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Moderate-to-Vigorous Physical Activity Is Associated With Higher Bone Mineral Density in Children With Inflammatory
Ivana Trivić1, Sara Sila1, Ana Tripalo Batoš2
1Referral Center for Pediatric Gastroenterology and Nutrition.
Insights
Physical activity, specifically moderate-to-vigorous physical activity (MVPA), is positively associated with bone mineral density (BMD) and lean body mass (LBM) in children with inflammatory bowel disease (IBD). These findings highlight the importance of MVPA for maintaining bone health and body composition in pediatric IBD patients.
Area of Science:
- Pediatric Gastroenterology
- Bone Metabolism
- Body Composition Analysis
Background:
- Children with inflammatory bowel disease (IBD) often experience decreased bone mineral density (BMD) and reduced lean body mass (LBM).
- Understanding factors influencing BMD and LBM is crucial for managing long-term health in pediatric IBD patients.
Purpose of the Study:
- To evaluate the relationship between BMD, body composition (including LBM and fat mass), and physical activity (PA) in children with IBD in remission.
- To identify potential modifiable factors contributing to bone health and body composition in this population.
Main Methods:
- Cross-sectional, observational study involving 40 pediatric IBD patients in clinical remission.
- Bone mineral density (BMD), fat mass (FM), and lean body mass (LBM) were measured using total body less head (TLBH) dual-energy X-ray absorptiometry (DXA).
- Physical activity (PA) was objectively measured using triaxial accelerometers over five consecutive days.
Main Results:
- A significant positive correlation was observed between moderate-to-vigorous physical activity (MVPA) and BMD z score (P=0.003) and LBM z score (P=0.026).
- Multivariate analysis confirmed the independent positive association between MVPA and BMD z score.
- Crohn's disease patients exhibited significantly lower BMD compared to ulcerative colitis patients (P<0.001).
- Cumulative glucocorticoid dose negatively correlated with LBM z score (P=0.003).
Conclusions:
- There is a strong positive relationship between MVPA, LBM, and BMD in children with IBD in remission.
- Physical activity represents a potentially modifiable factor for improving bone health and body composition in pediatric IBD.
- Further longitudinal studies are needed to elucidate causal relationships and optimize interventions.
Objectives:
Decreased mineral bone density (BMD) and reduced lean body mass (LBM) are common amongst children with inflammatory bowel disease (IBD). The aim of our cross-sectional, observational study was to evaluate the relationship between BMD, body composition and physical activity (PA) in children with IBD in remission.
Methods:
Total body less head (TLBH) dual energy X-ray absorptiometry (DXA) was used to measure BMD, fat mass (FM) and lean body mass (LBM). Triaxial accelerometer for five consecutive days was used to objectivize PA.
Results:
Forty pediatric IBD patients in clinical remission (24 boys; age 15.3 ± 0.4 years; Crohn disease [CD], n = 20, ulcerative colitis [UC], n = 18, inflammatory bowel disease-unclassified [IBD-U], n = 2) were recruited. Mean BMD was 0.940 g/cm2 and mean BMD z score was -0.42 ± 0.14. Patients with CD had significantly lower BMD than UC counterparts (P < 0.001). Average time spent in PA was 247.24 ± 16.71 min/day with 45.73 ± 8.22 min/day spent in moderate-to-vigorous PA (MVPA). We observed a significant positive correlation between the time spent in MVPA and BMD z score (P = 0.003) and LBM z score (P = 0.026). Multivariate analysis confirmed that the positive correlation of MVPA and BMD z score. There was no significant correlation between daily protein intake and BMD. Cumulative glucocorticoid dose negatively correlated with LBM z score (P = 0.003), but not with BMD z score (P = 0.069).
Conclusions:
This study points to a strong positive relationship between MVPA, LBM and BMD. Longitudinal studies are required in order to elucidate the modifiable processes that determine body health and favorable body composition.
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