Skip to main content
Top
Published in: Calcified Tissue International 4/2008

01-10-2008

A 3-Year Physical Activity Intervention Program Increases the Gain in Bone Mineral and Bone Width in Prepubertal Girls but not Boys: The Prospective Copenhagen School Child Interventions Study (CoSCIS)

Authors: H. A. Hasselstrøm, M. K. Karlsson, S. E. Hansen, V. Grønfeldt, K. Froberg, L. B. Andersen

Published in: Calcified Tissue International | Issue 4/2008

Login to get access

Abstract

The aim of this study was to evaluate the effect of increasing the amount of time spent in physical education classes on bone mineral accrual and gain in bone size in prepubertal Danish children. A total of 135 boys and 108 girls, aged 6–8 years, were included in a school-based curriculum intervention program where the usual time spent in physical education classes was doubled to four classes (180 min) per week. The control group comprised age-matched children (62 boys and 76 girls) recruited from a separate community who completed the usual Danish school curriculum of physical activity (90 min/week). Dual-energy X-ray absorptiometry was used to evaluate bone mineral content (BMC; g), bone mineral density (g/cm2), and bone width at the calcaneus and distal forearm before and after 3 years of intervention. Anthropometrics and Tanner stages were evaluated on the same occasions. General physical activity was measured with an accelerometer worn for 4 days. In girls, the intervention group had a 12.5% increase (P = 0.04) in distal forearm BMC and a 13.2% increase (P = 0.005) in distal forearm scanned area compared with girls in the control group. No differences were found between the intervention and control groups in boys. Increasing the frequency of physical education classes for prepubertal children is associated with a higher accrual of bone mineral and higher gain in bone size after 3 years in girls but not in boys.
Literature
1.
go back to reference Davies JH, Evans BAJ, Gregory JW (2005) Bone mass acquisition in healthy children. Arch Dis Child 90:373–378PubMedCrossRef Davies JH, Evans BAJ, Gregory JW (2005) Bone mass acquisition in healthy children. Arch Dis Child 90:373–378PubMedCrossRef
2.
go back to reference Cummings SR, Black DM, Nevitt MC, Browner W, Cauley J, Ensrud K, Genant HK, Palermo L, Scott J, Vogt TM (1993) Bone density at various sites for prediction of hip fractures. The Study of Osteoporotic Fractures Research Group. Lancet 341:72–75PubMedCrossRef Cummings SR, Black DM, Nevitt MC, Browner W, Cauley J, Ensrud K, Genant HK, Palermo L, Scott J, Vogt TM (1993) Bone density at various sites for prediction of hip fractures. The Study of Osteoporotic Fractures Research Group. Lancet 341:72–75PubMedCrossRef
3.
go back to reference Rubin CT, Lanyon LE (1984) Regulation of bone formation by applied dynamic loads. J Bone Joint Surg Am 66:397–402PubMed Rubin CT, Lanyon LE (1984) Regulation of bone formation by applied dynamic loads. J Bone Joint Surg Am 66:397–402PubMed
4.
go back to reference Kannus P, Haapasalo H, Sankelo M, Sievanen H, Pasanen M, Heinonen A, Oja P, Vuori I (1995) Effect of starting age of physical activity on bone mass in the dominant arm of tennis and squash players. Ann Intern Med 123:27–31PubMed Kannus P, Haapasalo H, Sankelo M, Sievanen H, Pasanen M, Heinonen A, Oja P, Vuori I (1995) Effect of starting age of physical activity on bone mass in the dominant arm of tennis and squash players. Ann Intern Med 123:27–31PubMed
5.
go back to reference Lanyon LE, Rubin CT (1984) Static vs. dynamic loads as an influence on bone remodelling. J Biomech 17:897–905PubMedCrossRef Lanyon LE, Rubin CT (1984) Static vs. dynamic loads as an influence on bone remodelling. J Biomech 17:897–905PubMedCrossRef
6.
go back to reference Khan K, McKay HA, Kannus P, Bailey DA, Wark JD, Bennell KL (2001) Physical activity and bone health. Human Kinetics, Champaign, IL Khan K, McKay HA, Kannus P, Bailey DA, Wark JD, Bennell KL (2001) Physical activity and bone health. Human Kinetics, Champaign, IL
7.
