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The Developmental Origins of Health and Disease hypothesis (DOHaD) proposes that growth during the prenatal period might play a critical role in health, affecting the development of diseases, such as osteoporosis. Bone health is particularly affected by human behaviors when sports participation constitutes the main manifestation of physical exercise. The aim of this study is to analyze the relationship between birth weight (BW) and bone mineral content (BMC) among adolescents, as well as to identify if sports participation and maturity can affect this relationship. The sample was composed of adolescents with ages ranging from 11 to 18 years, stratified according to normal birth weight (n = 331), low birth weight (n = 36), and macrosomia (n = 47), extracted from a wider cross-sectional study (ABCD Growth Study). BW was self-reported by the adolescent's parent. Sports participation was assessed by face-to-face interview. BMC was assessed using dual-energy X-ray absorptiometry. In the multivariate models, the relationships between BW and BMC remained non-significant, while sports participation was significantly related to BMC on lower limbs among boys (r = 0.154; p value = .001) and BMC of upper limbs among girls (r = 0.124; p value = .044). APHV was related to BMC of upper limbs among boys (r = 0.137; p value = .001). In conclusion, BMC was not affected by BW, while this phenomenon seems to be significantly affected by the positive impact of sports participation and maturation on it.

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OBJECTIVE: To systematically review the literature to verify the relationship between neuromuscular fitness indicators in childhood/adolescence and bone strength variables in adulthood. DATA SOURCES: A systematic review was conducted in PUBMED, SCOPUS, SPORTDiscus, Web of Science, PsycINFO, LILACS, and SciELO, covering the entire period until March 2019. DATA SYNTHESIS: The search identified 1149 studies. After duplicity analysis and eligibility criteria, four studies were reported. In one study, baseline was childhood and, in the others, adolescence. In childhood, when adjusting the model for age and body mass index, a statistically significant relation was found for girls: standing long jump with quantitative ultrasound index (ß=0.11; p<0.05) and with speed of sound (ß=0.14; p<0.01). However, when controlling muscular performance in adulthood, the relationship was no longer significant. In adolescence, coefficients ranged from 0.16 for neuromotor battery and bone mineral density (BMD) in the lumbar region to 0.38 for hanging leg lift test and BMD of arms. The explained variance varied between 2% (bent arm hang for BMD total) and 12% (hanging leg-lift for BMD arms), therefore, a higher performance in neuromuscular fitness in adolescence was associated with better bone strength in adulthood. CONCLUSIONS: In adults, bone strength variables showed significant correlation from low to moderate magnitude with neuromuscular fitness indicators in adolescence, but not in childhood, after controlling for adult performance in neuromuscular fitness. However, there is limited evidence to support the neuromuscular fitness in early life as a determinant of bone strength in adulthood.

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To analyze the impact of participation in sports with different cardiorespiratory fitness (CRF) demands on changes in metabolic and cardiovascular markers in adolescents. Longitudinal study with 12 months of follow-up (Analysis of Behaviors of Children During Growth [ABCD Growth Study]). Overall, 184 adolescents (age 15.6 ± 2.1) were classified according to sports participation: non-sport (control), low CRF sports, and high CRF sports. Metabolic outcomes were total cholesterol (TC) and its fractions, triacylglycerol (TG), glucose, insulin levels, and the insulin resistance index. Cardiovascular outcomes were arterial thickness (carotid and femoral [ultrasound]), blood pressure, and resting heart rate. Adolescents engaged in sports classified as high CRF demand presented a significant increase in HDL-c (1.2 mg/dL [95%CI: -0.5 to 3.0]) when compared to the non-sport group (-2.4 mg/dL [95%CI: -4.4 to -0.5]). Regular engagement in high CRF sports was significantly related to changes in TC (ß = -0.027 [95%CI: -0.048 to -0.005]), HDL-c (ß = 0.009 [95%CI: 0.001 to 0.019]), LDL-c (ß = -0.032 [95%CI: -0.049 to -0.016]), and glucose (ß = -0.017 [95%CI: -0.025 to -0.008]), while engagement in low CRF sports was related to changes in TG (ß = -0.065 [95%CI: -0.112 to -0.019]). No significant relationships for cardiovascular parameters were observed in the low CRF group, but one significant relationship was found between high CRF sports and changes in SBP (ß = -0.063 [95%CI: -0.117 to -0.009]). In conclusion, engagement in sports seems to be beneficial for improvements in metabolic and cardiovascular parameters in adolescents, mainly sports with higher CRF demand.

