Distribution of Calcaneal Bone Density According to the Mechanical Strain of Exercise and Calcium Intake in Premenarcheal Girls

Shin, Eun Kyung; Kim, Ki Suk; Kim, Hee Young; Lee, In Sook; Joung, Hyo Jee; Cho, Sung Il

Abstract

OBJECTIVE
The effects of exercise on bone density have been found to be inconsistent in previous studies. We conducted a cross-sectional study in premenarcheal girls to test two hypotheses to explain these inconsistencies. Firstly, "the intensity of mechanical strain, in terms of the ground reaction force (GRF), has more important effects on the bone mass at a weight-bearing site", and secondly, "calcium intake modifies the bone response to exercise". METHODS: The areal bone mineral density was measured at the Os calcis, using peripheral dual energy X-ray absorptiometry, in 91 premenarcheal girls aged between 9 and 12 years. The intensity of mechanical strain of exercise was assessed by a self-report questionnaire and scored by the GRF as multiples of body weight, irrespective of the frequency and duration of exercise. The energy and calcium intake were calculated from the 24-hour dietary recall. An analysis of covariance (ANCOVA) was used to determine the interaction and main effects of exercise and calcium on the bone density, after adjusting for age, weight, height and energy intake. RESULTS: The difference in the bone density between moderate and low impact exercise was more pronounced in the high than low calcium intake group. The bone density for moderate impact exercise and high calcium intake was significantly higher than that for low impact exercise (p=0.046) and low calcium intake, after adjusting for age, weight, height and energy intake. CONCLUSIONS: Our study suggests that the bone density at a weight-bearing site is positively related to the intensity of mechanical loading exercise, and the calcium intake may modify the bone response to exercise at the loaded site in premenarcheal girls.