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

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Abstract

Summary

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.

Introduction

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.

Methods

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.

Results

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).

Conclusions

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.

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References

  1. Ferrari SL (2005) Osteoporosis: a complex disorder of aging with multiple genetic and environmental determinants. Nutr Fit Ment Health, Aging, Implement Healthy Diet Phys Act Lifestyle 95:35–51

    Article  CAS  Google Scholar 

  2. Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733

    Article  PubMed  CAS  Google Scholar 

  3. Baroncelli GI, Bertelloni S, Sodini F, Saggese G (2005) Osteoporosis in children and adolescents: etiology and management. Paediatr Drugs 7:295–323

    Article  PubMed  Google Scholar 

  4. Rizzoli R, Bianchi ML, Garabedian M, McKay HA, Moreno LA (2010) Maximizing bone mineral mass gain during growth for the prevention of fractures in the adolescents and the elderly. Bone 46:294–305

    Article  PubMed  Google Scholar 

  5. Vicente-Rodriguez G, Ezquerra J, Mesana MI, Fernandez-Alvira JM, Rey-Lopez JP, Casajus JA, Moreno LA (2008) Independent and combined effect of nutrition and exercise on bone mass development. J Bone Miner Metab 26:416–424

    Article  PubMed  Google Scholar 

  6. Chan GM (1991) Dietary calcium and bone-mineral status of children and adolescents. Am J Dis Child 145:631–634

    PubMed  CAS  Google Scholar 

  7. Holick MF (2004) Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr 80:1678S–1688S

    PubMed  CAS  Google Scholar 

  8. Gordon CM, DePeter KC, Feldman HA, Grace E, Emans SJ (2004) Prevalence of vitamin D deficiency among healthy adolescents. Arch Pediatr Adolesc Med 158:531–537

    Article  PubMed  Google Scholar 

  9. Cashman KD (2002) Calcium intake, calcium bioavailability and bone health. Br J Nutr 87:S169–S177

    Article  PubMed  CAS  Google Scholar 

  10. Zerwekh JE (2008) Blood biomarkers of vitamin D status. Am J Clin Nutr 87:1087s–1091s

    PubMed  CAS  Google Scholar 

  11. Valtueña J, Breidenassel C, Folle J, Gonzalez-Gross M (2011) Retinol, beta-carotene, alpha-tocopherol and vitamin D status in European adolescents; regional differences an variability: a review. Nutr Hosp 26:280–288

    PubMed  Google Scholar 

  12. Gonzalez-Gross M, Valtuena J, Breidenassel C, Moreno LA, Ferrari M, Kersting M, De Henauw S, Gottrand F, Azzini E, Widhalm K, Kafatos A, Manios Y, Stehle P (2011) Vitamin D status among adolescents in Europe: the healthy lifestyle in Europe by nutrition in adolescence study. Br J Nutr 1–10 (in press)

  13. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes FaNB, Institute of Medicine (2011) Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D and fluoride. National Academy Press, Washington

    Google Scholar 

  14. Cranney A, Weiler HA, O’Donnell S, Puil L (2008) Summary of evidence-based review on vitamin D efficacy and safety in relation to bone health. Am J Clin Nutr 88:513S–519S

    PubMed  CAS  Google Scholar 

  15. Gracia-Marco LV-RG, Casajus JA, Molnar D, Castillo MJ, Moreno LA (2011) Effect of fitness and physical activity on bone mass in adolescents: the HELENA Study. Eur J Appl Physiol 11:2671–2680

    Article  Google Scholar 

  16. Calbet JAL, Vicente-Rodriguez G, Jimenez-Ramirez J, Ara I, Serrano-Sanchez JA, Dorado C (2003) Enhanced bone mass and physical fitness in prepubescent footballers. Bone 33:853–859

    Article  PubMed  Google Scholar 

  17. Gracia-Marco L, Moreno LA, Ortega FB, Leon F, Sioen I, Kafatos A, Martinez-Gomez D, Widhalm K, Castillo MJ, Vicente-Rodriguez G, Grp HS (2011) Levels of physical activity that predict optimal bone mass in adolescents: the HELENA Study. Am J Prev Med 40:599–607

