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Leisure time physical activity in adulthood is positively associated with bone mineral density 22 years later. The Tromsø study

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Abstract

Although the positive association between physical activity and bone mineral density (BMD) is well established, few epidemiological studies have investigated the long-term associations between physical activity during adulthood and BMD later in life. The aim of this prospective, population-based study was to examine the association between leisure time physical activity in adulthood and areal BMD (aBMD) later in life. We examined 1,766 women and 1,451 men aged 20–54 years at baseline who were followed up 22 years later, as part of a population-based study in Norway. Leisure time physical activity was assessed by questionnaire at baseline and follow-up. aBMD was measured at the hip and forearm at follow-up, using X-ray absorptiometry. The association between aBMD and physical activity was analyzed using general linear models. We observed a positive linear trend in aBMD across physical activity levels in both women and men, after adjustments for baseline age, height, weight, and smoking status (P < 0.05). The relationship between aBMD and leisure time physical activity was consistent over different sites of the hip (total hip, femoral neck and trochanter area) and forearm (distal and ultradistal area). In a subsample of 2,436 men and women under 70 years of age, those who where sedentary at both baseline and follow-up (6%) had lower aBMD than those who were moderately active or active at both baseline and follow-up (71%) (P ≤ 0.01). This study suggests that leisure time physical activity in adulthood is associated with higher aBMD and reduced risk of osteoporosis later in life.

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Abbreviations

aBMD:

Areal bone mineral density

CI:

Confidence interval

DXA:

Dual-energy X-ray absorptiometry

MET:

Metabolic equivalent

OR:

Odds ratio

QCT:

Quantitative computed tomography

SD:

Standard deviation

SXA:

Single X-ray absorptiometry

References

  1. Cole ZA, Dennison EM, Cooper C. Osteoporosis epidemiology update. Curr Rheumatol Rep. 2008;10:92–6.

    Article  PubMed  Google Scholar 

  2. Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. Lancet. 2002;359:1761–7.

    Article  PubMed  Google Scholar 

  3. Karlsson MK, Nordqvist A, Karlsson C. Sustainability of exercise-induced increases in bone density and skeletal structure. Food Nutr Res. 2008; 52. doi:10.3402/fnr.v52i0.1872. Epub 2008 Oct 1.

  4. Barry DW, Kohrt WM. Exercise and the preservation of bone health. J Cardiopulm Rehabil Prev. 2008;28:153–62.

    PubMed  Google Scholar 

  5. Beck BR, Snow CM. Bone health across the lifespan—exercising our options. Exerc Sport Sci Rev. 2003;31:117–22.

    Article  PubMed  Google Scholar 

  6. Kohrt WM, Bloomfield SA, Little KD, Nelson ME, Yingling VR, American College of Sports M. American College of Sports Medicine Position Stand: physical activity and bone health. Med Sci Sports Exerc. 2004;36:1985–96.

    Article  PubMed  Google Scholar 

  7. WHO Scientific Group on the Prevention, Management of Osteoporosis. Prevention and management of osteoporosis: report of a WHO Scientific Group. Geneva: World Health Organization; 2003.

    Google Scholar 

  8. Delvaux K, Lefevre J, Philippaerts R, Dequeker J, Thomis M, Vanreusel B, et al. Bone mass and lifetime physical activity in Flemish males: a 27-year follow-up study. Med Sci Sports Exerc. 2001;33:1868–75.

    Article  CAS  PubMed  Google Scholar 

  9. Van Langendonck L, Lefevre J, Claessens AL, Thomis M, Philippaerts R, Delvaux K, et al. Influence of participation in high-impact sports during adolescence and adulthood on bone mineral density in middle-aged men: a 27-year follow-up study. Am J Epidemiol. 2003;158:525–33.

    Article  PubMed  Google Scholar 

  10. Barnekow-Bergkvist M, Hedberg G, Pettersson U, Lorentzon R. Relationships between physical activity and physical capacity in adolescent females and bone mass in adulthood. Scand J Med Sci Sports. 2006;16:447–55.

    Article  CAS  PubMed  Google Scholar 

  11. Foley S, Quinn S, Dwyer T, Venn A, Jones G. Measures of childhood fitness and body mass index are associated with bone mass in adulthood: a 20-year prospective study. J Bone Miner Res. 2008;23:994–1001.

    Article  PubMed  Google Scholar 

  12. Duppe H, Gardsell P, Johnell O, Ornstein E. Bone mineral density in female junior, senior and former football players. Osteoporos Int. 1996;6:437–41.

