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01-12-2020 | Osteoporosis | Research article

Beat osteoporosis — nourish and exercise skeletons (BONES): a group randomized controlled trial in children

Authors: Christina D. Economos, Erin Hennessy, Kenneth Chui, Johanna Dwyer, Lori Marcotte, Aviva Must, Elena N. Naumova, Jeanne Goldberg

Published in: BMC Pediatrics | Issue 1/2020

Abstract

Background

Lifelong healthy habits developed during childhood may prevent chronic diseases in adulthood. Interventions to promote these habits must begin early. The BONES (Beat Osteoporosis – Nourish and Exercise Skeletons) project assessed whether early elementary school children participating in a multifaceted health behavior change, after-school based intervention would improve bone quality and muscular strength and engage in more bone-strengthening behaviors.

Methods

The 2-year BONES (B) intervention included bone-strengthening physical activity (85 min/week), educational materials (2 days/week), and daily calcium-rich snacks (380 mg calcium/day) delivered by after-school program leaders. BONES plus Parent (B + P) included an additional parent education component. From 1999 to 2004, n = 83 after-school programs (N = 1434 children aged 6–9 years) in Massachusetts and Rhode Island participated in a group randomized trial with two intervention arms (B only, n = 25 programs; B + P, n = 33) and a control arm (C, n = 25). Outcome measures (primary: bone quality (stiffness index of the calcaneus) and muscular strength (grip strength and vertical jump); secondary: bone-strengthening behaviors (calcium-rich food knowledge, preference, and intake; and physical activity level (metabolic equivalent time (MET) score, and weight-bearing factor (WBF) score)) were recorded at baseline, and after years one and two. Analyses followed an intent-to-treat protocol, and focused on individual subjects’ trajectories along the three time points adjusting for baseline age and race via a mixed-effects regression framework. Analyses were performed with and without sex stratification.

Results

Children in B + P increased bone stiffness compared to C (p = 0.05); No significant changes were observed in muscle strength, food knowledge, or vertical jump. Children in B + P showed significant improvement in their MET and WBF scores compared to C (p < 0.01) with a stronger effect in boys in both B and B + P (all p < 0.01).

Conclusion

After-school programs, coupled with parental engagement, serving early elementary school children are a potentially feasible platform to deliver bone-strengthening behaviors to prevent osteoporosis in adulthood, with some encouraging bone and physical activity outcomes.

Trial registration

ClinicalTrials.gov NCT00065247.

Retrospectively registered.

First posted July 22, 2003.

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Title: Beat osteoporosis — nourish and exercise skeletons (BONES): a group randomized controlled trial in children
Authors: Christina D. Economos
Erin Hennessy
Kenneth Chui
Johanna Dwyer
Lori Marcotte
Aviva Must
Elena N. Naumova
Jeanne Goldberg
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Osteoporosis
Osteoporosis
Published in: BMC Pediatrics / Issue 1/2020
Electronic ISSN: 1471-2431
DOI: https://doi.org/10.1186/s12887-020-1964-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Beat osteoporosis — nourish and exercise skeletons (BONES): a group randomized controlled trial in children

Abstract

Background

Methods

Results

Conclusion

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Trial registration

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