Osteoporosis International

, Volume 23, Issue 1, pp 121–130 | Cite as

Physical activity, calcium intake and childhood bone mineral: a population-based cross-sectional study

  • N. C. Harvey
  • Z. A. Cole
  • S. R. Crozier
  • M. Kim
  • G. Ntani
  • L. Goodfellow
  • S. M. Robinson
  • H. M. Inskip
  • K. M. Godfrey
  • E. M. Dennison
  • N. Wareham
  • U. Ekelund
  • C. CooperEmail author
  • The SWS Study Group
Original Article



In a free-living cohort of 4-year old children, mean daily time in moderate–vigorous physical activity and daily calcium intake at 3 years, were positively related to hip bone size and density. Relationships between physical activity and bone indices were stronger when calcium intake was above compared with below median (966 mg/day).


We examined the cross-sectional relationships between childhood physical activity, dietary calcium intake and bone size and density.


Children aged 4 years were recruited from the Southampton Women's Survey. They underwent measurement of bone mass by DXA (Hologic Discovery). Physical activity was assessed by accelerometry (Actiheart, Cambridge Neurotechnology Ltd, Cambridge, UK) for seven continuous days.


Four hundred twenty-two children (212 boys) participated. In a cross-sectional analysis, after adjusting for gender, daily mean time(minutes per day) spent in moderate to very vigorous activity (MVPA) was positively related to hip BA (R 2 = 3%, p < 0.001), BMC (R 2 = 4%, p < 0.001), aBMD (R 2 = 3%, p = 0.001) and estimated vBMD (R 2 = 2%, p = 0.01), but not height (r s = 0.04, p = 0.42) or weight (r s = 0.01, p = 0.76). Mean daily calcium intake (assessed at 3 years old) positively predicted bone indices in those with a calcium intake below the median (966 mg/day), but there was a much attenuated relationship in those above this. These associations persisted after inclusion of total energy, protein and phosphorus in multivariate models. The relationships between MVPA and bone indices were stronger in children with calcium intakes above the median. Thus, for aBMD, the variance explained by MVPA when daily calcium intake was below the median was 2% (p = 0.1) and above median was 6% (p = 0.001).


These results support the notion that adequate calcium intake may be required for optimal action of physical activity on bone development and that improving levels of physical activity and calcium intake in childhood may help to optimise accrual of bone mass.


Accelerometer Calcium Childhood DEXA Osteoporosis Physical activity 



We thank the mothers who gave us their time and a team of dedicated research nurses and ancillary staff for their assistance. This work was supported by grants from the Medical Research Council, British Heart Foundation, Arthritis Research UK, National Osteoporosis Society, International Osteoporosis Foundation, Cohen Trust, NIHR Nutrition Biomedical Research Unit, University of Southampton, and NIHR Musculoskeletal Biomedical Research Unit, University of Oxford. Participants were drawn from a cohort study funded by the Medical Research Council and the Dunhill Medical Trust. We thank Mrs. G. Strange and Mrs. L. Reeves for helping prepare the manuscript.

Conflicts of interest


Funding sources

Medical Research Council; Arthritis Research UK; National Osteoporosis Society; Wellbeing; Cohen Trust; NE (now North) Thames NHS R&D Directorate.


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2011

Authors and Affiliations

  • N. C. Harvey
    • 1
  • Z. A. Cole
    • 1
  • S. R. Crozier
    • 1
  • M. Kim
    • 1
  • G. Ntani
    • 1
  • L. Goodfellow
    • 1
  • S. M. Robinson
    • 1
  • H. M. Inskip
    • 1
  • K. M. Godfrey
    • 1
  • E. M. Dennison
    • 1
  • N. Wareham
    • 2
  • U. Ekelund
    • 2
  • C. Cooper
    • 1
    • 3
    Email author
  • The SWS Study Group
  1. 1.MRC Lifecourse Epidemiology Unit(University of Southampton), Southampton General HospitalSouthamptonUK
  2. 2.MRC Epidemiology Unit, Institute of Metabolic ScienceAddenbrooke’s HospitalCambridgeUK
  3. 3.Institute of Musculoskeletal ScienceUniversity of OxfordOxfordUK

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