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Table 2 Summary of the articles included in the present review

From: Physical activity during life course and bone mass: a systematic review of methods and findings from cohort studies with young adults

References Country Study Sample size Sex Age at baseline considered in the analysis Follow-up duration PA during adolescence PA during early adulthood Outcomes Main results
Bakker, 2003 [44] Netherlands Amsterdam Growth and Health Longitudinal Study (AGAHLS) 466 Both 27 years 10 years - Questionnaire developed for the AGAHLS. Semi-structured. Previous 3 months. Evaluation by metabolic activity score per week (METPA) and mechanical activity score (MECHPA) evaluated by sum of ground reaction force of each PA reported. BMD MECHPA was positively associated with BMD in males (β = 0,090, p < 0,001). Subjects of both sex in 2nd and 3rd quartile of METPA had greater BMD.
LS
Barnekow-Bergkvist, 2006 [57] Sweden - 36 Females 15-17 years 20 years Questions on participation in PA: leisure-time sports activity (yes/no), membership of a sports club (yes/no), and kind of activity/ies. Questions about leisure-time PA were collected regarding type of activity and frequency of overall PA. Only weight-bearing activities were taken into account. BMD Girls who were members of a sports club showed higher adult BMD in all sites. There was no association between current weight-bearing PA and adult BMD.
TB
LS
FN
Baxter-Jones, 2008 [48] Canada Saskatchewan Pediatric Bone Mineral Accrual Study (PBMAS) 154 Both 8-15 years 15 years PAQ-C was used on children and PAQ-A on adolescents many times. Nine items scored on a five-point Likert-type scale. Age and sex-specific Z-score was determined. Individuals were ranked into quartiles according to Z-score: highest - active, middle two quartiles- average, lowest – inactive. PAQ-AD. Used only for controlling the effect of past PA on BMC. BMC Active males during childhood/adolescence had higher BMD at TB and FN than inactive ones and active females had higher BMD at FN than inactive.
TB
LS
FN
Cooper, 1995 [58] England - 153 Females - 21 years Participation in sports at school asked in adulthood. Classified in ≤2 h and 2 or more hours per week. Duration of outdoor walking (none, 1–30, 31–60, 61–120 and >120 min/day), participation in sports and PA at work. BMC More than 2 hours/week of participation in sports at school was associated with higher BMD at FN. Duration of walking was positively associated with higher LS and FN BMD.
BMD
BMAD
LS
FN
Delvaux, 2001 [49] Belgium Leuven Longitudinal Study on Lifestyle, Fitness and Health (LLSLFH) 126 Males 13 years 27 years A standardized questionnaire was used. Sport activities during the past year were registered. From the reported time and frequency of sport participation, a global average score of hours per week was calculated. No distinction was made between weight-bearing activities and others. The same questionnaire used on adolescence. Baecke questionnaire. Four indices were calculated: PA at work, sports activities during leisure-time, PA during leisure time excluding sports, and the total PA index as the sum of the three previous indices. BMC Sports at 13y were not associated with bone mass. Sports at 18y were positively associated with LS BMC. Occupational and leisure-time PA (excluding sports) were not related to bone mass. Baecke sports index was positively associated with TB BMD and LS BMC and BMD.
BMD
TB
LS
Groothausen, 1997 [43] Netherlands Amsterdam Growth and Health Longitudinal Study (AGAHLS) 182 Both 13 years 14 years Questionnaire developed for the AGAHLS. Semi-structured. Previous 3 months. PS determined from 0 to 3 according to ground reaction force of each PA. Two different PS scores: A – sum of all PS, B – the highest PS. Same procedures used during adolescence period. PA evaluated at 21 and 27 years. BMD PS evaluated by sum of all PS in all periods (13–16 years;13–21 years; 21–27 years and whole period) was associated with LS BMD. PS evaluated by the highest PS was associated with LS BMD in 3 periods (13-21 years; 21–27 years and whole period).
PA evaluated from 13 to 16 years.
