Adam Baxter-Jones

Bone mineral accrual from 8 to 30 years of age: An estimation of peak bone mass

Bone area (BA) and bone mineral content (BMC) were measured from childhood to young adulthood at the total body (TB), lumbar spine (LS), total hip (TH), and femoral neck (FN). BA and BMC values were expressed as a percentage of young‐adult values to determine if and when values reached a plateau. Data were aligned on biological ages [years from peak height velocity (PHV)] to control for maturity. TB BA increased significantly from −4 to +4 years from PHV, with TB BMC reaching a plateau, on average, 2 years later at +6 years from PHV (equates to 18 and 20 years of age in girls and boys, respectively). LS BA increased significantly from −4 years from PHV to +3 years from PHV, whereas LS BMC increased until +4 from PHV. FN BA increased between −4 and +1 years from PHV, with FN BMC reaching a plateau, on average, 1 year later at +2 years from PHV. In the circumpubertal years (−2 to +2 years from PHV): 39% of the young‐adult BMC was accrued at the TB in both males and females; 43% and 46% was accrued in males and females at the LS and TH, respectively; 33% (males and females) was accrued at the FN. In summary, we provide strong evidence that BA plateaus 1 to 2 years earlier than BMC. Depending on the skeletal site, peak bone mass occurs by the end of the second or early in the third decade of life. The data substantiate the importance of the circumpubertal years for accruing bone mineral.

Do physical maturity and birth date predict talent in male youth ice hockey players

Abstract The aim of this study was to examine the relationships among biological maturity, physical size, relative age (i.e. birth date), and selection into a male Canadian provincial age-banded ice hockey team. In 2003, 619 male ice hockey players aged 14 – 15 years attended Saskatchewan provincial team selection camps, 281 of whom participated in the present study. Data from 93 age-matched controls were obtained from the Saskatchewan Pediatric Bone Mineral Accrual Study (1991 – 1997). During the initial selection camps, birth dates, heights, sitting heights, and body masses were recorded. Age at peak height velocity, an indicator of biological maturity, was determined in the controls and predicted in the ice hockey players. Data were analysed using one-way analysis of variance, logistic regression, and a Kolmogorov-Smirnov test. The ice hockey players selected for the final team were taller, heavier, and more mature (P < 0.05) than both the unselected players and the age-matched controls. Furthermore, age at peak height velocity predicted (P < 0.05) being selected at the first and second selection camps. The birth dates of those players selected for the team were positively skewed, with the majority of those selected being born in the months January to June. In conclusion, team selectors appear to preferentially select early maturing male ice hockey players who have birth dates early in the selection year.

Impact Exercise Increases BMC During Growth: An 8‐Year Longitudinal Study

Our aim was to assess BMC of the hip over 8 yr in prepubertal children who participated in a 7‐mo jumping intervention compared with controls who participated in a stretching program of equal duration. We hypothesized that jumpers would gain more BMC than control subjects. The data reported come from two cohorts of children who participated in separate, but identical, randomized, controlled, school‐based impact exercise interventions and reflect those subjects who agreed to long‐term follow‐up (N = 57; jumpers = 33, controls = 24; 47% of the original participants). BMC was assessed by DXA at baseline, 7 and 19 mo after intervention, and annually thereafter for 5 yr (eight visits over 8 yr). Multilevel random effects models were constructed and used to predict change in BMC from baseline at each measurement occasion. After 7 mo, those children that completed high‐impact jumping exercises had 3.6% more BMC at the hip than control subjects whom completed nonimpact stretching activities (p < 0.05) and 1.4% more BMC at the hip after nearly 8 yr (BMC adjusted for change in age, height, weight, and physical activity; p < 0.05). This provides the first evidence of a sustained effect on total hip BMC from short‐term high‐impact exercise undertaken in early childhood. If the benefits are sustained into young adulthood, effectively increasing peak bone mass, fracture risk in the later years could be reduced.

Comparison of physical activity in male and female children: does maturation matter?