    Article  CAS  PubMed  Google Scholar 

  13. Etherington J, Harris PA, Nandra D, Hart DJ, Wolman RL, Doyle DV, et al. The effect of weight-bearing exercise on bone mineral density: a study of female ex-elite athletes and the general population. J Bone Miner Res. 1996;11:1333–8.

    Article  CAS  PubMed  Google Scholar 

  14. Greendale GA, Barrett-Connor E, Edelstein S, Ingles S, Haile R. Lifetime leisure exercise and osteoporosis. The Rancho Bernardo study. Am J Epidemiol. 1995;141:951–9.

    CAS  PubMed  Google Scholar 

  15. Ilich-Ernst J, Brownbill RA, Ludemann MA, Fu R. Critical factors for bone health in women across the age span: how important is muscle mass? Medscape Women’s Health. 2002;7:2.

    PubMed  Google Scholar 

  16. Karlsson MK, Hasserius R, Obrant KJ. Bone mineral density in athletes during and after career: a comparison between loaded and unloaded skeletal regions. Calcif Tissue Int. 1996;59:245–8.

    Article  CAS  PubMed  Google Scholar 

  17. Karlsson MK, Johnell O, Obrant KJ. Is bone mineral density advantage maintained long-term in previous weight lifters? Calcif Tissue Int. 1995;57:325–8.

    Article  PubMed  Google Scholar 

  18. Karlsson MK, Linden C, Karlsson C, Johnell O, Obrant K, Seeman E. Exercise during growth and bone mineral density and fractures in old age. Lancet. 2000;355:469–70.

    CAS  PubMed  Google Scholar 

  19. Kolbe-Alexander TL, Charlton KE, Lambert EV. Lifetime physical activity and determinants of estimated bone mineral density using calcaneal ultrasound in older South African adults. J Nutr Health Aging. 2004;8:521–30.

    CAS  PubMed  Google Scholar 

  20. Kriska AM, Sandler RB, Cauley JA, LaPorte RE, Hom DL, Pambianco G. The assessment of historical physical activity and its relation to adult bone parameters. Am J Epidemiol. 1988;127:1053–63.

    CAS  PubMed  Google Scholar 

  21. Lynch NA, Ryan AS, Evans J, Katzel LI, Goldberg AP. Older elite football players have reduced cardiac and osteoporosis risk factors. Med Sci Sports Exerc. 2007;39:1124–30.

    Article  PubMed  Google Scholar 

  22. Nilsson M, Ohlsson C, Eriksson AL, Frandin K, Karlsson M, Ljunggren O, et al. Competitive physical activity early in life is associated with bone mineral density in elderly Swedish men. Osteoporos Int. 2008;19:1557–66.

    Article  CAS  PubMed  Google Scholar 

  23. Rideout CA, McKay HA, Barr SI. Self-reported lifetime physical activity and areal bone mineral density in healthy postmenopausal women: the importance of teenage activity. Calcif Tissue Int. 2006;79:214–22.

    Article  CAS  PubMed  Google Scholar 

  24. Uzunca K, Birtane M, Durmus-Altun G, Ustun F. High bone mineral density in loaded skeletal regions of former professional football (soccer) players: what is the effect of time after active career? Br J Sports Med. 2005;39:154–7.

    Article  CAS  PubMed  Google Scholar 

  25. Wilsgaard T, Arnesen E. Body mass index and coronary heart disease risk score: the Tromsø study, 1979 to 2001. Ann Epidemiol. 2007;17:100–5.

    Article  PubMed  Google Scholar 

  26. Graff-Iversen S, Anderssen SA, Holme IM, Jenum AK, Raastad T. Two short questionnaires on leisure-time physical activity compared with serum lipids, anthropometric measurements and aerobic power in a suburban population from Oslo, Norway. Eur J Epidemiol. 2008;23:167–74.

    Article  PubMed  Google Scholar 

  27. Løchen ML, Rasmussen K. The Tromsø study: physical fitness, self reported physical activity, and their relationship to other coronary risk factors. J Epidemiol Community Health. 1992;46(2):103–7.

    Article  PubMed  Google Scholar 

  28. Wilhelmsen L, Tibblin G, Aurell M, Bjure J, Ekstrom-Jodal B, Grimby G. Physical activity, physical fitness and risk of myocardial infarction. Adv Cardiol. 1976;18:217–30.

    CAS  PubMed  Google Scholar 

  29. Aadahl M, Kjær M, Jørgensen T. Associations between overall physical activity level and cardiovascular risk factors in an adult population. Eur J Epidemiol. 2007;22:369–78.