    Article  PubMed  Google Scholar 

  18. Moreno LA, Gonzalez-Gross M, Kersting M, Molnar D, de Henauw S, Beghin L, Sjostrom M, Hagstromer M, Manios Y, Gilbert CC, Ortega FB, Dallongeville J, Arcella D, Warnberg J, Hallberg M, Fredriksson H, Maes L, Widhalm K, Kafatos AG, Marcos A (2008) Assessing, understanding and modifying nutritional status, eating habits and physical activity in European adolescents: the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study. Public Health Nutr 11:288–299

    Article  PubMed  CAS  Google Scholar 

  19. Moreno LA, De Henauw S, Gonzalez-Gross M, Kersting M, Molnar D, Gottrand F, Barrios L, Sjostrom M, Manios Y, Gilbert CC, Leclercq C, Widhalm K, Kafatos A, Marcos A (2008) Design and implementation of the Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study. Int J Obes (Lond) 32(Suppl 5):S4–11

    Article  Google Scholar 

  20. Beghin L, Castera M, Manios Y, Gilbert CC, Kersting M, De Henauw S, Kafatos A, Gottrand F, Molnar D, Sjostrom M, Leclercq C, Widhalm K, Mesana MI, Moreno LA, Libersa C (2008) Quality assurance of ethical issues and regulatory aspects relating to good clinical practices in the HELENA cross-sectional study. Int J Obes (Lond) 32(Suppl 5):S12–18

    Article  Google Scholar 

  21. Nagy E, Vicente-Rodriguez G, Manios Y, Beghin L, Iliescu C, Censi L, Dietrich S, Ortega FB, De Vriendt T, Plada M, Moreno LA, Molnar D (2008) Harmonization process and reliability assessment of anthropometric measurements in a multicenter study in adolescents. Int J Obes (Lond) 32(Suppl 5):S58–65

    Article  Google Scholar 

  22. Tanner JM, Whitehouse RH (1976) Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty. Arch Dis Child 51:170–179

    Article  PubMed  CAS  Google Scholar 

  23. Calbet JA, Dorado C, Diaz-Herrera P, Rodriguez-Rodriguez LP (2001) High femoral bone mineral content and density in male football (soccer) players. Med Sci Sports Exerc 33:1682–1687

    Article  PubMed  CAS  Google Scholar 

  24. Gracia-Marco L, Vicente-Rodriguez G, Valtuena J, Rey-Lopez JP, Diaz Martinez AE, Mesana MI, Widhalm K, Ruiz JR, Gonzalez-Gross M, Castillo MJ, Moreno LA (2010) Bone mass and bone metabolism markers during adolescence: the HELENA Study. Horm Res Paediatr 74:339–350

    Article  PubMed  CAS  Google Scholar 

  25. Vereecken CA, Covents M, Sichert-Hellert W, Alvira JM, Le Donne C, De Henauw S, De Vriendt T, Phillipp MK, Beghin L, Manios Y, Hallstrom L, Poortvliet E, Matthys C, Plada M, Nagy E, Moreno LA (2008) Development and evaluation of a self-administered computerized 24-h dietary recall method for adolescents in Europe. Int J Obes (Lond) 32(Suppl 5):S26–34

    Article  Google Scholar 

  26. Haubrock J, Nothlings U, Volatier JL, Dekkers A, Ocke M, Harttig U, Illner AK, Knuppel S, Andersen LF, Boeing H (2011) Estimating usual food intake distributions by using the multiple source method in the EPIC-potsdam calibration study. J Nutr 141:914–920

    Article  PubMed  CAS  Google Scholar 

  27. Ekelund U, Anderssen SA, Froberg K, Sardinha LB, Andersen LB, Brage S (2007) Independent associations of physical activity and cardiorespiratory fitness with metabolic risk factors in children: the European youth heart study. Diabetologia 50:1832–1840

