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Bone mass and physical activity
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Abstract

Weak and osteoporotic bones in old age are an increasing cause of mortality and painful physical impairment of the elderly, especially in the western world. Bone mineral accrual during childhood and adolescence is thought to play a vital role in preventing osteoporosis. Identifying and optimizing the factors influencing peak bone mass is thus important for the prevention of osteoporosis and related fractures.

A main aim of this thesis was to investigate the potential effects of various types of weight-bearing physical activity on bone accretion in young males just out of puberty. The results from our subgroups of athletes consisting of badminton, ice hockey, and soccer players suggest that weight-bearing physical activity gives rise to regional specific bone response that is determined by the degree of impact of the activity in areas subject to mechanical loading (papers I–IV). In summary, the bone is sensitive to loading after puberty in males, and important bone mass gains can be achieved by proper amount and type of exercise.

Another aim of this thesis was to studythe effect of detraining on weight-bearing and non-weight-bearing bone in a cohort of adolescent males who participated in ice hockey and soccer training. Our results indicate that exercise-induced bone mineral density benefits decline, predominantly in weight-bearing bones, after retirement from an active sports career (papers II–IV). High bone density stemming from physical loading might be at least partly preserved even by reduced physical activity at nonweight-bearing sites after about three years of reduced activity (III, IV).

A final aim was to follow prospectively the development of BMD during years of reduced activity in former male athletes, and evaluate whether exercise during adolescence could be associated with fewer fractures in old age. We found fewer fragility fractures in a cohort of 400 former athletes compared to in 800 age-matched controls. Thus, high bone density stemming from previous weight-bearing physical activity may reduce the risk of sustaining fragility fractures in the elderly.

Key words: physical activity, peak bone mineral density, males.

Place, publisher, year, edition, pages
2004. , 50 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 881
Keyword [en]
Medicine, physical activity, peak bone mineral density, males, fractures
Keyword [sv]
Medicin
National Category
Dermatology and Venereal Diseases
Research subject
Medicine
Identifiers
URN: urn:nbn:se:umu:diva-224ISBN: 91-7305-618-9 (print)OAI: oai:DiVA.org:umu-224DiVA: diva2:142726
Public defence
2004-04-23, Sal 9B, 9 tr, Tandläkarhögskolan, Norrlands Universitets Sjukhus, 901 85, Umeå, 13:00 (English)
Opponent
Supervisors
Available from: 2004-03-31 Created: 2004-03-31 Last updated: 2010-08-10Bibliographically approved
List of papers
1. A 3-year longitudinal study of the effect of physical activity on the accrual of bone mineral density in healthy adolescent males.
Open this publication in new window or tab >>A 3-year longitudinal study of the effect of physical activity on the accrual of bone mineral density in healthy adolescent males.
2003 (English)In: Calcified Tissue International, ISSN 0171-967X, E-ISSN 1432-0827, Vol. 73, no 2, 108-114 p.Article in journal (Refereed) Published
Abstract [en]

It has previously been suggested that physical activity predominantly influences the accumulation of bone density before puberty. The purpose of the present study was to examine the effect of physical activity on the accumulation of bone mass in male athletes between 16 and 19 years of age. The cohort studied consisted of 12 badminton players (aged 16.1 +/- 0.5), 20 ice hockey players (aged 16.1 +/- 0.5), and 24 age-matched controls (aged 16.1 +/- 0.6). The bone mineral density (BMD, g/cm2) of the total body, spine, dominant and nondominant humerus, head and femoral neck was measured twice with a 3-year interval by dual energy X-ray absorptiometry (DXA). In addition, at the femoral neck, volumetric bone mineral density (vBMD, mg/cm3) was estimated. At baseline, the athletes as a whole group had significantly higher BMD at the total body (P = 0.03), dominant (P = 0.006) and nondominant humerus (P = 0.009) and femoral neck (P = 0.007) compared to the controls. At the 3-year followup, the athletes had significantly higher BMD at all sites (total body; P = 0.003, spine; P = 0.02, dominant humerus; P = 0.001, nondominant humerus; P = < 0.001, femoral neck; P = 0.001) except for the head (P = 0.91) compared with controls. The athletes also had higher vBMD at the femoral neck compared with the controls (P = 0.01). Furthermore, to be an athlete was found to be independently associated with a higher increase in nondominant humerus BMD (beta = 0.24; P < 0.05) and femoral neck BMD (beta = 0.30; P < 0.05) compared with the controls, during the study period. In summary, these results suggests that it is possible to achieve continuous gains in bone mass in sites exposed to osteogenic stimulation after puberty in males by engaging in weight-bearing physical activity.