    Article  PubMed  Google Scholar 

  30. Emaus N, Omsland TK, Ahmed LA, Grimnes G, Sneve M, Berntsen GK. Bone mineral density at the hip in Norwegian women and men—prevalence of osteoporosis depends on chosen references: the Tromsø Study. Eur J Epidemiol. 2009;24:321–8.

    Article  PubMed  Google Scholar 

  31. Emaus N, Berntsen GK, Joakimsen R, Fønnebø V. Bone mineral density measures in longitudinal studies: the choice of phantom is crucial for quality assessment. The Tromsø study, a population-based study. Osteoporos Int. 2005;16:1597–603.

    Article  PubMed  Google Scholar 

  32. Omsland TK, Emaus N, Gjesdal CG, Falch JA, Tell GS, Forsen L, et al. In vivo and in vitro comparison of densitometers in the NOREPOS study. J Clin Densitom. 2008;11:276–82.

    Article  PubMed  Google Scholar 

  33. Bønaa KH, Thelle DS. Association between blood pressure and serum lipids in a population. The Tromsø study. Circulation. 1991;83:1305–14.

    PubMed  Google Scholar 

  34. Brownbill RA, Lindsey C, Crncevic-Orlic Z, Ilich JZ. Dual hip bone mineral density in postmenopausal women: geometry and effect of physical activity. Calcif Tissue Int. 2003;73:217–24.

    Article  CAS  PubMed  Google Scholar 

  35. Cummings SR, Black DM, Nevitt MC, Browner W, Cauley J, Ensrud K, et al. Bone density at various sites for prediction of hip fractures. The Study of Osteoporotic Fractures Research Group. Lancet. 1993;341:72–5.

    Article  CAS  PubMed  Google Scholar 

  36. Johnell O, Kanis JA, Jonsson B, Oden A, Johansson H, De Laet C. The burden of hospitalised fractures in Sweden. Osteoporos Int. 2005;16:222–8.

    Article  CAS  PubMed  Google Scholar 

  37. Marshall D, Johnell O, Wedel H. Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ. 1996;312:1254–9.

    CAS  PubMed  Google Scholar 

  38. Kanis JA, Johnell O, Oden A, Johansson H, Eisman JA, Fujiwara S, et al. The use of multiple sites for the diagnosis of osteoporosis. Osteoporos Int. 2006;17:527–34.

    Article  CAS  PubMed  Google Scholar 

  39. Daly RM, Bass SL. Lifetime sport and leisure activity participation is associated with greater bone size, quality and strength in older men. Osteoporos Int. 2006;17:1258–67.

    Article  CAS  PubMed  Google Scholar 

  40. Uusi-Rasi K, Kannus P, Cheng S, Sievanen H, Pasanen M, Heinonen A, et al. Effect of alendronate and exercise on bone and physical performance of postmenopausal women: a randomized controlled trial. Bone. 2003;33:132–43.

    Article  CAS  PubMed  Google Scholar 

  41. Jacobsen BK, Thelle DS. The Tromsø Heart Study: responders and non-responders to a health questionnaire, do they differ? Scand J Soc Med. 1988;16:101–4.

    CAS  PubMed  Google Scholar 

  42. Saltin B, Grimby G. Physiological analysis of middle-aged and old former athletes. Comparison with still active athletes of the same ages. Circulation. 1968;38:1104–15.

    CAS  PubMed  Google Scholar 

  43. Lee IM. Epidemiologic methods in physical activity studies. Oxford: Oxford University Pres; 2009.

    Google Scholar 

  44. Anderssen SA, Strømme SB. Physical activity and health—recommendations. Tidsskr Nor Laegeforen. 2001;121:2037–41.

    CAS  PubMed  Google Scholar 

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Acknowledgments

This work was funded by the Research Council of Norway.

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Authors and Affiliations

  1. Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, 9037, Tromsø, Norway

    Bente Morseth, Nina Emaus, Tom Wilsgaard, Bjarne K. Jacobsen & Lone Jørgensen

  2. Department of Health and Care Sciences, University of Tromsø, Tromsø, Norway

    Lone Jørgensen

  3. Department of Clinical Therapeutic Services, University Hospital of Northern Norway, Tromsø, Norway

    Lone Jørgensen

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  1. Bente Morseth
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  2. Nina Emaus
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  4. Bjarne K. Jacobsen
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Correspondence to Bente Morseth.

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Morseth, B., Emaus, N., Wilsgaard, T. et al. Leisure time physical activity in adulthood is positively associated with bone mineral density 22 years later. The Tromsø study. Eur J Epidemiol 25, 325–331 (2010). https://doi.org/10.1007/s10654-010-9450-8

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  • DOI: https://doi.org/10.1007/s10654-010-9450-8

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