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ABSTRACT Objective: To systematically review the literature to verify the relationship between neuromuscular fitness indicators in childhood/adolescence and bone strength variables in adulthood. Data sources: A systematic review was conducted in PUBMED, SCOPUS, SPORTDiscus, Web of Science, PsycINFO, LILACS, and SciELO, covering the entire period until March 2019. Data synthesis: The search identified 1149 studies. After duplicity analysis and eligibility criteria, four studies were reported. In one study, baseline was childhood and, in the others, adolescence. In childhood, when adjusting the model for age and body mass index, a statistically significant relation was found for girls: standing long jump with quantitative ultrasound index (β=0.11; p<0.05) and with speed of sound (β=0.14; p<0.01). However, when controlling muscular performance in adulthood, the relationship was no longer significant. In adolescence, coefficients ranged from 0.16 for neuromotor battery and bone mineral density (BMD) in the lumbar region to 0.38 for hanging leg lift test and BMD of arms. The explained variance varied between 2% (bent arm hang for BMD total) and 12% (hanging leg-lift for BMD arms), therefore, a higher performance in neuromuscular fitness in adolescence was associated with better bone strength in adulthood. Conclusions: In adults, bone strength variables showed significant correlation from low to moderate magnitude with neuromuscular fitness indicators in adolescence, but not in childhood, after controlling for adult performance in neuromuscular fitness. However, there is limited evidence to support the neuromuscular fitness in early life as a determinant of bone strength in adulthood.

RESUMO Objetivo: Revisar sistematicamente a literatura para verificar a relação entre indicadores da aptidão neuromuscular na infância/adolescência e variáveis de resistência óssea na idade adulta. Fonte de dados: Revisão sistemática com pesquisa de artigos conduzida no PUBMED, SCOPUS, SPORTDiscus, Web of Science, PsycINFO, LILACS and SciELO, abrangendo todo o período da base até março de 2019. Síntese dos dados: A busca identificou 1.149 estudos, após análise de duplicidade e dos critérios de elegibilidade, quatro estudos foram relatados. Em um dos estudos, o baseline foi a infância e, nos demais, a adolescência. Na infância, ao ajustar o modelo por idade e índice de massa corporal, foi encontrada relação estatisticamente significativa para as meninas: salto em distância com índice quantitativo de ultrassom (β=0,11; p<0,05) e com velocidade do som (β=0,14; p<0,01). Entretanto, ao se fazer o controle do desempenho muscular na idade adulta, a relação deixou de ser significativa. Na adolescência, coeficientes variaram de 0,16 para bateria neuromotora e densidade mineral óssea (DMO) lombar a 0,38 para o teste de elevação de pernas em suspensão e a DMO dos braços. Variação explicada entre 2% (suspensão na barra e DMO do corpo total) e 12% (elevação de pernas em suspensão e DMO dos braços), portanto, melhor desempenho na aptidão neuromuscular na adolescência, mais resistência óssea na idade adulta. Conclusões: Em adultos, variáveis de resistência óssea apresentaram correlação significativa em magnitude baixa a moderada com indicadores da aptidão neuromuscular na adolescência, mas não na infância, após controlar pelo desempenho adulto na aptidão neuromuscular. No entanto, existe evidência limitada para apoiar a aptidão neuromuscular na juventude como fator determinante da resistência óssea na fase adulta.

