title: Physical activity, calcium intake and childhood bone mineral: a population-based cross-sectional study.
abstract: In a free-living cohort of 4-year old children, mean daily time in moderate-vigorous physical activity and daily calcium intake at 3 years, were positively related to hip bone size and density. Relationships between physical activity and bone indices were stronger when calcium intake was above compared with below median (966 mg/day).
  
  
  BACKGROUND
  We examined the cross-sectional relationships between childhood physical activity, dietary calcium intake and bone size and density.
  
  
  METHODS
  Children aged 4 years were recruited from the Southampton Women's Survey. They underwent measurement of bone mass by DXA (Hologic Discovery). Physical activity was assessed by accelerometry (Actiheart, Cambridge Neurotechnology Ltd, Cambridge, UK) for seven continuous days.
  
  
  RESULTS
  Four hundred twenty-two children (212 boys) participated. In a cross-sectional analysis, after adjusting for gender, daily mean time(minutes per day) spent in moderate to very vigorous activity (MVPA) was positively related to hip BA (R(2) = 3%, p < 0.001), BMC (R(2) = 4%, p < 0.001), aBMD (R (2) = 3%, p = 0.001) and estimated vBMD (R(2) = 2%, p = 0.01), but not height (r (s) = 0.04, p = 0.42) or weight (r(s) = 0.01, p = 0.76). Mean daily calcium intake (assessed at 3 years old) positively predicted bone indices in those with a calcium intake below the median (966 mg/day), but there was a much attenuated relationship in those above this. These associations persisted after inclusion of total energy, protein and phosphorus in multivariate models. The relationships between MVPA and bone indices were stronger in children with calcium intakes above the median. Thus, for aBMD, the variance explained by MVPA when daily calcium intake was below the median was 2% (p = 0.1) and above median was 6% (p = 0.001).
  
  
  CONCLUSIONS
  These results support the notion that adequate calcium intake may be required for optimal action of physical activity on bone development and that improving levels of physical activity and calcium intake in childhood may help to optimise accrual of bone mass.
authors.affiliation: MRC Lifecourse Epidemiology Unit, (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK. nch@mrc.soton.ac.uk
authors.forename: N C
authors.initials: NC
authors.lastname: Harvey
authors.forename: Z A
authors.initials: ZA
authors.lastname: Cole
authors.forename: S R
authors.initials: SR
authors.lastname: Crozier
authors.forename: M
authors.initials: M
authors.lastname: Kim
authors.forename: G
authors.initials: G
authors.lastname: Ntani
authors.forename: L
authors.initials: L
authors.lastname: Goodfellow
authors.forename: S M
authors.initials: SM
authors.lastname: Robinson
authors.forename: H M
authors.initials: HM
authors.lastname: Inskip
authors.forename: K M
authors.initials: KM
authors.lastname: Godfrey
authors.forename: E M
authors.initials: EM
authors.lastname: Dennison
authors.forename: N
authors.initials: N
authors.lastname: Wareham
authors.forename: U
authors.initials: U
authors.lastname: Ekelund
authors.forename: C
authors.initials: C
authors.lastname: Cooper
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000328:Adult; D015519:Bone Density / Q000187:drug effects / Q000502:physiology*; D002136:Calcium, Dietary / Q000008:administration & dosage* / Q000494:pharmacology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006621:Hip Joint / Q000033:anatomy & histology / Q000502:physiology; D006801:Humans; D008019:Life Style; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D012737:Sex Factors; D013997:Time Factors; D055815:Young Adult
chemical_list: D002136:Calcium, Dietary