Sedentary Behaviors in Children and Adolescents: What Is the Influence on Bone Strength?

Higgins, Simon; Belcher, Staci L.; Lewis, Richard D.

doi:10.1007/978-3-319-98464-3_9

“…In contrast, having a sedentary lifestyle with an excess of sitting time has negative consequences for health, reversing even those PA benefits mentioned above [ 6 , 7 ]. Although some authors have reported associations between poor bone health and sedentarism in early stages of life [ 8 , 9 ], literature about what happens in older adults is still scarce and, therefore, more evidence is needed. Strategies focused on reducing sedentary behaviors (SB) and increasing PA have been common in order to reverse the fear of falling, decrease fall rates, and reduce the number of bone fractures [ 10 , 11 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Associations between Daily Movement Distribution, Bone Structure, Falls, and Fractures in Older Adults: A Compositional Data Analysis Study

Moradell

¹

,

Rodríguez-Gómez

²

,

Fernández-García

³

et al. 2021

IJERPH

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With aging, bone density is reduced, increasing the risk of suffering osteoporosis and fractures. Increasing physical activity (PA) may have preventive effects. However, until now, no studies have considered movement behaviors with compositional data or its association to bone mass and structure measured by peripheral computed tomography (pQCT). Thus, the aim of our study was to investigate these associations and to describe movement behavior distribution in older adults with previous falls and fractures and other related risk parameters, taking into account many nutritional and metabolic confounders. In the current study, 70 participants above 65 years old (51 females) from the city of Zaragoza were evaluated for the EXERNET-Elder 3.0 project. Bone mass and structure were assessed with pQCT, and PA patterns were objectively measured by accelerometry. Prevalence of fear of falling, risk of falling, and history of falls and fractures were asked through the questionnaire. Analyses were performed using a compositional data approach. Whole-movement distribution patterns were associated with cortical thickness. In regard to other movement behaviors, moderate-to-vigorous PA (MVPA) showed positive association with cortical thickness and total true bone mineral density (BMD) at 38% (all p < 0.05). In addition, less light PA (LPA) and MVPA were observed in those participants with previous fractures and fear of falling, whereas those at risk of falling and those with previous falls showed higher levels of PA. Our results showed positive associations between higher levels of MVPA and volumetric bone. The different movement patterns observed in the groups with a history of having suffered falls or fractures and other risk outcomes suggest that different exercise interventions should be designed in these populations in order to improve bone and prevent the risk of osteoporosis and subsequent fractures.

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“…Factors such as time spent inactive or in education, time and type of paid work activity and socio-economic status of the participants were not assessed accurately, although these factors may affect the level and time spent in habitual PA (Ahrens et al, 2020). Defining and measuring any form of PA or sedentary behaviour is not simple (Higgins et al, 2019) and our study was completed without access to a validated accelerometer. Defining PA and measuring levels, frequency, intensity and duration of HRSA, competitive, non-competitive, physical leisure activity, inactivity, screen time and work-based activity are important variables which ideally are measured objectively.…”

Section: Accuracy In Assessment Toolsmentioning

confidence: 99%

A study of the relationship between habitual recreational sporting activity and bone health in adolescents and young adults