Keyword
Bone mineral density, Peak bone mass, Boys, physical activity
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-3840 (URN)10.1007/s00223-002-2026-1 (DOI)14565591 (PubMedID)
Available from: 2004-03-31 Created: 2004-03-31 Last updated: 2010-08-10Bibliographically approved
2. Rapid loss of bone mineral density of the femoral neck after cessation of ice hockey training: a 6-year longitudinal study in males.
Open this publication in new window or tab >>Rapid loss of bone mineral density of the femoral neck after cessation of ice hockey training: a 6-year longitudinal study in males.
2003 (English)In: Journal of Bone and Mineral Research, ISSN 0884-0431, E-ISSN 1523-4681, Vol. 18, no 11, 1964-1969 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to evaluate the effect of training and reduced training on BMD in young ice hockey players during 6 years of follow-up. We found BMD gains in the femoral neck in the ice hockey group compared with controls. However, these gains were lost with reduced activity after cessation of career. INTRODUCTION: It has been suggested that increasing bone mass by intense physical activity during childhood and adolescence may decrease the risk of osteoporosis later in life. MATERIALS AND METHODS: In this longitudinal study, 43 ice hockey players (16.7 +/- 0.6 years) and 25 control subjects (16.8 +/- 0.3 years) were studied at baseline and after a mean period of 30 and 70 months. The groups did not differ in weight or height. Bone mineral density (BMD; g/cm2) was measured for total body, femoral neck, and spine using DXA. Volumetric BMD (vBMD; mg/cm3) of the femoral neck was estimated. RESULTS: The ice hockey players were found to have gained significantly more femoral neck BMD than controls (0.07 versus 0.03 g/cm2, p = 0.04) and to have gained femoral neck vBMD, whereas the controls did not (16 versus 0 mg/cm3, p = 0.049) between baseline and the first follow-up. At the first follow-up, the ice hockey players were found to have significantly higher BMD at the femoral neck and total body versus controls (p < 0.05). Between the first and second follow-ups, 21 ice hockey players stopped their active sports career. During this time period, these subjects lost significantly more femoral neck BMD (0.10 versus 0.02 g/cm2, p < 0.001) and femoral neck vBMD (38 versus 4 mg/cm3, p < 0.001) compared with the 22 ice hockey players who continued training. The former ice hockey players also lost significantly more neck vBMD (38 versus 14 mg/cm3, p = 0.009) compared with the controls during the same period. At the second follow-up, only the 22 ice hockey players who had continued their training were found to have significantly higher BMD at the femoral neck (p = 0.01), total body (p = 0.04), and spine (p = 0.02) compared with the controls. The former athletes were found to have intermediate BMD at all sites. CONCLUSION: In summary, we have demonstrated fast BMD loss at the femoral neck after decreased physical activity in young men. We conclude that ice hockey training during childhood and adolescence may not prevent the development of osteoporosis of the femoral neck later in life if the activity is not maintained.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-3841 (URN)10.1359/jbmr.2003.18.11.1964 (DOI)14606508 (PubMedID)
Available from: 2004-03-31 Created: 2004-03-31 Last updated: 2010-08-10Bibliographically approved
3. Bone gained from physical activity and lost through detraining: a longitudinal study in young males.
Open this publication in new window or tab >>Bone gained from physical activity and lost through detraining: a longitudinal study in young males.
2005 (English)In: Osteoporosis International, ISSN 0937-941X, E-ISSN 1433-2965, Vol. 16, no 7, 835-841 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to investigate the effect of training and detraining on bone mineral density of both weight-bearing and non-weight-bearing bone in a cohort of young males who participated in ice hockey training. Forty-three healthy adolescent ice hockey players (16.7+/-0.6 years) training for a mean of 9.7+/-2.4 h/week and 25 control subjects (16.8+/-0.3 years) training for 2.1+/-2.7 h/week, were included in this longitudinal study. Bone mineral density (BMD, g/cm2) of the arms, the dominant and non-dominant humerus, dominant and non-dominant femur, and the right femoral neck, total hip, and bone area of the femur, humerus and hip were measured at baseline and again after 30 and 70 months using dual-energy X-ray absorptiometry. From baseline to the first follow-up, athletes gained significantly more BMD in the femoral neck (0.07 versus 0.03 g/cm2) and arms (0.09 versus 0.06 g/cm2) compared with the controls (P = 0.04 for both). Between the first and the second follow-up, 21 ice hockey players stopped their active sports career. These men lost significantly more BMD at the femoral neck (-0.02 versus -0.10 g/cm2, P < 0.001), total hip (-0.05 versus -0.09, P = 0.04), dominant (0.02 versus -0.03 g/cm2, P = 0.009) and non-dominant humerus (0.03 versus -0.01 g/cm2, P = 0.03) than the still active ice hockey players (n = 22). At the second follow-up examination, at 22 years of age, the former ice hockey players still had significantly higher BMD at the non-dominant humerus than the controls (P < 0.01). During the total study period, the still active athletes (n = 22) gained significantly more BMD compared with the controls at the femoral neck (0.09 g/cm2; P = 0.008), total hip (0.05 g/cm2, P = 0.04) and arms (0.07 g/cm2; P = 0.01). No differences were seen in bone areas when comparing the different groups. In conclusion, training associated with ice hockey is related to continuous accumulation of BMD after puberty in males. Reduced activity is followed by BMD loss within 3 years of cessation of sports career at predominantly weight-bearing sites. The effects are confined to bone density and not bone size.

