Physical activity during life course and bone mass: a systematic review of methods and findings from cohort studies with young adults

Abstract

BackgroundThe purpose of this paper was to review the literature of the cohort studies which evaluated the association between physical activity during the life course and bone mineral content or density in young adults.MethodsProspective cohort studies with bone mineral density or content measured in the whole body, lumbar spine and femoral neck by dual energy x-ray absorptiometry as outcome and physical activity as exposure were searched. Two independent reviewers selected studies retrieved from electronic databases (Medline, Lilacs, Web of Science and Scielo) and reviewed references of all selected full text articles. Downs & Black criterion was used in the quality assessment of these studies.ResultsNineteen manuscripts met inclusion criteria. Lumbar spine was the skeletal site most studied (n = 15). Different questionnaires were used for physical activity evaluation. Peak strain score was also used to evaluate physical activity in 5 manuscripts. Lack of statistical power calculation was the main problem found in the quality assessment. Positive associations between physical activity and bone mass were found more in males than in females; in weight bearing anatomical sites (lumbar spine and femoral neck) than in total body and when physical activity measurements were done from adolescence to adulthood – than when evaluated in only one period. Physical activity during growth period was associated with greater bone mass in males. It was not possible to conduct pooled analyses due to the heterogeneity of the studies, considering mainly the different instruments used for physical activity measurements.ConclusionsPhysical activity seems to be important for bone mass in all periods of life, but especially the growth period should be taking into account due to its important direct effect on bone mass and its influence in physical activity practice in later life. Low participation in peak strain activities may also explain the lower number of associations found in females.

The Tromsø Study: Fit Futures: a study of Norwegian adolescents’ lifestyle and bone health

“…A review from Bieleman et al [40] indicated that more studies have found positive associations between physical activity and bone mass in males than in females at weight bearing anatomical sites, and that low participation in peak strain activities may explain the weaker associations found in females. In our study both boys and girls that reported hard training had more than 1 SD higher BMD at the femoral sites, compared to those who were sedentary.…”

“…Despite the lack of evidence of effect of physical activity during adolescence on later fracture risk, it is important to take into account its influence of physical activity practice in later life [40].…”

Peak-bone-mass development in young adults: effects of study program related levels of occupational and leisure time physical activity and exercise. A prospective 5-year study

“…Physical activity and exercise during childhood and adolescence enhance peak bone mass (PBM) [1][2][3] and may thus reduce the risk of osteoporosis and osteoporosis-related fractures in later life [4][5][6]. Since the most prominent bone mineral accrual occurs during the period of accelerated growth, the potential of exercise to further maximize bone accrual may be exceptionally high during this period [1,7].…”

Effects of Pilates-Interventional Program on Calcaneus-Bone Density Parameters of Adult Women

“…Physical exercise in youth and adolescence positively affects the bone mass increase (Bielemann et al, 2013), while training in adulthood may maintain the bone mass and mechanical competence (Ahola et al, 2009). Similarly, exercise potentially prevents illness such as osteoporosis and bone fractures in women (Ahola et al) because of decrease of bone loss in aging process (Karlsson et al; Rasic & Tasic) and transformation of skeleton through increase of peak bone mineral density (Ahola et al;Karlsson et al;McKay et al, 2000).…”