    Article  PubMed  CAS  Google Scholar 

  28. Strong WB, Malina RM, Blimkie CJ, Daniels SR, Dishman RK, Gutin B, Hergenroeder AC, Must A, Nixon PA, Pivarnik JM, Rowland T, Trost S, Trudeau F (2005) Evidence based physical activity for school-age youth. J Pediatr 146:732–737

    Article  PubMed  Google Scholar 

  29. Ortega FB, Artero EG, Ruiz JR, Espana-Romero V, Jimenez-Pavon D, Vicente-Rodriguez G, Moreno LA, Manios Y, Beghin L, Ottevaere C, Ciarapica D, Sarri K, Dietrich S, Blair SN, Kersting M, Molnar D, Gonzalez-Gross M, Gutierrez A, Sjostrom M, Castillo MJ, Grp HS (2011) Physical fitness levels among European adolescents: the HELENA study. Br J Sports Med 45:20–29

    Article  PubMed  CAS  Google Scholar 

  30. Ortega FB, Artero EG, Ruiz JR, Vicente-Rodriguez G, Bergman P, Hagstromer M, Ottevaere C, Nagy E, Konsta O, Rey-Lopez JP, Polito A, Dietrich S, Plada M, Beghin L, Manios Y, Sjostrom M, Castillo MJ (2008) Reliability of health-related physical fitness tests in European adolescents. The HELENA Study. Int J Obes (Lond) 32(Suppl 5):S49–57

    Article  Google Scholar 

  31. Gonzalez-Gross M, Breidenassel C, Gomez-Martinez S, Ferrari M, Beghin L, Spinneker A, Diaz LE, Maiani G, Demailly A, Al-Tahan J, Albers U, Warnberg J, Stoffel-Wagner B, Jimenez-Pavon D, Libersa C, Pietrzik K, Marcos A, Stehle P (2008) Sampling and processing of fresh blood samples within a European multicenter nutritional study: evaluation of biomarker stability during transport and storage. Int J Obes (Lond) 32(Suppl 5):S66–75

    Article  CAS  Google Scholar 

  32. Racinais S, Hamilton B, Li CK, Grantham J (2010) Vitamin D and physical fitness in Qatari girls. Arch Dis Child 95:854–855

    Article  PubMed  CAS  Google Scholar 

  33. Lehtonen-Veromaa MKMT, Nuotio IO, Irjala KM, Leino AE, Viikari JS (2002) Vitamin D and attainment of peak bone mass among peripubertal Finnish girls: a 3-y prospective study. Am J Clin Nutr 76:8

    Google Scholar 

  34. Outila TA, Karkkainen MU, Lamberg-Allardt CJ (2001) Vitamin D status affects serum parathyroid hormone concentrations during winter in female adolescents: associations with forearm bone mineral density. Am J Clin Nutr 74:206–210

    PubMed  CAS  Google Scholar 

  35. LeBoff MS, Kohlmeier L, Hurwitz S, Franklin J, Wright J, Glowacki J (1999) Occult vitamin D deficiency in postmenopausal US women with acute hip fracture. JAMA 281:1505–1511

    Article  PubMed  CAS  Google Scholar 

  36. Greene DA, Naughton GA, Briody JN, Kemp A, Woodhead H, Corrigan L (2005) Bone strength index in adolescent girls: does physical activity make a difference? Br J Sports Med 39:622–627

    Article  PubMed  CAS  Google Scholar 

  37. Saggese G, Baroncelli GI, Bertelloni S (2002) Puberty and bone development. Best Pract Res Clin Endocrinol Metab 16:53–64

    Article  PubMed  CAS  Google Scholar 

  38. Vicente-Rodriguez G, Urzanqui A, Mesana MI, Ortega FB, Ruiz JR, Ezquerra J, Casajus JA, Blay G, Blay VA, Gonzalez-Gross M, Moreno LA (2008) Physical fitness effect on bone mass is mediated by the independent association between lean mass and bone mass through adolescence: a cross-sectional study. J Bone Miner Metab 26:288–294

