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Physical activity is associated with improved bone health in children with inflammatory bowel disease
Jérémy Vanhelst1, Florian Vidal1, Dominique Turck2
1Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, CIC 1403 - Centre d'investigation clinique, F-59000 Lille, France.
Insights
Physical activity (PA) is linked to better bone mineral density (BMD) in children with inflammatory bowel disease (IBD). Most IBD children do not meet PA recommendations, highlighting a need for targeted interventions to improve bone health.
Area of Science:
- Pediatric Gastroenterology
- Bone Metabolism
- Physical Activity Research
Background:
- Bone health is a critical concern for pediatric patients diagnosed with inflammatory bowel disease (IBD).
- Low bone mineral density (BMD) is a significant risk factor for fractures in this population.
- Limited data exist on physical activity (PA) levels and their impact on bone health in children and adolescents with IBD.
Purpose of the Study:
- To investigate the association between physical activity (PA) and bone mineral density (BMD) in pediatric patients with IBD.
- To explore the relationship between PA and quality of life in children with IBD.
Main Methods:
- Eighty-four pediatric IBD patients (mean age 14.3 years) were enrolled.
- Bone mineral density (BMD) was assessed using dual-energy X-ray absorptiometry (DXA).
- Objective physical activity (PA) was quantified using accelerometers over seven days; quality of life was measured using PedsQL™.
Main Results:
- The majority of IBD children (94%) did not meet the recommended 60 minutes of daily moderate-to-vigorous PA (MVPA).
- Over half of the participants exhibited osteopenia (51%), and 4% had osteoporosis.
- After adjusting for confounders, increased total PA and time in MVPA were positively correlated with higher BMD (P < 0.05).
Conclusions:
- Physical activity (PA) appears to be positively associated with improved bone health in children with inflammatory bowel disease (IBD).
- Further intervention studies are needed to establish a causal link between PA and BMD in pediatric IBD patients.
Background & Aims:
Bone health is an important concern in patients with inflammatory bowel disease (IBD). Low bone mineral density (BMD) is a powerful predictor of fracture risk in IBD patients. Physical activity (PA) plays an important role in bone health. However, PA data for children and adolescents with IBD are scarce. The primary aim is to evaluate the relationship between PA and BMD in children with IBD. The secondary aim was to assess the relationship between PA and quality of life.
Methods:
Eighty-four IBD paediatric patients (45 boys) aged 14.3 ± 2.7 years were included (disease activity: (i) remission, n = 62; (ii) mild, n = 18; (iii) severe disease, n = 1). BMD was measured using dual-energy X-ray absorptiometry and expressed as age- and sex-based Z-scores. Each patient wore a triaxial accelerometer for seven consecutive days for objective PA quantification. Quality of life was assessed using the PedsQL™ and energy intake was assessed prospectively for three days using a dietary diary.
Results:
BMD Z-score was -0.96 ± 1.11. Only five patients (6%) fulfilled the recommendation of 60 min of daily moderate-to-vigorous PA (MVPA). The proportion of children with osteopenia and osteoporosis was 51% and 4%, respectively. After adjustment for confounders (pubertal status and body mass index), total PA and time in MVPA were positively associated with BMD (regression coefficient per one standard deviation increase in PA parameters = 0.26; P < 0.05). There was no association between time spent in MVPA and total PA, and total quality of life score.
Conclusions:
PA likely is associated with improved bone health in IBD children. Intervention studies investigating a causal relationship between PA and BMD in paediatric patients with IBD are warranted.
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