The Longitudinal Effects of Physical Activity and Dietary Calcium on Bone Mass Accrual Across Stages of Pubertal Development
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…
How strong is the evidence?
Evidence Hub reads this as a clinical trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 1,743 participants or records.
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