Osteoporosis International

, Volume 23, Issue 8, pp 2227–2237 | Cite as

Vitamin D status and physical activity interact to improve bone mass in adolescents. The HELENA Study

  • J. ValtueñaEmail author
  • L. Gracia-Marco
  • G. Vicente-Rodríguez
  • M. González-Gross
  • I. Huybrechts
  • J. P. Rey-López
  • T. Mouratidou
  • I. Sioen
  • M. I. Mesana
  • A. E. Díaz Martínez
  • K. Widhalm
  • L. A. Moreno
  • on behalf of the HELENA Study Group
Original Article



The effects of vitamin D concentrations on bone mineral content in adolescents are still unclear. Vitamin D and physical activity (PA) may interact to determine bone mineral content (BMC) in two possible directions; 25(OH)D sufficiency levels improve BMC only in active adolescents, or PA increases BMC in individuals with replete vitamin D levels.


The effects of suboptimal 25-hydroxycholecalciferol (25(OH)D) concentrations on BMC in adolescents are still unclear. The main aim of this study was to evaluate the influence of 25(OH)D on BMC in adolescents, considering the effect of body composition, sex, age, Tanner stage, season, calcium and vitamin D intakes, physical fitness and PA.


Serum 25(OH)D concentrations, anthropometric measurements, dual energy X-ray absorptiometry measurements, calcium and vitamin D intakes, PA and physical fitness were obtained in 100 Spanish adolescents (47 males), aged 12.5–17.5 years, within the framework of the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. Relations were examined using ANCOVA and regression analyses including BMC as dependent variable.


Linear regression of BMC suggested that 25(OH)D concentrations independently influenced total and leg BMC after controlling for age, sex, lean mass, seasonality and calcium intake (B = 0.328, p < 0.05, and B = 0.221, p < 0.05, respectively) in the physically active group. No significant influence of 25(OH)D concentrations on BMC was observed in the inactive group. Significant effect was shown between the interaction of 25(OH)D and PA on BMC for the total body and legs (both p < 0.05).


Vitamin D and PA may interact to determine BMC. 25(OH)D sufficiency levels improve bone mass only in active adolescents, or PA has a positive influence on BMC in individuals with replete vitamin D levels.


Adolescents Bone Calcium Physical activity Physical fitness Vitamin D 



The HELENA Study has taken place with the financial support of the European Community Sixth RTD Framework Programme (contract FOOD-CT-2005-007034). The content of this article reflects only the authors' views, and the European Community is not liable for any use that may be made of the information contained therein. Additional support was gotten from the Spanish Ministry of Education (AGL2007-29784-E/ALI; AP-2005-3827). Jara Valtueña is financially supported by the Universidad Politécnica de Madrid (CH/018/2008). Isabelle Sioen is financially supported by the Research Foundation-Flanders (grant no. 1.2.683.11.N.00). Many thanks to Adelheid Schuch for her contribution to laboratory work and to Laura Barrios for statistical assistance.

Conflicts of interest



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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2012

Authors and Affiliations

  • J. Valtueña
    • 1
    • 2
    Email author
  • L. Gracia-Marco
    • 3
    • 4
  • G. Vicente-Rodríguez
    • 3
    • 4
  • M. González-Gross
    • 1
    • 5
  • I. Huybrechts
    • 2
  • J. P. Rey-López
    • 3
    • 4
  • T. Mouratidou
    • 3
    • 4
  • I. Sioen
    • 2
    • 6
  • M. I. Mesana
    • 3
    • 4
  • A. E. Díaz Martínez
    • 7
  • K. Widhalm
    • 8
  • L. A. Moreno
    • 3
    • 4
  • on behalf of the HELENA Study Group
  1. 1.Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences–INEFTechnical University of MadridMadridSpain
  2. 2.Department of Public HealthGhent UniversityGhentBelgium
  3. 3.GENUD (Growth, Exercise, Nutrition and Development) Research GroupZaragozaSpain
  4. 4.School of Health Sciences (EUCS)University of ZaragozaZaragozaSpain
  5. 5.Institut für Ernährungs-und Lebensmittelwissenschaften, HumanernährungRheinische Friedrich-Wilhelms UniversitätBonnGermany
  6. 6.FWOResearch Foundation FlandersBrusselsBelgium
  7. 7.Clinical LaboratorySport Medicine Center, Consejo Superior de DeportesMadridSpain
  8. 8.Division of Clinical Nutrition and Prevention, Department of PediatricsMedical University of ViennaViennaAustria

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