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Physical activity, bone gain and sustainment of peak bone mass
Umeå University, Faculty of Medicine, Surgical and Perioperative Sciences, Sports Medicine. Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Rehabilitation Medicine. Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Geriatric Medicine.
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Weak and osteoporotic bones are an increasing cause of mortality and painful physical impairment among the elderly, especially in the Western world. Bone mineral density (BMD, g/cm2) accrual during childhood and adolescence is thought to influence an individual’s risk of osteoporosis and the related fractures.

A main aim of this thesis is to investigate the effects that various types of weight-bearing physical activity have on bone accretion in young males during their active sports careers and to study the effects that detraining has on BMD. The results suggest that bone is sensitive to loading after puberty in males, and important gains in BMD stemming from physical activity were observed during the 12-year follow-up period (papers I-III). These gains seem to be site-specific and related to the type and amount of physical activity in which individuals participate (papers I-III). For example, badminton, a sport that is characterized by jumps and rapid versatile moments in multiple directions was associated with greater gains in BMD than ice hockey was. In addition, our results indicate that with reduced training, exercise-induced bone benefits decline, predominantly at trabecular sites (paper II). In contrast, high bone density attained from previous physical loading was partially preserved at cortical bone sites after about eight years of reduced activity (papers I-II). In study IV, the associations between self-perceived health, BMD, and other lifestyle factors were studied in a well-defined group of women and men of varying ages. We found that self-perceived health was related to several lifestyle factors, such as physical activity, which were also related to BMD at the femoral neck.

In summary, BMD in young males seem to be especially sensitive to activities associated with supposed high strains in unusual directions at specific bone sites. A high bone density stemming from previous weight-bearing physical activity is largely lost at trabecular bone sites with reduced physical activity levels. Finally, self-perceived health seems to be associated with several lifestyle factors that are also associated with BMD at the femoral neck.

Place, publisher, year, edition, pages
Umeå: Umeå university , 2009. , 87 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1282
Keyword [en]
BMD, physical activity, men, athletes, trabecular bone, cortical bone, self-perceived health
National Category
Medical and Health Sciences
Research subject
Medicine
Identifiers
URN: urn:nbn:se:umu:diva-26928ISBN: 978-91-7264-831-9 (print)OAI: oai:DiVA.org:umu-26928DiVA: diva2:274850
Public defence
2009-11-27, Aulan, Vårdvetarhuset, 90187, Umeå, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2009-11-13 Created: 2009-11-02 Last updated: 2010-01-18Bibliographically approved
List of papers
1. Constant adaptation of bone to current physical activity level in men: a 12-year longitudinal study
Open this publication in new window or tab >>Constant adaptation of bone to current physical activity level in men: a 12-year longitudinal study
2008 (English)In: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 93, no 12, 4873-4879 p.Article in journal (Refereed) Published
Abstract [en]

CONTEXT: A high peak bone mineral density (BMD; grams per square centimeter) could reduce the risk of osteoporosis related fractures later in life. OBJECTIVE: This 12-yr longitudinal study investigated whether a high BMD from previous high physical activity is maintained with reduced activity later in life. DESIGN: This was a longitudinal study. PARTICIPANTS: Three groups were investigated with a mean age of 17 yr at baseline; 51 athletes who stopped their active careers during follow-up (former athletes), 16 who were active throughout follow-up (active athletes), and 25 controls. Main Outcome Measures: BMD of the femoral neck, total body, and lumbar spine were examined five times during the 12-yr follow-up period. RESULTS: After adjustment for age, weight, and height, the former athletes were found to have higher BMD at all sites at every follow-up visit except the last one, when compared with controls (P < 0.05). The active athletes were found to have significantly higher BMD at all measured locations when compared with controls throughout the entire study (P < 0.05). From the first to the final follow-up visit, the former athletes were found to have lost more femoral neck BMD than both the active athletes (mean difference, 0.12 g/cm(2); P = 0.003) and controls (mean difference 0.08 g/cm(2); P = 0.02). CONCLUSION: This study suggests that BMD constantly adapts to the present physical activity levels in young men. Thus, increased BMD due to previous high physical activity may not prevent osteoporosis in later years.

National Category
Other Medical Sciences
Identifiers
urn:nbn:se:umu:diva-26917 (URN)10.1210/jc.2008-1313 (DOI)18827001 (PubMedID)
Available from: 2009-11-02 Created: 2009-11-02 Last updated: 2017-12-12Bibliographically approved
2. Reduced physical activity corresponds with greater bone loss at the trabecular than the cortical bone sites in men
Open this publication in new window or tab >>Reduced physical activity corresponds with greater bone loss at the trabecular than the cortical bone sites in men
2009 (English)In: Bone, ISSN 8756-3282, E-ISSN 1873-2763, Vol. 45, no 6, 1073-1078 p.Article in journal (Refereed) Published
Abstract [en]