LS
Kemper, 2000 [46] Netherlands Amsterdam Growth and Health Longitudinal Study (AGAHLS) 182 Both 13 years 16 years Questionnaire developed for the AGAHLS. Semi-structured. Evaluation by metabolic activity score per week (METPA) and mechanical activity score (MECHPA) evaluated by sum of ground reaction force of each PA. PA evaluated from 13 to 16 years. Same procedures used during adolescence period. PA evaluated at 21 and 27 years. BMD Positive association was found between METPA from 13 to 16 y and LS BMD only in males. MECHPA in young adulthood was associated with LS BMD in both sexes. No association was found between METPA and FN BMD. Positive association was found between MECHPA and FN BMD, adjusted for gender
LS
FN
Kemper, 2002 [45] Netherlands Amsterdam Growth and Health Longitudinal Study (AGAHLS) 302 Both 13 years 19 years Questionnaire developed for the AGAHLS. Semi-structured. Evaluation by metabolic activity score per week (METPA) and mechanical activity score (MECHPA) evaluated by sum of ground reaction force of each PA. PA evaluated from 13 to 16 years. Same procedures used during adolescence period. PA evaluated at 21, 27, 29 and 32 years. Only measures performed on 21 and 27 years were analyzed. BMD METPA and MECHPA scores from total period (13-27y) were positively associated with LS BMD. METPA in the teenage period (13-16y) and MECHPA in young adulthood period (21-27y) were also positively associated with LS BMD.
LS
Lloyd, 2004 [50] United States Penn State Young Women’s Health Study 75 Females 12 years 10 years Questionnaire based on existing instruments. The questionnaire listed 28 activities, including school-based activities; outside-of-school organized activities; and individual activities. The cumulative sports exercise score was an arithmetic sum. Questionnaire applied at least once per year from 12 to 18y. Same procedures used during adolescence period. Questionnaire applied at least once per year up to 22 years. BMD The cumulative sports-exercise score was positively correlated to FN BMD.
FN
McGuigan, 2002 [51] Ireland Young Hearts Project 460 Both 12-15 years 10 years PA scores in adolescence were calculated according to a method which assessed normal daily activity patterns based around the typical school day. Activities were scored from 1–100 according to their frequency, intensity and duration. Modification of the Baecke questionnaire, which records work-related PA, sports-related PA, and non-sports leisure activity. A total activity score was obtained from the sum of scores in these domains to give a total score ranging from 3 to 15. BMD Exercise history was the most important predictor of LS BMD in men. PA was also the strongest predictor of FN BMD in men. The results were almost identical when using exercise data collected at the age of 12–15 years.
LS
FN
Mein, 2004 [56] Australia - 62 Females 18.5 years 9 years Physical activity questionnaire (PAQ) was used. It measured additional sporting pursuits. To compare the two questionnaires, the units of the PAQ scores were transformed by adding the product of the z-score of the PAQ and the SD of KPAS (sports and exercise index) to this mean of KPAS. Kaiser Physical Activity Survey (KPAS) was used to evaluate habitual PA and exercise. Four indices could be calculated—Domestic, Occupational, Active Living, and Sports and Exercise. The average of these scores was expressed as a summary score. BMD Average PA was positively correlated with LS and FN BMD.
LS
FN
Neville, 2002 [52] Ireland Young Hearts Project 443 Both 12-15 years 8-10 years PA scores in adolescence were calculated according to a method which assessed normal daily activity patterns based around the typical school day. Activities were scored from 1–100 according to their frequency, intensity and duration. Modification of the Baecke questionnaire, which records work-related PA, sports-related PA, and non-sports leisure activity. BMD In males, PA during adolescence was associated only with FN BMD. PA on young adulthood was associated with both LS and FN BMD in males. In females, the PA in both periods was not associated with BMD.
LS
FN
A total activity score was obtained from the sum of scores in these domains to give a total score ranging from 3 to 15.
Petit, 2004 [53] United States Penn State Young Women’s Health Study 76 Females 12 years 10 years Questionnaire based on existing instruments used from 12 to 18y. The questionnaire listed 28 activities, including school-based activities; outside-of-school organized activities; and individual activities. Cumulative sports exercise score was an arithmetic sum. - BMD Sports exercise score during adolescence was not associated with FN BMD at 22 years and with change on BMD from 17 to 22 years.
