Does Exercise Influence Pediatric Bone? A Systematic Review.

Area of Science:

• Pediatric bone health
• Exercise physiology
• Public health

Background:

• Childhood growth is a critical period for bone development, influenced by physical activity.
• Optimal bone mineral acquisition during growth may reduce osteoporosis risk later in life.
• Factors like pubertal status, sex, and diet can influence bone response to exercise.

Purpose of the Study:

• To determine if bone-loading exercise in childhood consistently increases bone mineral content, bone area, or areal bone mineral density (aBMD).
• To investigate if exercise effects differ by pubertal status or sex.
• To examine if calcium intake modifies the bone response to exercise.

Main Methods:

• A meta-analysis of 22 unique trials involving children aged 3-18 years.
• Included randomized and observational studies with intervention lengths from 3 to 36 months.
• Analyzed changes in bone mineral content, bone area, and aBMD using random effects models and meta-regression.

Main Results:

• Exercise interventions led to greater mean percent changes in bone mineral content and aBMD compared to control groups.
• Benefits were most pronounced in prepubertal children, with significant increases in total body, femoral neck, and spine bone mineral content and aBMD.
• No significant differences in bone area changes were observed; effects did not differ by sex, though data for boys was limited.

Conclusions:

• Childhood exercise interventions promote significant bone accrual, primarily in prepubertal individuals.
• These findings have implications for osteoporosis prevention strategies.
• Further research is needed to identify factors influencing the bone response to exercise during growth.