Physical Activity for Bone Health: How Much and/or How Hard?

Purpose:

High-impact physical activity is associated with bone health, but higher volumes of lower intensity activity may also be important. The aims of this study were to: 1) investigate the relative importance of volume and intensity of physical activity accumulated during late adolescence for bone health at age 23; and 2) illustrate interpretation of the results.

Methods:

This is a secondary analysis of data from the Iowa Bone Development Study, a longitudinal study of bone health from childhood through to young adulthood. The volume (average acceleration) and intensity distribution (intensity gradient) of activity at ages 17, 19, 21 and 23 were calculated from raw acceleration ActiGraph data and averaged across ages. Hip areal bone mineral density (aBMD), total body bone mineral content (BMC), spine aBMD and hip structural geometry (DXA, Hologic QDR4500A) were assessed at age 23.Valid data, available for 220 participants (124 females),were analysed with multiple regression. To elucidate significant effects, we predicted bone outcomes when activity volume and intensity were high (+1SD), medium (mean),and low (-1SD).

Results:

There were additive associations of volume and intensity with hip aBMD and total body BMC(low-intensity/low-volume cf. high-intensity/high-volume = ∆0.082g·cm-2and ∆169.8g, respectively). or males’ only spine aBMD intensity was associated independently of volume(low-intensity cf. high-intensity = ∆0.049g.cm-2). For hip structural geometry, volume was associated independently of intensity(low-volume cf. high-volume = ∆4.8-6.6%).

Conclusion: The activity profile associated with optimal bone outcomes was high in intensity and volume. The variation in bone health across the activity volume and intensity distribution suggests intensity is key for aBMD and BMC, while high volumes of lower intensity activity may be beneficial for hip structural geometry.