go back to reference Sundberg M, Gardsell P, Johnell O, Karlsson MK, Ornstein E, Sandstedt B, Sernbo I (2002) Physical activity increases bone size in prepubertal boys and bone mass in prepubertal girls: a combined cross-sectional and 3-year longitudinal study. Calcif Tissue Int 71:406–415PubMedCrossRef Sundberg M, Gardsell P, Johnell O, Karlsson MK, Ornstein E, Sandstedt B, Sernbo I (2002) Physical activity increases bone size in prepubertal boys and bone mass in prepubertal girls: a combined cross-sectional and 3-year longitudinal study. Calcif Tissue Int 71:406–415PubMedCrossRef
8.
go back to reference Gutin B, Kasper MJ (1992) Can vigorous exercise play a role in osteoporosis prevention? A review. Osteopor Int 2:55–69CrossRef Gutin B, Kasper MJ (1992) Can vigorous exercise play a role in osteoporosis prevention? A review. Osteopor Int 2:55–69CrossRef
9.
go back to reference Forwood MR, Burr DB (1993) Physical activity and bone mass: exercise infutility? Bone Mineral 21:89–112CrossRef Forwood MR, Burr DB (1993) Physical activity and bone mass: exercise infutility? Bone Mineral 21:89–112CrossRef
10.
go back to reference Nordström P, Pettersson U, Lorentzon R (1998) Type of physical activity, muscle strength, and pubertal stage as determinants of bone mineral density and bone area in adolescent boys. J Bone Miner Res 13:1141–1148PubMedCrossRef Nordström P, Pettersson U, Lorentzon R (1998) Type of physical activity, muscle strength, and pubertal stage as determinants of bone mineral density and bone area in adolescent boys. J Bone Miner Res 13:1141–1148PubMedCrossRef
11.
go back to reference Morris FL, Naughton GA, Gibbs JL, Carlson JS, Wark JD (1997) Prospective 10-month exercise intervention in premenarcheal girls: positive effects on bone and lean mass. J Bone Miner Res 12:1453–1462PubMedCrossRef Morris FL, Naughton GA, Gibbs JL, Carlson JS, Wark JD (1997) Prospective 10-month exercise intervention in premenarcheal girls: positive effects on bone and lean mass. J Bone Miner Res 12:1453–1462PubMedCrossRef
12.
go back to reference Bradney M, Pearce G, Naughton G, Sullivan C, Bass S, Beck T, Carlson J, Seeman E (1998) Moderate exercise during growth in prepubertal boys: changes in bone mass, size, volumetric density, and bone strength: a controlled prospective study. J Bone Miner Res 13:1814–1821PubMedCrossRef Bradney M, Pearce G, Naughton G, Sullivan C, Bass S, Beck T, Carlson J, Seeman E (1998) Moderate exercise during growth in prepubertal boys: changes in bone mass, size, volumetric density, and bone strength: a controlled prospective study. J Bone Miner Res 13:1814–1821PubMedCrossRef
13.
go back to reference MacKelvie KJ, McKay HA, Petit MA, Moran O, Khan KM (2002) Bone mineral response to a 7-month randomized controlled, school-based jumping intervention in 121 prepubertal boys: associations with ethnicity and body mass index. J Bone Miner Res 17:834–844PubMedCrossRef MacKelvie KJ, McKay HA, Petit MA, Moran O, Khan KM (2002) Bone mineral response to a 7-month randomized controlled, school-based jumping intervention in 121 prepubertal boys: associations with ethnicity and body mass index. J Bone Miner Res 17:834–844PubMedCrossRef
14.
go back to reference McKay HA, Petit MA, Schultz RW, Prior JC, Barr SI, Khan KM (2000) Augmented trochanteric bone mineral density after modified physical education classes: a randomized school-based exercise intervention study in prepubescent and early pubescent children. J Pediatr 136:156–162PubMedCrossRef McKay HA, Petit MA, Schultz RW, Prior JC, Barr SI, Khan KM (2000) Augmented trochanteric bone mineral density after modified physical education classes: a randomized school-based exercise intervention study in prepubescent and early pubescent children. J Pediatr 136:156–162PubMedCrossRef
15.
