title: Youth: a health plan-based lifestyle intervention increases bone mineral density in adolescent girls.
abstract: OBJECTIVE
  To test the efficacy of a health plan-based lifestyle intervention to increase bone mineral density in adolescent girls.
  
  
  METHODS
  Two-year randomized, controlled trial.
  
  
  METHODS
  Large health maintenance organization.
  
  
  METHODS
  Girls 14 to 16 years old with body mass index below the national median. Intervention Behavioral intervention (bimonthly group meetings, quarterly coaching telephone calls, and weekly self-monitoring) designed to improve diet and increase physical activity.
  
  
  METHODS
  Total bone mineral density was measured by dual-energy x-ray absorptiometry. Behavioral outcomes included intake of calcium, vitamin D, soda, and fruits and vegetables; high-impact and strength-training physical activity; measures of strength and fitness; and biomarkers (osteocalcin and naltrexone).
  
  
  RESULTS
  Compared with control subjects, girls in the intervention group had significantly higher bone mineral density in the spine and trochanter regions during the first study year, which was maintained during the second study year. The naltrexone biomarker demonstrated a greater relative decrease in the intervention group compared with the control group, with nonsignificant changes in osteocalcin consistent with more bone building in the intervention group. Participants in the intervention group reported significantly greater consumption of calcium in both study years, vitamin D in the first year, and fruits and vegetables in both years. We found no effect on soda consumption or target exercise rates.
  
  
  CONCLUSIONS
  A comprehensive health care-based lifestyle intervention can effectively improve dietary intake and increase bone mineral gains in adolescent girls. To our knowledge, this study is the first to significantly improve bone mass in adolescent girls in a non-school-based intervention. Trial Registration ClinicalTrials.gov Identifier: NCT00067600.
authors.affiliation: Center for Health Research, Kaiser Permanente Northwest, Portland, OR 97227, USA. lynn.debar@kpchr.org
authors.forename: Lynn L
authors.initials: LL
authors.lastname: DeBar
authors.forename: Cheryl
authors.initials: C
authors.lastname: Ritenbaugh
authors.forename: Mikel
authors.initials: M
authors.lastname: Aickin
authors.forename: Eric
authors.initials: E
authors.lastname: Orwoll
authors.forename: Diane
authors.initials: D
authors.lastname: Elliot
authors.forename: John
authors.initials: J
authors.lastname: Dickerson
authors.forename: Nancy
authors.initials: N
authors.lastname: Vuckovic
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Stevens
authors.forename: Esther
authors.initials: E
authors.lastname: Moe
authors.forename: Lori M
authors.initials: LM
authors.lastname: Irving
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D004032:Diet; D004034:Diet Surveys; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D009271:Naltrexone / Q000097:blood; D015675:Osteocalcin / Q000097:blood
chemical_list: D015415:Biomarkers; D015675:Osteocalcin; D009271:Naltrexone