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Prepubertal Impact of Protein Intake and Physical Activity on Weight-Bearing Peak Bone Mass and Strength in Males
Thierry Chevalley1, Jean-Philippe Bonjour1, Marie-Claude Audet1
1Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, CH-1205, Switzerland.
Insights
Adequate protein intake during childhood significantly boosts the bone-building effects of physical activity, leading to stronger bones throughout life. These benefits, established in early years, contribute to higher peak bone mass and reduced fracture risk in males.
Area of Science:
- Pediatric Endocrinology
- Bone Biology
- Nutritional Science
Background:
- Peak bone mass (PBM) and strength are critical for preventing fractures later in life.
- Bone development during childhood is highly sensitive to nutrition and physical activity (PA), especially before puberty.
Purpose of the Study:
- To investigate the long-term effects of the synergistic interaction between protein intake (Prot-Int) and physical activity (PA) on bone development in healthy boys.
- To determine if the enhanced bone benefits observed in prepubertal boys with adequate protein and PA persist until peak bone mass attainment.
Main Methods:
- A longitudinal study followed 124 healthy boys from age 7.4 to 22.6 years.
- Participants were categorized based on median physical activity levels and protein intake at age 7.4 years.
- Bone mineral content (BMC) of the femoral neck (FN) and structural properties of the distal tibia were assessed.
Main Results:
- Boys with higher protein intake and greater physical activity at age 7.4 showed significantly greater femoral neck bone mineral content (+9.8%) that was sustained through age 22.6 (+11.3% to +12.7%).
- Higher protein intake, in conjunction with greater physical activity, led to increased femoral neck bone mineral content z-scores (+0.60 to +0.70) across all measurement points.
- Advanced analysis revealed that greater physical activity combined with higher protein intake resulted in improved bone structural properties (cross-sectional area, stiffness, failure load) in the tibia.
Conclusions:
- Protein intake plays a pivotal role in optimizing the bone-enhancing effects of physical activity during childhood.
- The prepubertal period is crucial for establishing a trajectory of bone growth that leads to higher peak bone mass and enhanced bone strength in males.
- Early nutritional and physical activity interventions can have lasting positive impacts on skeletal health.
Context:
Peak bone mass (PBM) and strength are important determinants of fracture risk in later life. During growth, bone is responsive to changes in nutrition and physical activity (PA), particularly before pubertal maturation.
Objective:
In prepubertal healthy boys, protein intake (Prot-Int) enhances the impact of PA on weight-bearing bone. We hypothesized that the synergism between Prot-Int and PA on proximal femur as recorded at 7.4 years would track until PBM.
Methods:
A total of 124 boys were followed from 7.4 to 15.2 and 22.6 years. At 7.4 years, they were dichotomized according to the median of both PA and Prot-Int.
Results:
In boys with PA greater than the median (310 vs 169 kcal ⋅ d-1), higher vs low Prot-Int (57.7 vs 38.0 g ⋅ d-1) was associated with +9.8% greater femoral neck (FN) bone mineral content (BMC) (P = 0.027) at 7.4 years. At 15.2 and 22.6 years, this difference was maintained: FN BMC: +12.7% (P = 0.012) and +11.3% (P = 0.016), respectively. With PA greater than the median, in Prot-Int greater than vs less than the median, differences in FN BMC z scores were +0.60, +0.70, and +0.68 at 7.4, 15.2, and 22.6 years, respectively. Microfinite element analysis of distal tibia at 15.2 and 22.6 years indicated that in the 2 groups with PA greater than the median, cross-sectional area, stiffness, and failure load were greater in Prot-Int greater than vs less than the median.
Conclusions:
This study demonstrates the crucial influence of Prot-Int on the response to enhanced PA and the importance of prepubertal years for modifying the bone growth trajectory and, thereby, for achieving higher PBM and greater strength in healthy male participants.
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