    Article  PubMed  Google Scholar 

  39. Constantini NW, Dubnov-Raz G, Chodick G, Rozen GS, Giladi A, Ish-Shalom S (2010) Physical activity and bone mineral density in adolescents with vitamin D deficiency. Med Sci Sports Exerc 42:646–650

    PubMed  Google Scholar 

  40. Foo LH, Zhang Q, Zhu K, Ma G, Hu X, Greenfield H, Fraser DR (2009) Low vitamin D status has an adverse influence on bone mass, bone turnover, and muscle strength in Chinese adolescent girls. J Nutr 139:1002–1007

    Article  PubMed  CAS  Google Scholar 

  41. Okuno J, Tomura S, Yabushita N, Kim MJ, Okura T, Tanaka K, Yanagi H (2010) Effects of serum 25-hydroxyvitamin D(3) levels on physical fitness in community-dwelling frail women. Arch Gerontol Geriatr 50:121–126

    Article  PubMed  CAS  Google Scholar 

  42. Bartoszewska M, Kamboj M, Patel DR (2010) Vitamin D, muscle function, and exercise performance. Pediatr Clin North Am 57:849–861

    Article  PubMed  Google Scholar 

  43. Calbet JA, Moysi JS, Dorado C, Rodriguez LP (1998) Bone mineral content and density in professional tennis players. Calcif Tissue Int 62:491–496

    Article  PubMed  CAS  Google Scholar 

  44. Pfeifer M, Begerow B, Minne HW, Suppan K, Fahrleitner-Pammer A, Dobnig H (2009) Effects of a long-term vitamin D and calcium supplementation on falls and parameters of muscle function in community-dwelling older individuals. Osteoporos Int 20:315–322

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

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

None.

Author information

Authors and Affiliations

  1. Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences–INEF, Technical University of Madrid, C/ Martín Fierro, 7, 28040, Madrid, Spain

    J. Valtueña & M. González-Gross

  2. Department of Public Health, Ghent University, Ghent, Belgium

    J. Valtueña, I. Huybrechts & I. Sioen

  3. GENUD (Growth, Exercise, Nutrition and Development) Research Group, Zaragoza, Spain

    L. Gracia-Marco, G. Vicente-Rodríguez, J. P. Rey-López, T. Mouratidou, M. I. Mesana & L. A. Moreno

  4. School of Health Sciences (EUCS), University of Zaragoza, Zaragoza, Spain

    L. Gracia-Marco, G. Vicente-Rodríguez, J. P. Rey-López, T. Mouratidou, M. I. Mesana & L. A. Moreno

  5. Institut für Ernährungs-und Lebensmittelwissenschaften, Humanernährung, Rheinische Friedrich-Wilhelms Universität, Bonn, Germany

    M. González-Gross

  6. FWO, Research Foundation Flanders, Brussels, Belgium

    I. Sioen

  7. Clinical Laboratory, Sport Medicine Center, Consejo Superior de Deportes, Madrid, Spain

    A. E. Díaz Martínez

  8. Division of Clinical Nutrition and Prevention, Department of Pediatrics, Medical University of Vienna, Vienna, Austria

    K. Widhalm

Authors
  1. J. Valtueña
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  2. L. Gracia-Marco
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  3. G. Vicente-Rodríguez
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  4. M. González-Gross
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  5. I. Huybrechts
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  6. J. P. Rey-López
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  7. T. Mouratidou
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  8. I. Sioen
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  9. M. I. Mesana
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  10. A. E. Díaz Martínez
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  12. L. A. Moreno
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on behalf of the HELENA Study Group

Corresponding author

Correspondence to J. Valtueña.

Appendix

Appendix

The HELENA Study Group was composed of the following:

Co-ordinator: Luis A. Moreno

Core Group members: Luis A. Moreno, Fréderic Gottrand, Stefaan De Henauw, Marcela González-Gross, Chantal Gilbert.