PURPOSE To investigate whether observed differences in physical activity levels in boys and girls are confounded by biological age differences particularly during the circumpubertal years. METHODS The physical activity questionnaire for children (PAQ-C) was administered biannually or triannually to 138 (70 boys; 68 girls) Canadian children for seven consecutive years from 1991 to 1997. Participants were 9-18 yr of age. Anthropometric measurements were taken biannually and age at peak height velocity (PHV) determined. Biological age was defined as years from PHV. The data were analyzed using t-tests and random effects models. RESULTS Level of physical activity decreased with increasing chronological age in both sexes. When aligned on chronological age bands, boys had statistically significantly higher PAQ-C summary scores than girls from 10 through 16 yr of age (P < 0.05). However, when aligned on biological age, sex differences were not apparent, except at 3 yr before PHV. Random effects models of individual growth patterns confirmed these findings. CONCLUSION Physical activity decreased with increasing chronological age in boys and girls. There were no sex differences in the longitudinal pattern of physical activity when the confounding effects of biological age were controlled except at 3 yr before PHV.

A longitudinal study of the relationship of physical activity to bone mineral accrual from adolescence to young adulthood

Physical activity in adolescence is beneficial for increasing bone mineral accrual; however, its unclear whether these benefits persist into adulthood. This prospective study investigated whether physically active adolescents maintained their higher bone mineral content (BMC) into the third decade of life when compared to their less active peers. Data were from 154 subjects (82 females and 72 males) who participated in the University of Saskatchewans Pediatric Bone Mineral Accrual Study (1991-1997), entry age 8 to 15 years. Participants returned for follow-up as young adults (2002-2006), follow-up age 23 to 30 years. Dual energy X-ray absorptiometry was used to measure BMC of total body (TB), lumbar spine (LS), total hip (TH) and femoral neck (FN) annually from 1991 to 1997 and from 2002 to 2006. Peak height velocity (PHV) was determined for each child as a measure of maturity. Age and gender-specific activity Z-scores were calculated for each participant based on the mean physical activity scores obtained from bi-annual questionnaire data during childhood and adolescence. Subjects were ranked into three adolescent activity groups: active, average and inactive (top, middle two, and bottom quartiles, respectively). Analysis of covariance (ANCOVA) was used to compare adjusted TB, LS, TH and FN BMC across the three adolescent activity groups at 1 year post PHV and in young adulthood. When compared to the inactive group, active males had 8% greater adjusted BMC at the TB, 13% at the LS and 11% at the TH (p<0.05) in adolescence. Active females also had 8% and 15% more adjusted BMC (p<0.05) at the TB and LS, respectively, during adolescence. In young adulthood the male and female adolescent active groups were still significantly more active than their peers (p>0.05). It was found that active adolescent males had 8-10% more adjusted BMC at the TB, TH and FN (p<0.05) in young adulthood and that active adolescent females had 9% and 10% more adjusted BMC at the TH and FN. These results suggest that the skeletal benefits of physically activity in adolescents are maintained into young adulthood.

Positive effects of vegetable and fruit consumption and calcium intake on bone mineral accrual in boys during growth from childhood to adolescence : the University of Saskatchewan Pediatric Bone Mineral Accrual Study

BACKGROUND Nutrition is an important modifiable factor in the development of bone mass during adolescence. Recent studies of children and adolescents examined the effects of foods such as milk products and fruit and vegetables on bone growth; however, few studies included both boys and girls. OBJECTIVE The purpose was to ascertain the role of consumption of milk products and vegetables and fruit in the accrual of total-body bone mineral content (TBBMC) in boys and girls from childhood to late adolescence. DESIGN Seven-year longitudinal data were obtained from 85 boys and 67 girls aged 8-20 y. Biological maturity was defined by the number of years from the age at peak height velocity. Dietary intake was assessed by serial 24-h recalls. Anthropometric measurements and physical activity were assessed every 6 mo. TBBMC assessed with dual-energy X-ray absorptiometry in the fall of each year was the indicator of bone mass. RESULTS Most boys (87.8%) met Canadian recommendations for milk product intake. Few subjects (<30%) consumed vegetables and fruit in recommended amounts. Using a multilevel modeling statistical approach containing important biological and environmental factors, we found that vegetable and fruit intakes, calcium intake, and physical activity were significant independent environmental predictors of TBBMC in boys but not in girls. CONCLUSIONS In addition to adequate dietary calcium intake, appropriate intakes of vegetables and fruit have a beneficial effect on TBBMC in boys aged 8-20 y. Underreporting of dietary intake by girls may explain why this effect was not apparent in girls.