Patel¹

0

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<p>Osteoporosis is a major worldwide public health problem through its association with fragility fracture. Acquisition of peak bone mass (PBM) is an important contributor to later osteoporosis risk and may be modified by lifestyle factors, including habitual recreational sporting activity (HRSA). Previous studies that have considered the relationship between HRSA and bone health have focused on older people, elite sporting activity and used dual energy X-ray absorptiometry as a measure of bone density, rather than calcaneal quantitative ultrasound (cQUS), the outcome measure in this study. This research is important because it considers younger adults, to determine relationships between HRSA and bone health in adolescents and young adults, and the factors that affect their engagement with HRSA. In this thesis we consider the relationship between HRSA and bone health in three separate studies, reported as four manuscripts: (1) a systematic literature review of studies that considered relationships between non-elite sporting activity and bone health in adolescents and young adults as assessed by calcaneal heel ultrasound; (2) a quantitative study of 452 adolescents and young adults aged 16 to 35 years, who completed a questionnaire detailing sporting activity and relevant lifestyle confounders and underwent heel ultrasound measurements; and (3) nine focus groups of young adults to better understand their knowledge of bone health, the factors that impact it, and the barriers and facilitators to increasing HRSA. The results of the systematic literature review suggested that the available literature was scarce, with few studies focusing on relationships between HRSA and cQUS in adolescents and young adults. The studies available were too heterogeneous to perform a meta-analysis although, through a narrative synthesis, we reported that all six studies included in the systematic literature review reported significant benefits from weight-bearing HRSA on cQUS outcomes. In the quantitative study, selected bone cQUS parameters were positively associated with: BMI (SI- stiffness index, BUA-broadband ultrasound attenuation, and T-score); physical activity (SI, SOS-speed of sound, BUA, and T-score); and past HRSA score (SOS only), with weight-bearing sporting activity such as running (SI and SOS), soccer (SI and BUA) and rugby (T-score and Z-score) associated with better bone health. This study also reported that lifetime sport participation typically declined after individuals’ mid-teens. The qualitative study suggested that knowledge of PBM and risk of osteoporotic fracture were limited in the young adult age group. There was a general awareness of the positive and negative impacts of many lifestyle behaviours such as physical activity, diet, tobacco smoking and alcohol consumption on health in general, but not specifically how these impact PBM and good bone health in later life. Furthermore three main barriers to sports participation that emerged were: a) structural (disorientation in a new living environment, facilities, access to healthcare); b) social (financial and time constraints); and c) personal (social pressures and lack of an understanding of why sporting activity matters for bone health). On the other hand, enablers of sports participation included: a) supportive environments; b) access to health checks including support to avoid injury; and c) education to better understand the benefits of HRSA. In conclusion, HRSA that is of higher impact appears to be associated with more favourable bone health as assessed by heel ultrasound, but few studies have adequately considered these relationships. The quantitative study performed as part of this thesis provides further evidence that high impact HRSA is associated with more favourable bone health in adolescence and early adulthood, and while participation in sport in New Zealand is common until late teens, subsequently HRSA often decreases during the window of PBM acquisition. Knowledge of factors impacting bone health is poor, and barriers and facilitators to HRSA have been identified. Further work to consider how best to address these knowledge and evidence gaps is now warranted, including focus on young school to early adulthood populations to reduce their future fragility fracture risk.</p>

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“…During sedentary activity, energy expenditure is ≤1.5 metabolic equivalents of intensity. Examples of sedentary activities include screen-based activities like television watching and cell phone usage, and non-screen-based activities like reading, homework and crafts (Higgins et al, 2019). They found inconclusive evidence of a relationship between sedentary behaviour on adolescents' and young adults' bone health, in part because it is difficult to estimate activity of this type accurately without a validated accelerometery assessment.…”

Section: Other Lifestyle and Medical Factors Relevant To Bone Healthmentioning

confidence: 99%

“…Factors such as time spent inactive or in education, time and type of paid work activity and socio-economic status of the participants were not assessed accurately, although these factors may affect the level and time spent in habitual PA (Ahrens et al, 2020). Defining and measuring any form of PA or sedentary behaviour is not simple (Higgins et al, 2019) and our study was completed without access to a validated accelerometer. Defining PA and measuring levels, frequency, intensity and duration of HRSA, competitive, non-competitive, physical leisure activity, inactivity, screen time and work-based activity are important variables which ideally are measured objectively.…”

Section: Accuracy In Assessment Toolsmentioning

confidence: 99%

A study of the relationship between habitual recreational sporting activity and bone health in adolescents and young adults