Steering Committee: Anthony Kafatos (President), Luis A. Moreno, Christian Libersa, Stefaan De Henauw, Jackie Sáchez, Fréderic Gottrand, Mathilde Kesting, Michael Sjostrom, Dénes Molnár, Marcela González-Gross, Jean Dallongeville, Chantal Gilbert, Gunnar Hall, Lea Maes, Luca Scalfi.

Project Manager: Pilar Meléndez

  1. 1.

    Universidad de Zaragoza (Spain): Luis A. Moreno, Jesús Fleta, José A. Casajús, Gerardo Rodríguez, Concepción Tomás, María I. Mesana, Germán Vicente-Rodríguez, Adoración Villarroya, Carlos M. Gil, Ignacio Ara, Juan Revenga, Carmen Lachen, Juan Fernández Alvira, Gloria Bueno, Aurora Lázaro, Olga Bueno, Juan F. León, Jesús Ma Garagorri, Manuel Bueno, Juan Pablo Rey López, Iris Iglesia, Paula Velasco, Silvia Bel, Theodora Mouratidou.

  2. 2.

    Consejo Superior de Investigaciones Científicas (Spain): Ascensión Marcos, Julia Wärnberg, Esther Nova, Sonia Gómez, Esperanza Ligia Díaz, Javier Romeo, Ana Veses, Mari Angeles Puertollano, Belén Zapatera, Tamara Pozo.

  3. 3.

    Université de Lille 2 (France): Laurent Beghin, Christian Libersa, Frédéric Gottrand, Catalina Iliescu, Juliana Von Berlepsch.

  4. 4.

    Research Institute of Child Nutrition Dortmund, Rheinische Friedrich-Wilhelms-Universität Bonn (Germany): Mathilde Kersting, Wolfgang Sichert-Hellert, Ellen Koeppen.

  5. 5.

    Pécsi Tudományegyetem (University of Pécs) (Hungary): Dénes Molnar, Eva Erhardt, Katalin Csernus, Katalin Török, Szilvia Bokor, Mrs. Angster, Enikö Nagy, Orsolya Kovács, Judit Repásy.

  6. 6.

    University of Crete School of Medicine (Greece): Anthony Kafatos, Caroline Codrington, María Plada, Angeliki Papadaki, Katerina Sarri, Anna Viskadourou, Christos Hatzis, Michael Kiriakakis, George Tsibinos, Constantine Vardavas Manolis Sbokos, Eva Protoyeraki, Maria Fasoulaki.

  7. 7.

    Institut für Ernährungs-und Lebensmittelwissenschaften–Ernährungphysiologie. Rheinische Friedrich Wilhelms Universität (Germany): Peter Stehle, Klaus Pietrzik, Marcela González-Gross, Christina Breidenassel, Andre Spinneker, Jasmin Al-Tahan, Miriam Segoviano, Anke Berchtold, Christine Bierschbach, Erika Blatzheim, Adelheid Schuch, Petra Pickert.

  8. 8.

    University of Granada (Spain): Manuel J. Castillo, Ángel Gutiérrez, Francisco B. Ortega, Jonatan R. Ruiz, Enrique G. Artero, Vanesa España-Romero, David Jiménez-Pavón, Palma Chillón.

  9. 9.

    Istituto Nazionale di Ricerca per gli Alimenti e la Nutrizione (Italy): Davide Arcella, Elena Azzini, Emma Barrison, Noemi Bevilacqua, Pasquale Buonocore, Giovina Catasta, Laura Censi, Donatella Ciarapica, Paola D'Acapito, Marika Ferrari, Myriam Galfo, Cinzia Le Donne, Catherine Leclercq, Giuseppe Maiani, Beatrice Mauro, Lorenza Mistura, Antonella Pasquali, Raffaela Piccinelli, Angela Polito, Raffaella Spada, Stefania Sette, Maria Zaccaria.

  10. 10.