FN
Uusi-Rasi, 2002 [60] Finland - 92 Females 25-30 years 4.2 years - PA was classified into 4 categories according to type and frequency: (1) ‘high’ vigorous PA ≥ 2 times a week, (2) ‘moderate’ vigorous PA ≤ once a week or less demanding PA few times a week, (3) ‘low’ less demanding PA once a week or very light PA several times a week (4) ‘no activity’. Category 1 was the PA + group and categories 3 and 4 were PA– groups. BMC There were no statistically significant differences for the FN BMC between the PA + and PA– groups
FN
Uusi-Rasi, 2008 [59] Finland - 133 Females 25-30 years 10 years - PA was classified into 4 categories according to type and frequency: (1) ‘high’ vigorous PA ≥ 2 times a week, (2) ‘moderate’ vigorous PA ≤ once a week or less demanding PA few times a week, (3) ‘low’ less demanding PA once a week or very light PA several times a week (4) ‘no activity’. Category 1 was the PA + group and categories 3 and 4 were PA– groups. BMC There was no statistical difference between PA + and PA- group at FN BMC evaluated by three repeated measures (baseline, 5-year, 10-year).
FN
Valimaki, 1994 [61] Finland Young Finns study 264 Both 9-18 years 11 years Subjects were asked about weekly frequency of PA exceeding 30 minutes per performance. This same question was used in baseline and 6-year follow-up. Having two or more weekly sessions was called 1 and less than two sessions was called 0. PA on childhood or adolescence was analyzed with PA on adulthood. Same question was used in 10-year follow-up. The sum of the three years answers ranging from 0 to 3 was calculated. BMD LS BMD was greater in males with PA evaluated as score 3. FN BMD was greater in both males and females with PA evaluated as score 3 than subjects with other PA values.
LS
FN
Van Langendonck, 2003 [54] Belgium Leuven Longitudinal Study of Lifestyle, Fitness and Health (LLSLFH) 154 Males 13 years 27 years Sports participation inventory was used. Information about the types of sports and the time per week was obtained. The score for 13–18y was calculated. Other two different analyses of PA were performed. 1) PS determined from 0 to 3 according to ground reaction force of each PA. Sum of all PS scores was calculated. 2) Groups were created from the ground reaction force: high, moderate, light or nonimpact. Same questionnaire used during adolescence asked at 30, 35 and 40y. PS from adulthood was added to PS obtained on adolescence. Groups obtained on second analysis according to engagement on high (H) or nonimpact (N) in each period were: HH, HN, NN. NH group was excluded of analysis, as well as subjects whose sports participation did not meet these criteria. BMD PS score during adulthood was a positive predictor of TB and LS BMD. HH group showed greater LS BMD than HN and NN groups.
TB
LS
Wang, 2003 [55] United States Berkeley Bone Health Study (BBHS) 341 Females 9-10 years 10-15 years PA level assessed by self reported habitual activities, with scores derived by using MET values and time estimates (years 1, 3, and 5–10). Sedentary activity assessed by self-reports of weekly hours of television-video viewing (years 1, 3, and 5–10). - BMC Physical activity was not associated with bone mass. Only sedentary activity on pre-puberty was negatively associated with FN BMD and BMAD.
BMD
BMAD
TB
LS
FN
Welten, 1994 [47] Netherlands Amsterdam Growth and Health Longitudinal Study (AGAHLS) 182 Both 13 years 14 years Questionnaire measuring habitual PA in the last 3 months. Only PA with a minimal of 4 METs were considered. The average weekly time spent in 3 activity level was collected: light (4-7METs), medium heavy (7-10METs) and heavy (>10METs). Total PA/week was the product of the time spent per level of intensity (1, 2 or 3). Only PA with a weight-bearing component was used. Adolescent period was considered from 13 to 17y Same questionnaire used during adolescence. PA on young adulthood was analyzed on period between 13 and 22y and on total period – between 13 and 28y BMD Weight-bearing PA in all periods (13-17y; 13-22y and 13-27y) was positively associated with LS BMD only in males.
LS
  1. PA Physical activity, BMC Bone mineral content, BMD Bone mineral density, BMAD Bone mineral apparent density, TB Total body, LS Lumbar spine, FN Femoral neck, PS Peak strain.