Patel¹

0

View full text Add to dashboard Cite

<p>Osteoporosis is a major worldwide public health problem through its association with fragility fracture. Acquisition of peak bone mass (PBM) is an important contributor to later osteoporosis risk and may be modified by lifestyle factors, including habitual recreational sporting activity (HRSA). Previous studies that have considered the relationship between HRSA and bone health have focused on older people, elite sporting activity and used dual energy X-ray absorptiometry as a measure of bone density, rather than calcaneal quantitative ultrasound (cQUS), the outcome measure in this study. This research is important because it considers younger adults, to determine relationships between HRSA and bone health in adolescents and young adults, and the factors that affect their engagement with HRSA. In this thesis we consider the relationship between HRSA and bone health in three separate studies, reported as four manuscripts: (1) a systematic literature review of studies that considered relationships between non-elite sporting activity and bone health in adolescents and young adults as assessed by calcaneal heel ultrasound; (2) a quantitative study of 452 adolescents and young adults aged 16 to 35 years, who completed a questionnaire detailing sporting activity and relevant lifestyle confounders and underwent heel ultrasound measurements; and (3) nine focus groups of young adults to better understand their knowledge of bone health, the factors that impact it, and the barriers and facilitators to increasing HRSA. The results of the systematic literature review suggested that the available literature was scarce, with few studies focusing on relationships between HRSA and cQUS in adolescents and young adults. The studies available were too heterogeneous to perform a meta-analysis although, through a narrative synthesis, we reported that all six studies included in the systematic literature review reported significant benefits from weight-bearing HRSA on cQUS outcomes. In the quantitative study, selected bone cQUS parameters were positively associated with: BMI (SI- stiffness index, BUA-broadband ultrasound attenuation, and T-score); physical activity (SI, SOS-speed of sound, BUA, and T-score); and past HRSA score (SOS only), with weight-bearing sporting activity such as running (SI and SOS), soccer (SI and BUA) and rugby (T-score and Z-score) associated with better bone health. This study also reported that lifetime sport participation typically declined after individuals’ mid-teens. The qualitative study suggested that knowledge of PBM and risk of osteoporotic fracture were limited in the young adult age group. There was a general awareness of the positive and negative impacts of many lifestyle behaviours such as physical activity, diet, tobacco smoking and alcohol consumption on health in general, but not specifically how these impact PBM and good bone health in later life. Furthermore three main barriers to sports participation that emerged were: a) structural (disorientation in a new living environment, facilities, access to healthcare); b) social (financial and time constraints); and c) personal (social pressures and lack of an understanding of why sporting activity matters for bone health). On the other hand, enablers of sports participation included: a) supportive environments; b) access to health checks including support to avoid injury; and c) education to better understand the benefits of HRSA. In conclusion, HRSA that is of higher impact appears to be associated with more favourable bone health as assessed by heel ultrasound, but few studies have adequately considered these relationships. The quantitative study performed as part of this thesis provides further evidence that high impact HRSA is associated with more favourable bone health in adolescence and early adulthood, and while participation in sport in New Zealand is common until late teens, subsequently HRSA often decreases during the window of PBM acquisition. Knowledge of factors impacting bone health is poor, and barriers and facilitators to HRSA have been identified. Further work to consider how best to address these knowledge and evidence gaps is now warranted, including focus on young school to early adulthood populations to reduce their future fragility fracture risk.</p>

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Sedentary Behaviors in Children and Adolescents: What Is the Influence on Bone Strength?

Cited by 3 publications

References 55 publications

Associations between Daily Movement Distribution, Bone Structure, Falls, and Fractures in Older Adults: A Compositional Data Analysis Study

Associations between Daily Movement Distribution, Bone Structure, Falls, and Fractures in Older Adults: A Compositional Data Analysis Study

A study of the relationship between habitual recreational sporting activity and bone health in adolescents and young adults

A study of the relationship between habitual recreational sporting activity and bone health in adolescents and young adults

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