n International SportMed Journal - Growing bones : how important is exercise?

Volume 2, Issue 5
  • ISSN : 1528-3356



It has been postulated that the antecedents of adult osteoporosis may be present in childhood. Factors that affect skeletal strength and design include genetics, physical activity, hormones, and dietary factors. Of these, the mechanical loading activity of bone is vitally important. During the last decade, animal studies have clearly defined the key role that mechanical loading plays in the attainment of a healthy skeleton. The idea of a 'critical period' at ages 10-12 when the skeleton most readily adapts to physical work has been postulated. Recently a number of prospective intervention trials in children have provided new insights to support this hypothesis. However, the vast majority of pediatric bone studies have been performed with dual-energy X-ray absorptiometric (DXA) systems. Recent studies point out that bone outcomes from DXA may significantly underestimate the effect of exercise intervention on overall bone strength. The aim of this review is firstly, to familiarize the reader with the normal pattern of bone mineral accrual during childhood. The role of exercise in modulating how bone is accrued during childhood and adolescent growth is then discussed. From that foundation, the literature that evaluates the ideal age when childhood physical activity has the most profound effect on bone mass and bone structural parameters (all of which contribute to overall bone strength) is summarized. Some methodological considerations when evaluating the pediatric skeleton using bone densitometry are also discussed. Finally, some studies that have utilized novel approaches to assess bone mass and structural change in the pediatric skeleton are introduced.

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