go back to reference MacKelvie KJ, Khan KM, Petit MA, Janssen PA, McKay HA (2003) A school-based exercise intervention elicits substantial bone health benefits: a 2-year randomized controlled trial in girls. Pediatrics 112:e447–e452PubMedCrossRef MacKelvie KJ, Khan KM, Petit MA, Janssen PA, McKay HA (2003) A school-based exercise intervention elicits substantial bone health benefits: a 2-year randomized controlled trial in girls. Pediatrics 112:e447–e452PubMedCrossRef
16.
go back to reference MacKelvie KJ, Petit MA, Khan KM, Beck TJ, McKay HA (2004) Bone mass and structure are enhanced following a 2-year randomized controlled trial of exercise in prepubertal boys. Bone 34:755–764PubMedCrossRef MacKelvie KJ, Petit MA, Khan KM, Beck TJ, McKay HA (2004) Bone mass and structure are enhanced following a 2-year randomized controlled trial of exercise in prepubertal boys. Bone 34:755–764PubMedCrossRef
17.
go back to reference MacKelvie KJ, McKay HA, Khan KM, Crocker PR (2001) A school-based exercise intervention augments bone mineral accrual in early pubertal girls. J Pediatr 139:501–508PubMedCrossRef MacKelvie KJ, McKay HA, Khan KM, Crocker PR (2001) A school-based exercise intervention augments bone mineral accrual in early pubertal girls. J Pediatr 139:501–508PubMedCrossRef
18.
go back to reference Valdimarsson O, Linden C, Johnell O, Gardsell P, Karlsson MK (2006) Daily physical education in the school curriculum in prepubertal girls during 1 year is followed by an increase in bone mineral accrual and bone width—data from the prospective controlled Malmo Pediatric Osteoporosis Prevention Study. Calcif Tissue Int 78:65–71PubMedCrossRef Valdimarsson O, Linden C, Johnell O, Gardsell P, Karlsson MK (2006) Daily physical education in the school curriculum in prepubertal girls during 1 year is followed by an increase in bone mineral accrual and bone width—data from the prospective controlled Malmo Pediatric Osteoporosis Prevention Study. Calcif Tissue Int 78:65–71PubMedCrossRef
19.
go back to reference Linden C, Alwis G, Ahlborg H, Gardsell P, Valdimarsson O, Stenevi-Lundgren S, Besjakov J, Karlsson MK (2007) Exercise, bone mass and bone size in prepubertal boys: one-year data from the Pediatric Osteoporosis Prevention Study. Scand J Med Sci Sports 17:340–347PubMed Linden C, Alwis G, Ahlborg H, Gardsell P, Valdimarsson O, Stenevi-Lundgren S, Besjakov J, Karlsson MK (2007) Exercise, bone mass and bone size in prepubertal boys: one-year data from the Pediatric Osteoporosis Prevention Study. Scand J Med Sci Sports 17:340–347PubMed
20.
go back to reference Linden C, Ahlborg HG, Besjakov J, Gardsell P, Karlsson MK (2006) A school curriculum–based exercise program increases bone mineral accrual and bone size in prepubertal girls: two-year data from the Pediatric Osteoporosis Prevention (POP) study. J Bone Miner Res 21:829–835PubMedCrossRef Linden C, Ahlborg HG, Besjakov J, Gardsell P, Karlsson MK (2006) A school curriculum–based exercise program increases bone mineral accrual and bone size in prepubertal girls: two-year data from the Pediatric Osteoporosis Prevention (POP) study. J Bone Miner Res 21:829–835PubMedCrossRef
21.
go back to reference Bailey RC, Olson J, Pepper SL, Porzasz J, Barstow TJ, Cooper DM (1995) The level and tempo of children’s physical activities: an observational study. Med Sci Sports Exerc 27:1033–1041PubMedCrossRef Bailey RC, Olson J, Pepper SL, Porzasz J, Barstow TJ, Cooper DM (1995) The level and tempo of children’s physical activities: an observational study. Med Sci Sports Exerc 27:1033–1041PubMedCrossRef
22.
