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PEDIATRICS Vol. 112 No. 6 December 2003, pp. e447-e452

A School-Based Exercise Intervention Elicits Substantial Bone Health Benefits: A 2-Year Randomized Controlled Trial in Girls

Kerry J. MacKelvie, PhD*, Karim M. Khan, MD, PhD{ddagger},§,||, Moira A. Petit, PhD§,||, Patricia A. Janssen, PhD and Heather A. McKay, PhD§

* Endocrinology and Diabetes Unit, British Columbia Children’s Hospital and Food, Nutrition and Health
{ddagger} School of Human Kinetics
§ Faculty of Medicine
Department of Health Care and Epidemiology, University of British Columbia, Vancouver, BC, Canada
|| Department of Health Evaluation Sciences, Pennsylvania State University College of Medicine, Hershey, Pennsylvania

Objective. Childhood weight-bearing physical activity is recognized as an important determinant of peak bone mass, and physical activity intervention may represent a feasible strategy for primary prevention of osteoporosis. Previous school-based exercise interventions have all been of <10 months in duration. We implemented a high-impact, circuit-based, jumping intervention (10 minutes, 3 times a week) over 2 school years and compared changes in bone mineral content (BMC) over 20 months (2 school years) in 9.9 ± 0.6-year-old intervention girls (N = 32) and controls (10.3 ± 0.4 years, N = 43).

Methods. We measured BMC for the total body, lumbar spine, proximal femur (and femoral neck and trochanteric subregions), and lean and fat mass by dual-energy radiograph absorptiometry (Hologic QDR 4500), and height, sitting height, leg length, and weight at baseline and 20 months. We assessed Tanner stage, general physical activity, and calcium intake by questionnaire.

Results. Girls were Tanner breast stage 1 to 3 at baseline. There were no significant differences in baseline or 20-month change in body size or composition, average physical activity, or calcium intake between groups. There were substantially greater gains in lumbar spine (41.7% vs 38.0%) and femoral neck (24.8% vs 20.2%) BMC in intervention than in control girls (P < .05, analysis of covariance; covariates were baseline BMC and height, change in height, physical activity, and final Tanner stage).

Conclusion. Three brief sessions of high-impact exercise per week implemented over 2 consecutive years within the elementary school curriculum elicited a substantial bone mineral accrual advantage in pubertal girls.

Key Words: girls • bone health • bone mineral content • exercise • intervention

Abbreviations: LS, lumbar spine • FN, femoral neck • PE, physical education • BMC, bone mineral content • BA, bone area • TB, total body • PF, proximal femur • TR, trochanteric

Received for publication May 30, 2003; Accepted Aug 25, 2003.


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