The mode of school transportation in pre-pubertal children does not influence the accrual of bone mineral or the gain in bone size--two year prospective data from the paediatric osteoporosis preventive (POP) study.
BACKGROUND
Walking and cycling to school are one source of regular physical activity. The aim of this two years observational study in pre-pubertal children was to evaluate if walking and cycling to school was associated with higher total amount of physical activity and larger gain in bone mineral content (BMC) and bone width than when going by car or bus.


METHODS
133 boys and 99 girls aged 7-9 years were recruited to the Malmö Prospective Paediatric Osteoporosis Prevention (POP) study. BMC (g) was measured by dual X-ray absorptiometry (DXA) in total body, lumbar spine (L2-L4) and femoral neck (FN) at baseline and after 24 months. Bone width was measured in L2-L4 and FN. Skeletal changes in the 57 boys and 48 girls who consistently walked or cycled to school were compared with the 24 boys and 17 girls who consistently went by bus or car. All children remained in Tanner stage I. Level of everyday physical activity was estimated by accelerometers worn for four consecutive days and questionnaires. Comparisons were made by independent student's t-tests between means and Fisher's exact tests. Analysis of covariance (ANCOVA) was used to adjust for group differences in age at baseline, duration of organized physical activity, annual changes in length and BMC or bone width if there were differences in these traits at baseline.


RESULTS
After the adjustments, there were no differences in the annual changes in BMC or bone width when comparing girls or boys who walked or cycled to school with those who went by car or bus. Furthermore, there were no differences in the levels of everyday physical activity objectively measured by accelerometers and all children reached above the by the United Kingdom Expert Consensus Group recommended level of 60 minutes moderate to vigorous physical activity per day.


CONCLUSIONS
A physical active transportation to school for two years is in pre-pubertal children not associated with a higher accrual of BMC or bone width than a passive mode of transportation, possibly due to the fact that the everyday physical activity in these pre-pubertal children, independent of the mode of school transportation, was high.
Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences, Lund University, Department of Orthopaedics Malmö University Hospital, SE- 20502 Malmö, Sweden. bjarne.lofgren@med.lu.se
Bjarne
B
Löfgren
Susanna
S
Stenevi-Lundgren
Magnus
M
Dencker
Magnus K
MK
Karlsson
D001642:Bicycling / Q000706:statistics & numerical data*; D015519:Bone Density; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity; D010024:Osteoporosis / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D011446:Prospective Studies; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012574:Schools; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D014186:Transportation / Q000706:statistics & numerical data*; D016138:Walking / Q000706:statistics & numerical data*