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BACKGROUND: To compare bone density accrual and markers of bone geometry and formation between female adolescents engaged and not engaged in artistic gymnastics (AGs). METHODS: This was a 12-month longitudinal study involving 20 female adolescents, including 10 controls and 10 gymnasts (AGs) aged 11 to 16 years. At baseline, the gymnasts had a minimum of 12 months of practice, and the controls reported no participation in any organized sport. Bone mineral density (BMD) was measured in the lower limbs, upper limbs, spine, and whole body. In addition, BMD and geometrical properties of the femur were assessed. As a bone formation marker, osteocalcin level was measured. RESULTS: Femoral aspects were increased in the gymnasts by 19% (P=0.009), 14% (P=0.047), and 10% (P=0.046) in the Ward's triangle, trochanter, and the overall bone, respectively, than in the control girls. Geometrical parameters, bone accrual, and osteocalcin levels were similar in both groups. The weekly training load explained 30.8% of all bone gains on the lower limbs and affected the density on parts of the femur. CONCLUSIONS: The gymnasts, after a 12-month follow-up, demonstrated a higher BMD in the Ward's triangle and whole femur than the controls, as well as an improvement in femur density. These changes were mainly due to the weekly training load. Lastly, the gymnasts had significant bone accrual (after 12 months) in the upper limbs, lower limbs, and whole body.

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BACKGROUND: Sports participation plays an important role in bone gain during childhood and adolescence. The aim here was to identify sex-related determinants of bone mineral density (BMD) differences between male and female adolescents, with emphasis on the role of sports participation. DESIGN AND SETTING: Longitudinal study conducted in a public university in Presidente Prudente, Brazil. METHODS: The sample comprised 48 adolescents aged 11-17 years, of both sexes, who were matched according to sex, age and sports participation. BMD was the main outcome, while muscle mass, sports participation, calendar age and biological maturation were treated as covariates. Participants were followed up after nine months. RESULTS: At baseline, BMD values were similar between the sexes. However, adjustment for covariates showed that BMD was higher among girls at all sites, with a contribution from lean soft tissue (LST) in the model (partial eta-squared, ES-r = 0.619 in upper limbs; 0.643 in lower limbs; 0.699 in spine; and 0.599 in whole body). Sports participation only explained the upper-limb variance (ES-r = 0.99). At the follow-up, the results resembled the baseline except in the lower limbs (P = 0.109), in which BMD was similar between the groups. BMD gain over time was similar between girls and boys in all segments, and baseline LST affected upper-limb and whole-body BMD accrual (ES-r = 0.396 and 0.107, respectively). CONCLUSION: Whole-body and specific-site BMD differed between baseline and follow-up. However,BMD accrual was similar between the sexes, given that muscle mass constituted the most relevant determinant of the difference between them.

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ABSTRACT BACKGROUND: Sports participation plays an important role in bone gain during childhood and adolescence. The aim here was to identify sex-related determinants of bone mineral density (BMD) differences between male and female adolescents, with emphasis on the role of sports participation. DESIGN AND SETTING: Longitudinal study conducted in a public university in Presidente Prudente, Brazil. METHODS: The sample comprised 48 adolescents aged 11-17 years, of both sexes, who were matched according to sex, age and sports participation. BMD was the main outcome, while muscle mass, sports participation, calendar age and biological maturation were treated as covariates. Participants were followed up after nine months. RESULTS: At baseline, BMD values were similar between the sexes. However, adjustment for covariates showed that BMD was higher among girls at all sites, with a contribution from lean soft tissue (LST) in the model (partial eta-squared, ES-r = 0.619 in upper limbs; 0.643 in lower limbs; 0.699 in spine; and 0.599 in whole body). Sports participation only explained the upper-limb variance (ES-r = 0.99). At the follow-up, the results resembled the baseline except in the lower limbs (P = 0.109), in which BMD was similar between the groups. BMD gain over time was similar between girls and boys in all segments, and baseline LST affected upper-limb and whole-body BMD accrual (ES-r = 0.396 and 0.107, respectively). CONCLUSION: Whole-body and specific-site BMD differed between baseline and follow-up. However,BMD accrual was similar between the sexes, given that muscle mass constituted the most relevant determinant of the difference between them.

