Associations between Physical Activity, Sunshine Duration and Osteoporosis According to Obesity and Other Lifestyle Factors: A Nested Case–Control Study

Abstract

(1) Background: The purpose of the study was to evaluate the associations between physical activity (PA), sunshine duration (SD) and the occurrence of osteoporosis according to lifestyle status. (2) Methods: Data from the Korean National Health Insurance Service–National Sample Cohort (NHIS-NSC) collected from 2009 to 2015 were used. Osteoporosis (n = 19,351) and control (n = 38,702) participants were matched in a 1:2 ratio according to age, sex, income, and region of residence. PA was classified as moderate- to high-intensity PA (MHPA) or low-intensity PA (LPA) based on the International Physical Activity Questionnaire (IPAQ). SD was classified as short (≤6 h) or long (>6 h). Conditional logistic regression was used to calculate the odds ratios (ORs) with 95% confidence intervals (CIs) of MHPA and long SD for the occurrence of osteoporosis. Subgroup analyses were performed according to SD (or PA), obesity, smoking, and alcohol consumption. (3) The adjusted OR of MHPA for osteoporosis was 0.90 (95% CI = 0.87–0.94). The results were consistent in the age/sex, SD, obesity, smoking, and alcohol consumption subgroups, but not the <60-year-old male and underweight subgroups. The adjusted OR of long SD for osteoporosis was 0.96 (95% CI = 0.93–1.00). The findings were consistent in the <60-year-old female, obese, nonsmoker, and <1 time a week alcohol consumption subgroups. (4) Conclusions: We suggest that both higher intensity of PA and long SD could decrease the risk of osteoporosis. Specifically, PA could decrease the risk of osteoporosis in individuals with most characteristics except male sex or underweight. Long SD could decrease the risk of osteoporosis in young females, obese individuals, nonsmokers, and individuals with lower alcohol consumption.

Physical Activity, Sunshine Duration, and Osteoporotic Fractures: A Nested Case-Control Study

“…Our previous study, which used the same national cohort data and meteorological data as our present study, found that a long sunshine duration (SD) and higher intensity PA were associated with a lower occurrence of osteoporosis [17]. A study using national cohort data from Korea also reported that PA was associated with low fracture risk regardless of the type of PA and site of fracture [18].…”

“…Because the PA information was different from 2002 to 2008, those participants and participants without PA records were removed (n = 33,337 in the osteoporotic fractures group; n = 57,788 in the control group). In the osteoporotic fractures group, participants who did not undergo the BMD test before the first fracture diagnosis (index date) were excluded (n = 10,875; claim codes were described elsewhere [17]). In the control group, participants who did not undergo the BMD test from 2002 to 2015 were excluded (n = 277,717).…”

“…In the control group, participants who did not undergo the BMD test from 2002 to 2015 were excluded (n = 277,717). The matching method that was previously used in our studies was conducted [17,20]. The total fracture group and control group were matched in 1:2 ratios by age, sex, income, and region of residence.…”

“…We used PA information from the first record of health screening. PA was classified as our previous study [17]. Specifically, 'moderate-to high-intensity PA (High PA)' was defined as walking ≥5 days in ≥30 min at a time, performing a moderateintensity activity ≥5 days in ≥30 min at a time, performing a vigorous-intensity activity ≥3 days in ≥20 min at a time, or any combination of walking, moderate-intensity activity, or vigorous-intensity activity ≥5 days with ≥600 metabolic equivalent (MET)-min/week based on the IPAQ.…”

Osteoporosis in COPD patients: Risk factors and pulmonary rehabilitation

“…On the one hand, excessive use or abuse of alcohol, 15,79–82 caffeine, 83,84 and carbonated drinks 83 should be avoided, which are harmful for both health people and patients with osteoporosis. On the other hand, any form of nicotine should be discouraged 85,86 .…”