title: Extracurricular physical activity participation modifies the association between high TV watching and low bone mass.
abstract: OBJECTIVE
  To examine whether different sedentary behaviours are associated with the risk of low bone mineral content in adolescents, and if so, whether extracurricular physical-sporting activity influences this association.
  
  
  METHODS
  A total of 277 adolescents from Zaragoza (168 females and 109 males) aged 13.0-18.5 yr within frame work of the multicentre AVENA study participated in this study. Bone mineral content (BMC), lean mass, and fat mass were measured with DXA. Physical activity and sedentary independent variables: participation in extracurricular physical-sporting activity (PA), h/d of television watching, playing video/computer games during school days and on weekend days and doing homework/studying. They all were assessed by questionnaire. The main outcome was low BMC, as defined by BMC Z-score for age and sex < percentile 10. Logistic regression was used to test the interaction and association of PA and sedentary variables with low BMC, after controlling for confounders like height, maturational status or lean mass.
  
  
  RESULTS
  Among the sedentary variables studied, only television watching > or =3 h/d was associated with an increased risk for low BMC in males (OR, 95% CI: 7.01, 1.73 to 28.40), after controlling for sexual maturation. When PA was in the models, television watching was not any longer associated with low BMC, while PA was so (OR, 95% CI: 0.23, 0.09 to 0.55). Involvement in such activity reduced the risk of low bone mass by 76% (P<0.01) independently of body mass, height and fat mass, but not of the lean mass.
  
  
  CONCLUSIONS
  Watching television for 3 or more h/d seems to be associated with an increased risk for low BMC in male adolescents. However, this association is mediated by participation in PA, suggesting that negative consequences of excessive television watching on adolescent bone health could be counteracted by sport participation. Longitudinal data and randomized controlled trials will confirm or contrast our findings.
authors: Growth, Exercise, Nutrition and Development (GENUD) research group, Zaragoza, Spain. gervicen@unizar.es
authors: G
authors: G
authors: Vicente-Rodríguez
authors: F B
authors: FB
authors: Ortega
authors: J P
authors: JP
authors: Rey-López
authors: V
authors: V
authors: España-Romero
authors: V A
authors: VA
authors: Blay
authors: G
authors: G
authors: Blay
authors: M
authors: M
authors: Martín-Matillas
authors: L A
authors: LA
authors: Moreno
mesh_terms: D050154:Adiposity / Q000502:physiology; D000293:Adolescent; D000886:Anthropometry; D001827:Body Height; D001835:Body Weight; D015519:Bone Density / Q000502:physiology; D001842:Bone and Bones / Q000033:anatomy & histology*; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D016017:Odds Ratio; D009929:Organ Size / Q000502:physiology; D057185:Sedentary Behavior; D013690:Television