title: Adolescence physical activity is associated with higher tibial pQCT bone values in adulthood after 28-years of follow-up--the Cardiovascular Risk in Young Finns Study.
abstract: High peak bone mass and strong bone phenotype are known to be partly explained by physical activity during growth but there are few prospective studies on this topic. In this 28-year follow-up of Cardiovascular Risk in Young Finns Study cohort, we assessed whether habitual childhood and adolescence physical activity or inactivity at the age of 3-18 years were associated with adult phenotype of weight-bearing tibia and the risk of low-energy fractures. Baseline physical activity and data on clinical, nutritional and lifestyle factors were assessed separately for females and males aged 3-6-years (N=395-421) and 9-18-years (N=923-965). At the age of 31-46-years, the prevalence of low-energy fractures was assessed with a questionnaire and several tibial traits were measured with pQCT (bone mineral content (BMC; mg), total and cortical cross-sectional areas (mm(2)), trabecular (for the distal site only) and cortical (for the shaft only) bone densities (mg/cm(3)), stress-strain index (SSI; mm(3), for the shaft only), bone strength index (BSI; mg(2)/cm(4), for the distal site only) and the cortical strength index (CSI, for the shaft only)). For the statistical analysis, each bone trait was categorized as below the cohort median or the median and above and the adjusted odds ratios (OR) were determined. In females, frequent physical activity at the age of 9-18-years was associated with higher adulthood values of BSI, total and cortical areas, BMC, CSI and SSI at the tibia independently of many health and lifestyle factors (ORs 0.33-0.53, P≤0.05; P-values for trend 0.002-0.05). Cortical density at the tibial shaft showed the opposite trend (P-value for trend 0.03). Similarly in males, frequent physical activity was associated with higher values of adult total and cortical areas and CSI at the tibia (ORs 0.48-0.53, P≤0.05; P-values for trend 0.01-0.02). However, there was no evidence that childhood or adolescence physical activity was associated with lower risk of low energy fractures during the follow-up. In conclusion, frequent habitual physical activity in adolescence seems to confer benefits on tibial bone size and geometry in adulthood.
authors.affiliation: Division of Nutrition, Department of Applied Chemistry and Microbiology, University of Helsinki, Helsinki, Finland; Vaasa Central Hospital, Vaasa, Finland. Electronic address: sanna.tolonen@vshp.fi.
authors.forename: S
authors.initials: S
authors.lastname: Tolonen
authors.affiliation: The UKK-institute for Health Promotion Research, Tampere, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Sievänen
authors.affiliation: Division of Nutrition, Department of Applied Chemistry and Microbiology, University of Helsinki, Helsinki, Finland; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
authors.forename: V
authors.initials: V
authors.lastname: Mikkilä
authors.affiliation: LIKES Research Center for Sport and Health Sciences, Jyväskylä, Finland.
authors.forename: R
authors.initials: R
authors.lastname: Telama
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Oikonen
authors.affiliation: Division of Nutrition, Department of Applied Chemistry and Microbiology, University of Helsinki, Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Laaksonen
authors.affiliation: Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Viikari
authors.affiliation: Department of Clinical Physiology, Tampere University Hospital and University of Tampere, Tampere, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Kähönen
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland.
authors.forename: O T
authors.initials: OT
authors.lastname: Raitakari
mesh_terms: D000293:Adolescent; D000328:Adult; D015519:Bone Density / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000453:epidemiology*; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D016017:Odds Ratio; D015995:Prevalence; D013977:Tibia / Q000000981:diagnostic imaging* / Q000254:growth & development; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Bone strength; Exercise; Fractures; Prospective cohort study