go back to reference De Lorenzo A, Bertini I, Candeloro N, Iacopino L, Andreoli A, Van Loan MD (1998) Comparison of different techniques to measure body composition in moderately active adolescents. Br J Sports Med 32:215–219PubMedCrossRef De Lorenzo A, Bertini I, Candeloro N, Iacopino L, Andreoli A, Van Loan MD (1998) Comparison of different techniques to measure body composition in moderately active adolescents. Br J Sports Med 32:215–219PubMedCrossRef
23.
go back to reference Altmann DG (1991) Practical Statistics for Medical Research. Chapman & Hall, London Altmann DG (1991) Practical Statistics for Medical Research. Chapman & Hall, London
24.
go back to reference Janz KF, Burns TL, Levy SM, Torner JC, Willing MC, Beck TJ, Gilmore JM, Marshall TA (2004) Everyday activity predicts bone geometry in children: the Iowa Bone Development Study. Med Sci Sports Exerc 36:1124–1131PubMedCrossRef Janz KF, Burns TL, Levy SM, Torner JC, Willing MC, Beck TJ, Gilmore JM, Marshall TA (2004) Everyday activity predicts bone geometry in children: the Iowa Bone Development Study. Med Sci Sports Exerc 36:1124–1131PubMedCrossRef
25.
go back to reference Janz KF, Burns TL, Torner JC, Levy SM, Paulos R, Willing MC, Warren JJ (2001) Physical activity and bone measures in young children: the Iowa Bone Development Study. Pediatrics 107:1387–1393PubMedCrossRef Janz KF, Burns TL, Torner JC, Levy SM, Paulos R, Willing MC, Warren JJ (2001) Physical activity and bone measures in young children: the Iowa Bone Development Study. Pediatrics 107:1387–1393PubMedCrossRef
26.
go back to reference Ridgers ND, Stratton G, Fairclough SJ (2005) Assessing physical activity during recess using accelerometry. Prev Med 41:102–107PubMedCrossRef Ridgers ND, Stratton G, Fairclough SJ (2005) Assessing physical activity during recess using accelerometry. Prev Med 41:102–107PubMedCrossRef
27.
go back to reference Riddoch CJ, Bo AL, Wedderkopp N, Harro M, Klasson-Heggebo L, Sardinha LB, Cooper AR, Ekelund U (2004) Physical activity levels and patterns of 9- and 15-yr-old European children. Med Sci Sports Exerc 36:86–92PubMedCrossRef Riddoch CJ, Bo AL, Wedderkopp N, Harro M, Klasson-Heggebo L, Sardinha LB, Cooper AR, Ekelund U (2004) Physical activity levels and patterns of 9- and 15-yr-old European children. Med Sci Sports Exerc 36:86–92PubMedCrossRef
28.
go back to reference Trost SG, Pate RR, Sallis JF, Freedson PS, Taylor WC, Dowda M, Sirard J (2002) Age and gender differences in objectively measured physical activity in youth. Med Sci Sports Exerc 34:350–355PubMedCrossRef Trost SG, Pate RR, Sallis JF, Freedson PS, Taylor WC, Dowda M, Sirard J (2002) Age and gender differences in objectively measured physical activity in youth. Med Sci Sports Exerc 34:350–355PubMedCrossRef
29.
go back to reference Hasselstrom H, Karlsson KM, Hansen SE, Gronfeldt V, Froberg K, Andersen LB (2006) Sex differences in bone size and bone mineral density exist before puberty. The Copenhagen School Child Intervention Study (CoSCIS). Calcif Tissue Int 79:7–14PubMedCrossRef Hasselstrom H, Karlsson KM, Hansen SE, Gronfeldt V, Froberg K, Andersen LB (2006) Sex differences in bone size and bone mineral density exist before puberty. The Copenhagen School Child Intervention Study (CoSCIS). Calcif Tissue Int 79:7–14PubMedCrossRef
30.