    University of Napoli ‘Federico II’ Dept of Food Science (Italy): Luca Scalfi, Paola Vitaglione, Concetta Montagnese.

  11. 11.

    Ghent University (Belgium): Ilse De Bourdeaudhuij, Stefaan De Henauw, Tineke De Vriendt, Lea Maes, Christophe Matthys, Carine Vereecken, Mieke de Maeyer, Charlene Ottevaere, Inge Huybrechts.

  12. 12.

    Medical University of Vienna (Austria): Kurt Widhalm, Katharina Phillipp, Sabine Dietrich.

  13. 13.

    Harokopio University (Greece): Yannis Manios, Eva Grammatikaki, Zoi Bouloubasi, Tina Louisa Cook, Sofia Eleutheriou, Orsalia Consta, George Moschonis, Ioanna Katsaroli, George Kraniou, Stalo Papoutsou, Despoina Keke, Ioanna Petraki, Elena Bellou, Sofia Tanagra, Kostalenia Kallianoti, Dionysia Argyropoulou, Katerina Kondaki, Stamatoula Tsikrika, Christos Karaiskos.

  14. 14.

    Institut Pasteur de Lille (France): Jean Dallongeville, Aline Meirhaeghe.

  15. 15.

    Karolinska Institutet (Sweden): Michael Sjöstrom, Patrick Bergman, María Hagströmer, Lena Hallström, Mårten Hallberg, Eric Poortvliet, Julia Wärnberg, Nico Rizzo, Linda Beckman, Anita Hurtig Wennlöf, Emma Patterson, Lydia Kwak, Lars Cernerud, Per Tillgren, Stefaan Sörensen.

  16. 16.

    Asociación de Investigación de la Industria Agroalimentaria (Spain): Jackie Sánchez-Molero, Elena Picó, Maite Navarro, Blanca Viadel, José Enrique Carreres, Gema Merino, Rosa Sanjuán, María Lorente, María José Sánchez, Sara Castelló.

  17. 17.

    Campden & Chorleywood Food Research Association (UK): Chantal Gilbert, Sarah Thomas, Elaine Allchurch, Peter Burguess.

  18. 18.

    SIK—Institutet foer Livsmedel och Bioteknik (Sweden): Gunnar Hall, Annika Astrom, Anna Sverkén, Agneta Broberg.

  19. 19.

    Meurice Recherche & Development asbl (Belgium): Annick Masson, Claire Lehoux, Pascal Brabant, Philippe Pate, Laurence Fontaine.

  20. 20.

    Campden & Chorleywood Food Development Institute (Hungary): Andras Sebok, Tunde Kuti, Adrienn Hegyi.

  21. 21.

    Productos Aditivos SA (Spain): Cristina Maldonado, Ana Llorente.

  22. 22.

    Cárnicas Serrano SL (Spain): Emilio García.

  23. 23.

    Cederroth International AB (Sweden): Holger von Fircks, Marianne Lilja Hallberg, Maria Messerer.

  24. 24.

    Lantmännen Food R&D (Sweden): Mats Larsson, Helena Fredriksson, Viola Adamsson, Ingmar Börjesson.

  25. 25.

    European Food Information Council (Belgium): Laura Fernández, Laura Smillie, Josephine Wills.

  26. 26.

    Universidad Politécnica de Madrid (Spain): Marcela González-Gross, Jara Valtueña, David Jiménez-Pavón, Ulrike Albers, Raquel Pedrero, Agustín Meléndez, Pedro J. Benito, Juan José Gómez Lorente, David Cañada, Alejandro Urzanqui, Juan Carlos Ortiz, Francisco Fuentes, Rosa María Torres, Paloma Navarro.

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Valtueña, J., Gracia-Marco, L., Vicente-Rodríguez, G. et al. Vitamin D status and physical activity interact to improve bone mass in adolescents. The HELENA Study. Osteoporos Int 23, 2227–2237 (2012). https://doi.org/10.1007/s00198-011-1884-7

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  • DOI: https://doi.org/10.1007/s00198-011-1884-7

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