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We analyzed the effects of 1 year of engagement in ≥ 300 min/week of organized sports on inflammatory levels and vascular structure in adolescents. The sample was composed of 89 adolescents (11.6 ± 0.7 years old [43 boys and 46 girls]), stratified according to engagement in ≥ 300 min/week of sport practice during at least 12 months of follow-up (n = 15, sport practice; n = 74, non-sport practice). Arterial thickness (carotid and femoral) was assessed by ultrasound scan, while high sensitive C-reactive protein levels were used to assess inflammatory status. Trunk fatness (densitometry scanner), biological maturation (age at peak height velocity), blood pressure, and skipping breakfast were treated as covariates. Independently of body fatness and biological maturation, the group engaged in sports presented a higher reduction in C-reactive protein (mean difference -1.559 mg/L [95%CI -2.539 to -0.579]) than the non-sport group (mean difference -0.414 mg/L [95%CI -0.846 to 0.017]) (p = 0.040). There was a significant relationship between changes in C-reactive protein and changes in femoral intima-media thickness in the non-sport group (r = 0.311 [95%CI 0.026 to 0.549]). CONCLUSION: Inflammation decreased in adolescents engaged in organized sports, independently of trunk fatness and biological maturation. Moreover, inflammation was related to arterial thickening only in adolescents not engaged in sports. What is Known: • Intima media thickness is a relevant marker of cardiovascular disease in pediatric groups, being affected by obesity and inflammation. • The importance of monitoring inflammatory markers from childhood is enhanced by the fact that alterations in these inflammatory markers in early life predict inflammation and alterations in carotid IMT in adulthood. What is New: • Anti-inflammatory properties related to physical exercise performed at moderate intensity, on inflammation and alterations in IMT are not clear in pediatric groups. • Due to the importance that sport participation has assumed as a promoter of improvements in health and quality of life, it is necessary to understand its potential benefits for cardiovascular health during human growth.

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CONTEXT AND OBJECTIVE:: Peak height velocity (PHV) is an important maturational event during adolescence that affects skeleton size. The objective here was to compare bone variables in adolescents who practiced different types of sports, and to identify whether differences in bone variables attributed to sports practice were dependent on somatic maturation status. DESIGN AND SETTING:: Cross-sectional study, São Paulo State University (UNESP). METHODS:: The study was composed of 93 adolescents (12 to 16.5 years old), divided into three groups: no-sport group (n = 42), soccer/basketball group (n = 26) and swimming group (n = 25). Bone mineral density and content were measured using dual-energy x-ray absorptiometry and somatic maturation was estimated through using peak height velocity. Data on training load were provided by the coaches. RESULTS:: Adolescents whose PHV occurred at an older age presented higher bone mineral density in their upper limbs (P = 0.018). After adjustments for confounders, such as somatic maturation, the swimmers presented lower values for bone mineral density in their lower limbs, spine and whole body. Only the bone mineral density in the upper limbs was similar between the groups. There was a negative relationship between whole-body bone mineral content and the weekly training hours (ß: -1563.967; 95% confidence interval, CI: -2916.484 to -211.450). CONCLUSION:: The differences in bone variables attributed to sport practice occurred independently of maturation, while high training load in situations of hypogravity seemed to be related to lower bone mass in swimmers.

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PURPOSE: To compare bone mineral density (BMD) gains in adolescents of both genders stratified according to different martial art styles in a 9-month follow-up study. METHODS: The longitudinal study consisted of 29 adolescents of both genders and age between 11 and 17 years stratified into a control group (not engaged in any sport) and 50 fighters (kung fu/karate, n = 29; judo, n = 21). All 79 subjects underwent anthropometric measures (weight, height, leg length, and height set) and dual-energy X-ray absorptiometry (BMD, in g/cm2) at 2 moments, baseline and 9 months later. Maturity offset (age at peak height velocity), lean soft tissue, chronological age, and resistance training were treated as covariates. RESULTS: Male judoists presented higher gains in BMD-spine [0.098 g/cm2 (95% confidence interval, 0.068-0.128)] than control group [0.040 g/cm2 (95% confidence interval, 0.011-0.069)] (post hoc test with P = .030). There was no effect of martial art on BMD gains among girls. Independently of gender, in all multivariate models, lean soft tissue constituted the most relevant covariate. CONCLUSIONS: Judo practice in adolescents affected the bone accrual significantly after 9-month follow-up compared with controls, mainly in boys.

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