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The Relationship of Weight-Bearing Physical Activity and Dietary Calcium Intake with Bone Mass Accrual in the Bone Mineral Density in Childhood Study Cohort

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Nutritional Influences on Bone Health

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Abstract

Background: Although it is widely accepted that dietary calcium intake (CaI) and weight-bearing physical activity (WBA) increase bone mass accrual during growth, few prospective studies have followed children from early childhood to sexual maturity to evaluate this relationship.

Aims: To describe the relationship between CaI and WBA and total body bone mineral content (TBBMC) accrual in a large, multiracial cohort of children followed prospectively.

Methods: Five US centers recruited 2014 healthy children (ages 5–19 years) and measured them annually for up to 7 years. Subjects with at least two annual visits are included in this analysis (944 boys, 973 girls). Assessments included TBBMC, Tanner stage, WBA, and CaI. Multiple regression was used to model annual increases in TBBMC, controlled for annualized overall height growth, Tanner stages, and baseline TBBMC. The effect of adding WBA and CaI to the model was evaluated for four subgroups: nonblack boys and girls and black boys and girls.

Results: WBA had a positive association with adjusted annual increases in TBBMC in all subgroups (p < 0.05), while CaI was positively related to TBBMC increase in nonblack males and nonblack females.

Conclusion: These findings support the importance of public health efforts to increase physical activity in children and adolescents while assuring adequate calcium intake.

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Abbreviations

BMC:

Bone mineral content

BMDCS:

Bone Mineral Density in ­Childhood Study

CaI:

Calcium Intake

CHGTO:

Changed to

DXA:

Dual Energy ­Absorptiometry

NICHD:

National Institute for Child health and Human ­Development

RCT:

Randomized Clinical Trial

SD:

Standard Deviation

SS:

Sums of Squares

TBBMC:

Total Body Bone Mineral Content

WBA:

Weight Bearing Activity

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Acknowledgements

We acknowledge the study participants and their families for their dedication to this project. We thank the study staff members at each site who worked to achieve successful completion of this study.

Author information

Authors and Affiliations

  1. Osteoporosis Research Center, Creighton University, 601 N. 30th St, Omaha, NE, 68131, USA

    Joan Lappe PhD

  2. Departments of Preventive Medicine and Medicine, Creighton University School of Medicine, Omaha, NE, USA

    Patrice Watson PhD

  3. Department of Radiology, Children’s Hospital Los Angeles/University of Southern California, Los Angeles, CA, USA

    Vicente Gilsanz MD, PhD

  4. Department of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Heidi J. Kalkwarf PhD

  5. BioMedical Imaging Laboratory, Wright State University, Dayton, OH, USA

    Thomas N. Hangartner PhD

  6. Division of Pediatric Endocrinology, Diabetes, and Metabolism, Department of Pediatrics, Columbia University Medical Center, New York, NY, USA

    Sharon E. Oberfield MD

  7. Department of Radiology and Bioimaging, University of California at San Francisco, San Francisco, CA, USA

    John Shepherd PhD

  8. Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

    Babette S. Zemel PhD

  9. Department of Endocrinology, Nutrition, and Growth Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health, Bethesda, MD, USA

    Karen K. Winer MD

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  1. Joan Lappe PhD
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  9. Karen K. Winer MD
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Corresponding author

Correspondence to Joan Lappe PhD .

Editor information

Editors and Affiliations

  1. , Department of Internal Medicine, Hirslanden Clinic/Bois Cerf, Ave. d'Ouchy 31, Lausanne, 1006, Vaud, Switzerland

    Peter Burckhardt

  2. , Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, 02111, Massachusetts, USA

    Bess Dawson-Hughes

  3. , Nutrition and Science, Purdue University, W. State Street 700, West Lafayette, 47907-2059, Indiana, USA

    Connie M. Weaver

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Lappe, J. et al. (2013). The Relationship of Weight-Bearing Physical Activity and Dietary Calcium Intake with Bone Mass Accrual in the Bone Mineral Density in Childhood Study Cohort. In: Burckhardt, P., Dawson-Hughes, B., Weaver, C. (eds) Nutritional Influences on Bone Health. Springer, London. https://doi.org/10.1007/978-1-4471-2769-7_31

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  • DOI: https://doi.org/10.1007/978-1-4471-2769-7_31

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  • Publisher Name: Springer, London

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