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Introduction Nearly 8 million American adolescents participate in sports. Participation declines in young adulthood. Purpose This study assessed longitudinal effects of high school sport participation and muscle power on young adult bone strength. Methods Two hundred twenty-eight young adults from the Iowa Bone Development Study completed an interscholastic sport participation questionnaire. Current physical activity (PA) behaviors were assessed via questionnaire. Dual x-ray absorptiometry assessed hip areal bone mineral density and was used with hip structure analysis to estimate femoral neck section modulus and hip cross-sectional area. Peripheral quantitative computed tomography provided strength-strain index and bone strength index at 38% and 4% midshaft tibial sites, respectively. Vertical jump estimated muscle power at 17 yr. Sex-specific multiple linear regression predicted young adult bone outcomes based on sport participation groups. Mediation analysis analyzed the effects of muscle power on relationships between sport participation and bone strength. Results At follow-up, males participating in any interscholastic sport had greater bone strength than males who did not participate in sport. The explained variability in bone outcomes was 2% to 16%. Females who participated in sports requiring muscle power had greater bone strength than females who did not participate in sports or females who participated in nonpower sports (explained variability was 4%-10%). Muscle power mediated 24.7% to 41% of the effect of sport participation on bone outcomes in males and 19.4% to 30% in females. Conclusions Former male interscholastic sport participants and female interscholastic power sport participants have stronger bones than peers even when adjusting for current PA. Muscle power did not fully explain differences in all bone outcomes, suggesting that sport participation has additional bone health benefits.

Purpose This study analyzed prospective associations between distinct trajectories of objectively measured physical activity (PA) and late adolescent bone parameters and explored the mediating effects of lean soft tissue, a surrogate of muscle mass to associations. Methods Physical activity was measured by accelerometry starting at age 5 yr and continuing at 8, 11, 13, 15, and 17 yr in approximately 524 participants from the Iowa Bone Development Study. Sex-specific group-based trajectory modeling was used to construct developmental trajectories of moderate- and vigorous-intensity PA (MVPA) from childhood to late adolescence. At age 17 yr, proximal femur bone mineral density (aBMD) was assessed by dual X-ray energy absorptiometry, and its distribution was calculated by aBMD ratios. Specific geometric measures of the proximal femur were assessed using hip structural analysis. Results A significant portion of the total effect of MVPA from age 5 to 17 yr on bone parameters at age 17 yr was explained by an increase in leg lean soft tissue in both sexes. For males and females, indirect effects were observed on the total and all regional proximal femur aBMD, and on the ratio between the inferomedial and superolateral neck aBMD. The effect on the ratio between the trochanter and the total proximal femur was specific to females, whereas the effect on the hip axis length was specific to males. Direct effects of MVPA on aBMD were identified only in males. Conclusions Using robust mediation analysis, this is the first study addressing the indirect effect (through muscle) of PA across childhood and adolescence on proximal femur bone parameters. To improve bone health at the proximal femur, the results suggest PA interventions during growth that increase muscle mass, particularly in females.

Purpose To examine the associations among physical activity (PA), sedentary time (SED), and TV viewing (TV) with fat mass (FAT) and visceral adipose tissue mass (VAT) from childhood through adolescence (5-19 yr). Methods Participants in the Iowa Bone Development Study (n = 230 males and 233 females) were examined at ages 5, 8, 11, 13, 15, 17, and 19 yr. Accelerometers measured moderate- or vigorous-intensity PA (MVPA; min·d), light-intensity PA (LPA; min·d), and SED (h·d). Parent-proxy report (5 and 8 yr) and child-report (11, 13, 15, 17, and 19 yr) measured TV (h·d). X-ray absorptiometry scans measured FAT (kg) and VAT (g). Sex-specific growth models were used to create FAT and VAT growth curves for individual participants (level 1), and to test the effect of MVPA, LPA, SED, and TV (level 2) after adjusting for weight, height, linear age, nonlinear age, and maturity. Results Growth models indicated that low levels of MVPA were associated with high levels of FAT and VAT for males and high levels of FAT for females. TV viewing was positively associated with FAT and VAT for males and females. LPA was positively associated with FAT in males. Sedentary time was not associated with FAT or VAT for males or females (P > 0.05). Conclusions This study supports current PA guidelines focusing on MVPA rather than SED. The contribution of high TV, but not high SED, to high levels of adiposity suggests that TV's contribution to obesity is not just a function of low energy expenditure.

To assess association between lower body muscle power and bone strength as well as the mediating effect of muscle cross-sectional area (MCSA) on that association.Participants (141 males and 162 females) were approximately 17 yr. Muscle power was predicted using vertical jump and the Sayers equation. Using peripheral quantitative computed tomography (pQCT), bone strength indices were obtained at two locations of the tibia, corresponding to primary stressors acting upon each site: bone strength index for compression (BSI) at the distal 4% site; density-weighted polar section modulus strength-strain index (SSIp) and cortical bone area (CoA) at the 66% midshaft site for torsion. Muscle cross-sectional area was measured at the 66% site. Pearson bivariate and partial correlation coefficients were estimated to quantify the strength of the associations among variables. Direct and indirect mediation model effects were estimated, and 95% bootstrap confidence intervals were constructed to test the causal hypothesis. Height and maturity were examined as covariates.Pearson correlation coefficients among muscle power, MCSA, and bone strength were statistically significant (P0.01) and ranged from r = 0.54 to r = 0.78. After adjustment for covariates, associations were reduced (r = 0.37 to 0.69) (P0.01). Mediation models for males for BSI, SSIp, and CoA accounted for 38%, 66%, and 54% of the variance in bone strength, respectively. Models for females for BSI, SSIp, and CoA accounted for 46%, 77%, and 66% of the variance, respectively.We found strong and consistent associations as well as direct and indirect pathways, among muscle power, MCSA, and tibia strength. These results support the use of muscle power as a component of health-related fitness in bone health interventions for older adolescents.

Purpose: The aim of this study was to examine whether adiposity level is associated with subsequent physical activity (PA) level in childhood. Methods: Study participants were 326 children participating in the Iowa Bone Development Study. PA and fat mass were measured using accelerometers and dual-energy x-ray absorptiometry (DXA) at approximately 5, 8, and 11 yr. Data for relevant variables such as parents' education and PA levels and family income were also collected. Gender-specific generalized linear models were fit to examine the association between percentage body fat (%BF) at age 8 and intensity-weighted moderate- to vigorous-intensity PA (IW-MVPA) at age 11. Results: After adjusting for IW-MVPA at age 8, the interval between the age 8 and 11 examinations, residualized change scores of %BF and IW-MVPA from age 5 to 8, and mother's education level, %BF at age 8 was negatively associated with IW-MVPA at age 11 among boys (P < 0.05). After adjusting for IW-MVPA at age 8, physical maturity, and family income, %BF at age 8 was negatively associated with IW-MVPA at age 11 among girls (P < 0.05). Categorical data analysis also showed that the odds ratio (OR) of being in the lowest quartile relative to the highest quartile of IW-MVPA at age 11 for boys and girls with high %BF at age 8 were approximately four times higher than the OR for those with low %BF at age 8 (OR = 4.38, 95% CI = 1.05-18.24 for boys; OR = 4.48, 95% CI = 1.35-14.85 for girls). Conclusions: This study suggests that adiposity level may be a determinant of PA behavior. Specific intervention strategies for overweight children may be needed to promote PA