The longitudinal effects of physical activity and dietary calcium on bone mass accrual across stages of pubertal development

Joan M. Lappe, Patrice Watson, Vicente Gilsanz, Thomas Hangartner, Heidi J. Kalkwarf, Sharon Oberfield, John Shepherd, Karen K. Winer, Babette Zemel

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Childhood and adolescence are critical periods of bone mineral content (BMC) accrual that may have long-term consequences for osteoporosis in adulthood. Adequate dietary calcium intake and weight-bearing physical activity are important for maximizing BMC accrual. However, the relative effects of physical activity and dietary calcium on BMC accrual throughout the continuum of pubertal development in childhood remains unclear. The purpose of this study was to determine the effects of self-reported dietary calcium intake and weight-bearing physical activity on bone mass accrual across the five stages of pubertal development in a large, diverse cohort of US children and adolescents. The Bone Mineral Density in Childhood study was a mixed longitudinal study with 7393 observations on 1743 subjects. Annually, we measured BMC by dual-energy X-ray absorptiometry (DXA), physical activity and calcium intake by questionnaire, and pubertal development (Tanner stage) by examination for up to 7 years. Mixed-effects regression models were used to assess physical activity and calcium intake effects on BMC accrual at each Tanner stage. We found that self-reported weight-bearing physical activity contributed to significantly greater BMC accrual in both sexes and racial subgroups (black and nonblack). In nonblack males, the magnitude of the activity effect on total body BMC accrual varied among Tanner stages after adjustment for calcium intake; the greatest difference between high- and low-Activity boys was in Tanner stage 3. Calcium intake had a significant effect on bone accrual only in nonblack girls. This effect was not significantly different among Tanner stages. Our findings do not support differential effects of physical activity or calcium intake on bone mass accrual according to maturational stage. The study demonstrated significant longitudinal effects of weight-bearing physical activity on bone mass accrual through all stages of pubertal development.

Original languageEnglish
Pages (from-to)156-164
Number of pages9
JournalJournal of Bone and Mineral Research
Volume30
Issue number1
DOIs
StatePublished - Jan 1 2015

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Dietary Calcium
Bone Density
Exercise
Bone and Bones
Weight-Bearing
Calcium
Photon Absorptiometry
Osteoporosis
Longitudinal Studies

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine
  • Endocrinology, Diabetes and Metabolism
  • Medicine(all)

Cite this

The longitudinal effects of physical activity and dietary calcium on bone mass accrual across stages of pubertal development. / Lappe, Joan M.; Watson, Patrice; Gilsanz, Vicente; Hangartner, Thomas; Kalkwarf, Heidi J.; Oberfield, Sharon; Shepherd, John; Winer, Karen K.; Zemel, Babette.

In: Journal of Bone and Mineral Research, Vol. 30, No. 1, 01.01.2015, p. 156-164.

Research output: Contribution to journalArticle

Lappe, JM, Watson, P, Gilsanz, V, Hangartner, T, Kalkwarf, HJ, Oberfield, S, Shepherd, J, Winer, KK & Zemel, B 2015, 'The longitudinal effects of physical activity and dietary calcium on bone mass accrual across stages of pubertal development', Journal of Bone and Mineral Research, vol. 30, no. 1, pp. 156-164. https://doi.org/10.1002/jbmr.2319
Lappe, Joan M. ; Watson, Patrice ; Gilsanz, Vicente ; Hangartner, Thomas ; Kalkwarf, Heidi J. ; Oberfield, Sharon ; Shepherd, John ; Winer, Karen K. ; Zemel, Babette. / The longitudinal effects of physical activity and dietary calcium on bone mass accrual across stages of pubertal development. In: Journal of Bone and Mineral Research. 2015 ; Vol. 30, No. 1. pp. 156-164.
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