go back to reference Bailey DA, McKay HA, Mirwald RL, Crocker PR, Faulkner RA (1999) A six-year longitudinal study of the relationship of physical activity to bone mineral accrual in growing children: the University of Saskatchewan Bone Mineral Accrual Study. J Bone Miner Res 14:1672–1679PubMedCrossRef Bailey DA, McKay HA, Mirwald RL, Crocker PR, Faulkner RA (1999) A six-year longitudinal study of the relationship of physical activity to bone mineral accrual in growing children: the University of Saskatchewan Bone Mineral Accrual Study. J Bone Miner Res 14:1672–1679PubMedCrossRef
31.
go back to reference Bass S, Pearce G, Bradney M, Hendrich E, Delmas PD, Harding A, Seeman E (1998) Exercise before puberty may confer residual benefits in bone density in adulthood: studies in active prepubertal and retired female gymnasts. J Bone Miner Res 13:500–507PubMedCrossRef Bass S, Pearce G, Bradney M, Hendrich E, Delmas PD, Harding A, Seeman E (1998) Exercise before puberty may confer residual benefits in bone density in adulthood: studies in active prepubertal and retired female gymnasts. J Bone Miner Res 13:500–507PubMedCrossRef
32.
go back to reference Fuchs RK, Bauer JJ, Snow CM (2001) Jumping improves hip and lumbar spine bone mass in prepubescent children: a randomized controlled trial. J Bone Miner Res 16:148–156PubMedCrossRef Fuchs RK, Bauer JJ, Snow CM (2001) Jumping improves hip and lumbar spine bone mass in prepubescent children: a randomized controlled trial. J Bone Miner Res 16:148–156PubMedCrossRef
33.
go back to reference McKay HA, Petit MA, Bailey DA, Wallace WM, Schutz RW, Khan KM (2000) Analysis of proximal femur DXA scans in growing children: comparisons of different protocols for cross-sectional 8-month and 7-year longitudinal data. J Bone Miner Res 15:1181–1188PubMedCrossRef McKay HA, Petit MA, Bailey DA, Wallace WM, Schutz RW, Khan KM (2000) Analysis of proximal femur DXA scans in growing children: comparisons of different protocols for cross-sectional 8-month and 7-year longitudinal data. J Bone Miner Res 15:1181–1188PubMedCrossRef
34.
go back to reference Cussler EC, Going SB, Houtkooper LB, Stanford VA, Blew RM, Flint-Wagner HG, Metcalfe LL, Choi JE, Lohman TG (2005) Exercise frequency and calcium intake predict 4-year bone changes in postmenopausal women. Osteoporos Int 16:2129–2141PubMedCrossRef Cussler EC, Going SB, Houtkooper LB, Stanford VA, Blew RM, Flint-Wagner HG, Metcalfe LL, Choi JE, Lohman TG (2005) Exercise frequency and calcium intake predict 4-year bone changes in postmenopausal women. Osteoporos Int 16:2129–2141PubMedCrossRef
35.
go back to reference Robling AG, Hinant FM, Burr DB, Turner CH (2002) Improved bone structure and strength after long-term mechanical loading is greatest if loading is separated into short bouts. J Bone Miner Res 17:1545–1554PubMedCrossRef Robling AG, Hinant FM, Burr DB, Turner CH (2002) Improved bone structure and strength after long-term mechanical loading is greatest if loading is separated into short bouts. J Bone Miner Res 17:1545–1554PubMedCrossRef
36.
go back to reference Bass SL, Saxon L, Daly RM, Turner CH, Robling AG, Seeman E, Stuckey S (2002) The effect of mechanical loading on the size and shape of bone in pre-, peri-, and postpubertal girls: a study in tennis players. J Bone Miner Res 17:2274–2280PubMedCrossRef Bass SL, Saxon L, Daly RM, Turner CH, Robling AG, Seeman E, Stuckey S (2002) The effect of mechanical loading on the size and shape of bone in pre-, peri-, and postpubertal girls: a study in tennis players. J Bone Miner Res 17:2274–2280PubMedCrossRef
37.
go back to reference Janz K (2002) Physical activity and bone development during childhood and adolescence. Implications for the prevention of osteoporosis. Minerva Pediatr 54:93–104PubMed Janz K (2002) Physical activity and bone development during childhood and adolescence. Implications for the prevention of osteoporosis. Minerva Pediatr 54:93–104PubMed
38.