Previous research has been inconclusive as to whether high peak bone mineral density (BMD, g/cm(2)) resulting from previous physical activity is retained with reduced activity later in life. The aim of this 12-year longitudinal study was to investigate the association between BMD loss and reduced physical activity (h/wk) at trabecular and cortical bone sites in men. Three groups with a mean age of 17 years at baseline were investigated: i) 51 athletes who discontinued their active careers during the follow-up period (former athletes), ii) 16 athletes who were active throughout the follow-up period (active athletes), and iii) 25 controls. BMD loss at the hip, spine, and pelvis (mainly trabecular bone) was compared to BMD loss at femur, humerus, and legs (mainly cortical bone) during a 12-year follow-up period. Across the total follow-up period in the total cohort, reduced physical activity was more strongly associated with changes at trabecular BMD sites, i.e. hip, spine, and pelvis (B=0.008-0.005 g/cm(2) per weekly hour physical activity (h), p<0.001), than at cortical bone sites, i.e. humerus, legs (B=0.002-0.003 g/cm(2)/h, p<0.05), and femur (p>0.05). At the final follow-up, former athletes showed higher BMD than controls only at the cortical bone sites of the humerus, legs, and femur (difference 0.05-0.10 g/cm(2), p<0.05). In conclusion, this study indicates that predominantly trabecular bone is lost with reduced physical activity levels in young men. Benefits were still evident at the more cortical sites eight years after the discontinuation of an active sports career.

Place, publisher, year, edition, pages
Elsevier, 2009
National Category
Geriatrics Sport and Fitness Sciences
Identifiers
urn:nbn:se:umu:diva-26915 (URN)10.1016/j.bone.2009.07.007 (DOI)19631302 (PubMedID)
Available from: 2009-11-02 Created: 2009-11-02 Last updated: 2017-12-12Bibliographically approved
3. Effetcs of badminton and ice hockey on bone mass in young males: a 12-year follow-up
Open this publication in new window or tab >>Effetcs of badminton and ice hockey on bone mass in young males: a 12-year follow-up
(English)Manuscript (preprint) (Other academic)
Abstract [en]

The purpose of the present study was to investigate the influence of different types of weight bearing physical activity on bone gain during an active sports career and to identify any residual benefits in BMD after the active sports career. Beginning at 17 years of age, BMD was measured 5 times, during 12 years, at multiple sites in 19badminton players, 48 ice hockey players and 25 controls. Levels of vitamin D and fatty acids were also evaluated in relation to changes in BMD during the study. During the time the athletes were active, badminton players were found to have gained significantly more BMD in their femoral neck, humerus, and lumbar spine in comparison to control subjects (mean difference = 0.05-0.17 g/cm2, p < 0.05 for all), and significantly more in their legs compared to both ice hockey players and controls (mean difference = 0.03-0.05 g/cm2, p < 0.05). At final follow-up, badminton players had significantly higher BMD of the femoral neck, humerus, lumbar spine and legs (mean difference = 0.08-0.20 g/cm2, p<0.01 for all) than both ice hockey players and controls. Levels of vitamin D and fatty acids were not related to changes in BMD at any bone site (p > 0.05 for all). In summary, the present study suggests that badminton is a more osteogenic sport and therefore related to greater gains in BMD compared to ice hockey. These BMD benefits were partly sustained with reduced activity.

Keyword
BMD, physical activity, men, athletes
Research subject
Medicine
Identifiers
urn:nbn:se:umu:diva-26919 (URN)
Available from: 2009-11-02 Created: 2009-11-02 Last updated: 2009-11-13Bibliographically approved
4. Association between self-perceived health, physical activity, and BMD in middle-aged men and women
Open this publication in new window or tab >>Association between self-perceived health, physical activity, and BMD in middle-aged men and women
2011 (English)In: The Open Bone Journal, ISSN 1876-5254, no 3, 6-10 p.Article in journal (Refereed) Published
Abstract [en]

Background: Osteoporosis is a skeletal disease that affects one out of every two women and one out of every five men. The clinical significance of this disease lies in the associated increased risk of fractures that mainly affect the femoral neck, spine, and wrist. One of the strongest risk factors for low-energy fractures is low bone mineral density (BMD, g/cm2). The purpose of this study was to examine the relationship between BMD, self-perceived health, and lifestyle factors in a well-defined cohort of middle-aged men and women.

Methods: The Västerbotten Intervention Project (VIP) is a study that has been ongoing in Västerbotten since 1985. All people in Västerbotten who are 40, 50 and 60 years of age are offered a comprehensive health survey in which a questionnaire is completed and blood pressure and blood lipids are measured. BMD has been measured in the Sports Medicine Unit in Umeå since 1991. As of December 31, 2006, 4,333 women and 2,320 men had been evaluated.  Of these, 1,595 were examined as part of the VIP before their BMD was measured, and these subjects included in the present study.  

Results: The mean age of the investigated cohort was 57 years (range 30-74). After adjusting for age, weight, sex, and follow-up time, self-perceived health (Beta = 0.08, p<0.001), training[ED1]  (Beta = 0.11, p<0.001), snow shoveling (Beta = 0.07, p=0.001), and smoking more than 15 cigarettes per day (Beta =- 0.05, p=0.04) were found to be related to femoral neck BMD. Only self-perceived health, age, and weight were found to be related to spine BMD. Self-perceived health was found to be related to some of the lifestyle factors that were significantly related to BMD, such as training (r = 0.14, p <0.001) and snow shoveling (Beta = 0.15, p <0.001).

Conclusion: In this cohort study, several lifestyle factors related to self-perceived health were also found to be related to bone mineral density in a well-defined cohort of middle-aged men and women.

 

National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:umu:diva-26922 (URN)10.2174/1876525401103010006 (DOI)
Available from: 2009-11-02 Created: 2009-11-02 Last updated: 2014-12-01Bibliographically approved

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