Keyword
Adolescent, Analysis of Variance, Bone Density/*physiology, Case-Control Studies, Densitometry; X-Ray, Exercise/*physiology, Femur Neck/physiopathology, Humans, Humerus/physiopathology, Longitudinal Studies, Male, Pelvic Bones/physiopathology, Sports
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-13115 (URN)10.1007/s00198-004-1749-4 (DOI)15517188 (PubMedID)
Available from: 2008-01-17 Created: 2008-01-17 Last updated: 2010-08-10Bibliographically approved
4. Bone loss and fracture risk after reduced physical activity.
Open this publication in new window or tab >>Bone loss and fracture risk after reduced physical activity.
Show others...
2005 (English)In: Journal of Bone and Mineral Research, ISSN 0884-0431, E-ISSN 1523-4681, Vol. 20, no 2, 202-207 p.Article in journal (Refereed) Published
Abstract [en]

Former male young athletes partially lost benefits in BMD (g/cm2) with cessation of exercise, but, despite this, had a higher BMD 4 years after cessation of career than a control group. A higher BMD might contribute to the lower incidence of fragility fractures found in former older athletes > or =60 years of age compared with a control group. INTRODUCTION: Physical activity increases peak bone mass and may prevent osteoporosis if a residual high BMD is retained into old age. MATERIALS AND METHODS: BMD was measured by DXA in 97 male young athletes 21.0 +/- 4.5 years of age (SD) and 48 controls 22.4 +/- 6.3 years of age, with measurements repeated 5 years later, when 55 of the athletes had retired from sports. In a second, older cohort, fracture incidence was recorded in 400 former older athletes and 800 controls > or =60 years of age. RESULTS: At baseline, the young athletes had higher BMD than controls in total body (mean difference, 0.08 g/cm2), spine (mean difference, 0.10 g/cm2), femoral neck (mean difference, 0.13 g/cm2), and arms (mean difference, 0.05 g/cm2; all p < 0.001). During the follow-up period, the young athletes who retired lost more BMD than the still active athletes at the femoral neck (mean difference, 0.07 g/cm2; p = 0.001) and gained less BMD at the total body (mean difference, 0.03 g/cm2; p = 0.004). Nevertheless, BMD was still higher in the retired young athletes (mean difference, 0.06-0.08 g/cm2) than in the controls in the total body, femoral neck, and arms (all p < 0.05). In the older cohort, there were fewer former athletes > or =60 of age than controls with fragility fractures (2.0% versus 4.2%; p < 0.05) and distal radius fractures (0.75% versus 2.5%; p < 0.05). CONCLUSIONS: Although exercise-induced BMD benefits are reduced after retirement from sports, former male older athletes have fewer fractures than matched controls.

Keyword
Adult, Age Factors, Aged, Analysis of Variance, Bone Density, Case-Control Studies, Cohort Studies, Densitometry; X-Ray, Exercise, Fractures; Bone/*diagnosis/*epidemiology, Hockey, Humans, Male, Middle Aged, Osteoporosis/prevention & control, Risk, Soccer, Sports, Time Factors
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-14826 (URN)10.1359/JBMR.041012 (DOI)15647813 (PubMedID)
Available from: 2007-10-26 Created: 2007-10-26 Last updated: 2010-08-10Bibliographically approved

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