go back to reference Branca F, Valtuena S, Vatuena S (2001) Calcium, physical activity and bone health–building bones for a stronger future. Public Health Nutr 4:117–123PubMedCrossRef Branca F, Valtuena S, Vatuena S (2001) Calcium, physical activity and bone health–building bones for a stronger future. Public Health Nutr 4:117–123PubMedCrossRef
39.
go back to reference Haapasalo H, Kontulainen S, Sievanen H, Kannus P, Jarvinen M, Vuori I (2000) Exercise-induced bone gain is due to enlargement in bone size without a change in volumetric bone density: a peripheral quantitative computed tomography study of the upper arms of male tennis players. Bone 27:351–357PubMedCrossRef Haapasalo H, Kontulainen S, Sievanen H, Kannus P, Jarvinen M, Vuori I (2000) Exercise-induced bone gain is due to enlargement in bone size without a change in volumetric bone density: a peripheral quantitative computed tomography study of the upper arms of male tennis players. Bone 27:351–357PubMedCrossRef
40.
go back to reference Kontulainen S, Sievanen H, Kannus P, Pasanen M, Vuori I (2003) Effect of long-term impact-loading on mass, size, and estimated strength of humerus and radius of female racquet-sports players: a peripheral quantitative computed tomography study between young and old starters and controls. J Bone Miner Res 18:352–359PubMedCrossRef Kontulainen S, Sievanen H, Kannus P, Pasanen M, Vuori I (2003) Effect of long-term impact-loading on mass, size, and estimated strength of humerus and radius of female racquet-sports players: a peripheral quantitative computed tomography study between young and old starters and controls. J Bone Miner Res 18:352–359PubMedCrossRef
41.
go back to reference Duan Y, Seeman E, Turner CH (2001) The biomechanical basis of vertebral body fragility in men and women. J Bone Miner Res 16:2276–2283PubMedCrossRef Duan Y, Seeman E, Turner CH (2001) The biomechanical basis of vertebral body fragility in men and women. J Bone Miner Res 16:2276–2283PubMedCrossRef
42.
go back to reference Seeman E, Duan Y, Fong C, Edmonds J (2001) Fracture site–specific deficits in bone size and volumetric density in men with spine or hip fractures. J Bone Miner Res 16:120–127PubMedCrossRef Seeman E, Duan Y, Fong C, Edmonds J (2001) Fracture site–specific deficits in bone size and volumetric density in men with spine or hip fractures. J Bone Miner Res 16:120–127PubMedCrossRef
43.
go back to reference Ahlborg HG, Johnell O, Turner CH, Rannevik G, Karlsson MK (2003) Bone loss and bone size after menopause. N Engl J Med 349:327–334PubMedCrossRef Ahlborg HG, Johnell O, Turner CH, Rannevik G, Karlsson MK (2003) Bone loss and bone size after menopause. N Engl J Med 349:327–334PubMedCrossRef
44.
go back to reference Duan Y, Parfitt A, Seeman E (1999) Vertebral bone mass, size, and volumetric density in women with spinal fractures. J Bone Miner Res 14:1796–1802PubMedCrossRef Duan Y, Parfitt A, Seeman E (1999) Vertebral bone mass, size, and volumetric density in women with spinal fractures. J Bone Miner Res 14:1796–1802PubMedCrossRef
Metadata
Title
A 3-Year Physical Activity Intervention Program Increases the Gain in Bone Mineral and Bone Width in Prepubertal Girls but not Boys: The Prospective Copenhagen School Child Interventions Study (CoSCIS)
Authors
H. A. Hasselstrøm
M. K. Karlsson
S. E. Hansen
V. Grønfeldt
K. Froberg
L. B. Andersen
Publication date
01-10-2008
Publisher
Springer-Verlag
Published in
Calcified Tissue International / Issue 4/2008
Print ISSN: 0171-967X
Electronic ISSN: 1432-0827
DOI
https://doi.org/10.1007/s00223-008-9166-x

Other articles of this Issue 4/2008

Calcified Tissue International 4/2008 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.