 5 in pubertal (Tanner IV-V). Sample sizes ranged from n=10 to 65 per group. Exercise interventions included games, dance, resistance training and jumping exercises, ranging in duration from 3 to 48 months. Approximately half of the trials (n=10) included ground reaction force (GRF) data (2 to 9 times body weight). All trials in early pubertal children, 6 in pre pubertal and 2 in pubertal children, reported positive effects of exercise on bone (P<0.05). Mean increases in bone parameters over 6 months were 0.9-4.9% in prepubertal, 1.1-5.5% in early pubertal and 0.3-1.9% in pubertal exercisers compared to controls (P<0.05). Although weight-bearing exercise appears to enhance bone mineral accrual in children, particularly during early puberty; it remains unclear as to what constitutes the optimal exercise programme. Many studies to date have a high risk for bias and only a few have a low risk. Major limitations concerned selection procedures, compliance rates and control of variables. More well designed and controlled investigations are needed. Furthermore, the specific exercise intervention that will provide the optimal stimulus for peak bone mineral accretion is unclear. Future quantitative, dose-response studies using larger sample sizes and interventions that vary in GRF and frequency may characterise the most and least effective exercise programmes for bone mineral accrual in this population. In addition, the measurement of bone quality parameters and volumetric BMD would provide a greater insight into the mechanisms implicated in the adaptation of bone to exercise.
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              Periosteal bone formation--a neglected determinant of bone strength.

              Ego Seeman (2003)
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                Author and article information

                Journal
                J Clin Endocrinol Metab
                J. Clin. Endocrinol. Metab
                jcem
                jceme
                jcem
                The Journal of Clinical Endocrinology and Metabolism
                Endocrine Society (Chevy Chase, MD )
                0021-972X
                1945-7197
                October 2012
                16 July 2012
                16 July 2012
                : 97
                : 10
                : 3734-3743
                Affiliations
                Musculoskeletal Research Unit (K.D., A.S., J.H.T.), School of Clinical Sciences, University of Bristol, Bristol BS10 5NB, United Kingdom; Division Space Physiology (J.R.), Institute of Aerospace Medicine, German Aerospace Center, Linder Höhe 1, D-51147 Cologne, Germany; and Institute for Biomedical Research into Human Movement and Health (J.R.), Manchester Metropolitan University, Manchester M1 7EL, United Kingdom
                Author notes
                Address all correspondence and requests for reprints to: Professor Jon Tobias, Avon Orthopaedic Centre, Southmead Hospital, Bristol BS10 5NB, United Kingdom. E-mail: Jon.Tobias@ 123456bristol.ac.uk .
                Article
                12-1752
                10.1210/jc.2012-1752
                3462937
                22802090
                d572e088-0a1d-45ba-9ca9-cf55328a61cc
                Copyright © 2012 by The Endocrine Society

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/us/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 March 2012
                : 26 June 2012
                Categories
                2
                Endocrine Research

                Endocrinology & Diabetes
                Endocrinology & Diabetes

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