Association of objectively measured physical activity and bone health in children and adolescents:​ a systematic review and narrative synthesis

Bland, V. L.<sup>1</sup>; Heatherington-Rauth, M.<sup>2</sup>; Howe, C.<sup>3</sup>; Going, S. B.<sup>1</sup>; Bea, J. W.<sup>1,4</sup>

Affiliations

¹Department of Nutritional Sciences, University of Arizona, Tucson, USA

²Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Portugal

³University of Arizona Health Sciences Library, University of Arizona, Tucson, USA

⁴University of Arizona Cancer Center, Tucson, USA

Abstract and keywords

The influence of day-to-day physical activity on bone in adolescence has not been well characterized. Forty articles were identified that assessed the relationship between accelerometry-derived physical activity and bone outcomes in adolescents. Physical activity was positively associated with bone strength in peri-pubertal males, with less consistent evidence in females. Physical activity (PA) is recommended to optimize bone development in childhood and adolescence; however, the influence of day-to-day PA on bone development is not well defined. The aim of this review was to describe the current evidence for objectively measured PA on bone outcomes in healthy children and adolescents. MEDLINE, Embase, Cochrane Library, Scopus, Web of Science, CINAHL, PsycInfo, and ClinicalTrials.gov were searched for relevant articles up to April 2020. Studies assessing the relationship between accelerometry-derived PA and bone outcomes in adolescents (6–18 years old) were included. Two reviewers independently screened studies for eligibility, extracted data, and rated study quality. Forty articles met inclusion criteria (25 cross-sectional, 15 longitudinal). There was significant heterogeneity in accelerometry methodology and bone outcomes measured. Studies in males indicated a significant, positive relationship between moderate to vigorous PA (MVPA) and bone outcomes at the hip and femur, particularly during the peri-pubertal years. The results for MVPA and bone outcomes in females were mixed. There was a paucity of longitudinal studies using pQCT and a lack of data regarding how light PA and/or impact activity influences bone outcomes. The current evidence suggests that objectively measured MVPA is positively associated with bone outcomes in children and adolescents, especially in males. However, inconsistencies in methodology make it difficult to determine the amount and type of PA that leads to favorable bone outcomes. Given that the majority of research has been conducted in Caucasian adolescents, further research is needed in minority populations.

Keywords: Accelerometry; Adolescents; Bone; Child; Exercise

Links

DOI: 10.1007/s00198-020-05485-y

PubMed: 32542544

WoS: 000540391100001

History

Received: 2020-03-04

Accepted: 2020-06-01

Online: 2020-06-16

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Cited By (2)

Year	Entry
2023	Tan J, Ng C-A, Hart NH, Rantalainen T, Sim M, Scott D, Zhu K, Hands B, Chivers P. Reduced peak bone mass in young adults with low motor competence. J Bone Miner Res. May 2023;38(5):665-677.
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