Evidence of sustained skeletal benefits from impact-loading exercise in young females: A 3-year longitudinal study

The skeletal effects from intensive exercise throughout puberty are undefined. Forty‐five female gymnasts and 52 controls were studied over 3 years, including a heredity aspect. The effects of size, maturity, exercise, and diet were identified using a multilevel regression model. Results demonstrated sustained skeletal benefits resulting from exercise throughout all stages of pubertal development.

Size-corrected BMD decreases during peak linear growth: Implications for fracture incidence during adolescence

Peak adolescent fracture incidence at the distal end of the radius coincides with a decline in size‐corrected BMD in both boys and girls. Peak gains in bone area preceded peak gains in BMC in a longitudinal sample of boys and girls, supporting the theory that the dissociation between skeletal expansion and skeletal mineralization results in a period of relative bone weakness.

Menarche in intensively trained gymnasts, swimmers and tennis players

It has been hypothesized that young athletes, undertaking intensive training, have delayed menarche due to the effects of training at an early age, although it is known that other genetic and environmental factors contribute to this observed later menarche. As part of a longitudinal study of the effects of intensive training during puberty and adolescence we investigated age of menarche in 222 athletes and their mothers. All the sports studied (gymnastics, swimming and tennis) had later mean ages of menarche (14.3, 13.3 and 13.2 years respectively) than the previously reported UK reference value of 13.00 years. A positive correlation was found between menarcheal age in mothers and daughters (r = 0.27, p < 0.01). Analysis of covariance, using maternal menarcheal age, socioeconomic group, duration of training and type of sport, confirmed that maternal menarcheal age and type of sport were having a significant influence on subjects age of menarche. As maternal menarcheal age and sport were the best predictors of menarcheal age in the athletes we studied, it would appear that menarche was intrinsically late rather than delayed. This suggests that some form of sport-specific selection may have occurred. It therefore seems likely that late maturation of gymnasts contributes to a girls decision to continue participating in the sport rather than intensive training delaying menarche.

Jump starting skeletal health: A 4-year longitudinal study assessing the effects of jumping on skeletal development in pre and circum pubertal children ☆

INTRODUCTION Evidence suggests bone mineral increases attributable to exercise training prior to puberty may confer a significant advantage into adulthood. However, there is a dearth of supportive prospective longitudinal data. The purpose of this study was to assess bone mineral content (BMC) of the whole body (WB), total hip (TH), femoral neck (FN) and lumbar spine (LS) over four years in pre-pubertal boys and girls following a 7-month jumping intervention. METHODS The study population included 107 girls and 98 boys aged 8.6+/-0.88 years at baseline. Participating schools were randomly assigned as either intervention or control school. Children at the intervention school (n=101) participated in a jumping intervention embedded within the standard PE curriculum. The control school children (n=104) had similar exposure to PE without the jumping intervention. BMC was assessed by DXA at baseline, at 7-month post intervention, and annually thereafter for three years totaling 5 measurement opportunities. Multi-level random effects models were constructed and used to predict change from study entry in BMC parameters at each measurement occasion. RESULTS A significant intervention effect was found at all bone sites. The effect was greatest immediately following the intervention (at 7 months) but still significant three years after the intervention. At 7 months, intervention participants had BMC values that were 7.9%, 8.4%, 7.7% and 7.3% greater than the controls at the LS, TH, FN and WB, respectively (p<0.05), when the confounders of age, maturity and tissue mass were controlled. Three years after the intervention had concluded the intervention group had 2.3%, 3.2%, 4.4% and 2.9% greater BMC than controls at the LS, TH, FN and WB respectively (p<0.05), when the confounders of age, maturity and tissue mass were controlled. CONCLUSIONS This provides evidence that short-term high impact exercise in pre-puberty has a persistent effect over and above the effects of normal growth and development. If the benefits are sustained until BMC plateaus in early adulthood, this could have substantial effects on fracture risk.