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Funder: City of Kuopio, Funder: Diabetestutkimussäätiö; Id: http://dx.doi.org/10.13039/501100013500, Funder: Doctoral Programs in Public Health (FI), Funder: Finnish Innovation Fund Sitra, Funder: Juho Vainion Säätiö; Id: http://dx.doi.org/10.13039/501100004037, Funder: Kela; Id: http://dx.doi.org/10.13039/501100002327, Funder: Kuopion Yliopistollinen Sairaala; Id: http://dx.doi.org/10.13039/501100004092, Funder: Lastentautien Tutkimussäätiö; Id: http://dx.doi.org/10.13039/501100005744, Funder: Medical Research Council; Id: http://dx.doi.org/10.13039/501100007155, Funder: NIHR Applied Research Collaborations ‐ East Midlands, Funder: NIHR Cambridge Biomedical Research Centre; Id: http://dx.doi.org/10.13039/501100018956, Funder: NIHR Leicester Biomedical Research Centre; Id: http://dx.doi.org/10.13039/501100020013, Funder: Opetus‐ ja Kulttuuriministeriö, Funder: Orionin Tutkimussäätiö; Id: http://dx.doi.org/10.13039/501100007083, Funder: Paavo Nurmen Säätiö; Id: http://dx.doi.org/10.13039/501100008484, Funder: Paulon Säätiö; Id: http://dx.doi.org/10.13039/501100007417, Funder: Research Committee of the Kuopio University Hospital Catchment Area, Funder: Sosiaali‐ ja Terveysministeriö, Funder: Suomalainen Lääkäriseura Duodecim; Id: http://dx.doi.org/10.13039/501100008403, Funder: Suomen Kulttuurirahasto; Id: http://dx.doi.org/10.13039/501100003125, Considering physical activity (PA) volume and intensity may provide novel insights into the relationships of PA with bone, lean, and fat mass. This study aimed to assess the associations of PA volume, PA intensity distribution, including moderate-to-vigorous PA (MVPA) with total-body-less-head bone mineral content (BMC), lean, and fat mass in children. A population sample of 290 Finnish children (158 females) aged 9-11 years from the Physical Activity and Nutrition in Children (PANIC) Study was studied. PA, including MVPA, was assessed with a combined heart rate and movement sensor, and the uniaxial acceleration was used to calculate average-acceleration (a proxy metric for PA volume) and intensity-gradient (reflective of PA intensity distribution). Linear regression analyzed the associations of PA volume, PA intensity and MVPA with BMC, lean mass, and fat mass assessed by dual-energy X-ray absorptiometry. PA volume was positively associated with BMC in females (unstandardised regression coefficient [ß] = 0.26) and males (ß = 0.47), and positively associated with lean (ß = 7.33) and negatively associated with fat mass in males (ß = -20.62). PA intensity was negatively associated with BMC in males (ß = -0.13). MVPA was positively associated with lean mass in females and males (ß = 0.007 to 0.012), and negatively associated with fat mass in females and males (ß = -0.030 to -0.029). PA volume may be important for improving BMC in females and males, and increasing lean and reducing fat mass in males, whereas MVPA may be important for favorable lean and fat outcomes in both sexes.

It is unclear how physical activity intensity and vitamin D status are related to bone health in prepubertal children. We found positive associations between vitamin D status and moderate-to-vigorous physical activity with bone in boys and girls. This highlights the importance of lifestyle factors for skeletal health prepuberty. The sex-specific independent and interactive associations of physical activity (PA) intensity and serum 25-hydroxyvitamin D (25(OH)D) levels with areal bone mineral density (aBMD) were investigated in prepubertal children. The participants were 366 prepubertal Finnish children (190 boys, 176 girls) aged 6–8 years. Linear regression analysed the associations of sedentary time (ST), light PA (LPA), moderate PA (MPA), moderate-to-vigorous PA (MVPA) and vigorous PA (VPA) measured by accelerometery, and serum 25(OH)D with total body less head (TBLH) and lower-limb aBMD, measured by dual-energy X-ray absorptiometry. There was no interaction between PA intensity or serum 25(OH)D and sex with aBMD. MPA and MVPA were positively associated with TBLH and lower-limb aBMD (β = 0.11, 95% CI 0.02–0.20, p = 0.01). Serum 25(OH)D was positively associated with TBLH and lower-limb aBMD (β = 0.09, 95% CI 0.01–0.18, p = 0.03). There were no interactions between PA intensity and serum 25(OH)D with aBMD. Vitamin D status, MPA and MVPA levels in active prepubertal children were positively associated with aBMD. The influence of MVPA is due to the MPA component, though our findings regarding the role of VPA should be interpreted with caution, as shorter accelerometer epochs are needed to more accurately assess VPA. This study adds evidence to the promotion of MPA and behaviours to encourage optimal vitamin D status in supporting skeletal health in childhood, though these need not be used in conjunction to be beneficial, and a sex-specific approach is not necessary in prepubertal children. NCT01803776 . Date of registration: 4/03/2013

Purpose 1) To investigate the effectiveness of school-based high-intensity interval training (HIIT) interventions in promoting health outcomes of children and adolescents compared with either a control group or other exercise modality; and 2) to explore the intervention characteristics and process outcomes of published school-based HIIT interventions. Methods We searched Medline, Embase, CINAHL, SPORTDiscus, and Web of Science from inception until 31 March 2021. Studies were eligible if 1) participants aged 5–17 years old; 2) a HIIT intervention within a school setting ≥ 2 weeks duration; 3) a control or comparative exercise group; 4) health-related, cognitive, physical activity, nutrition, or program evaluation outcomes; and 5) original research published in English. We conducted meta-analyses between HIIT and control groups for all outcomes with ≥ 4 studies and meta-regressions for all outcomes with ≥ 10 studies. We narratively synthesised results between HIIT and comparative exercise groups. Results Fifty-four papers met eligibility criteria, encompassing 42 unique studies (35 randomised controlled trials; 36 with a high risk of bias). Meta-analyses indicated significant improvements in waist circumference (mean difference (MD) = -2.5cm), body fat percentage (MD = -1.7%), body mass index (standardised mean difference (SMD) = -1.0), cardiorespiratory fitness (SMD = +1.0), resting heart rate (MD = -5bpm), homeostatic model assessment–insulin resistance (MD = -0.7), and low-density lipoprotein cholesterol (SMD = -0.9) for HIIT compared to the control group. Our narrative synthesis indicated mixed findings between HIIT and other comparative exercise groups. Conclusion School-based HIIT is effective for improving several health outcomes. Future research should address the paucity of information on physical activity and nutrition outcomes and focus on the integration and long-term effectiveness of HIIT interventions within school settings. Trial registration number PROSPERO CRD42018117567.

Made available in DSpace on 2020-12-12T01:50:05Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-01-01 Objective: To analyze the risk of bone traumatic fractures according to the engagement in sports, as well as to identify the potential impact of sports participation and traumatic fractures on health-care costs among adolescents. Methods: This is a longitudinal 12-month study of 285 adolescents of both sexes in Brazil. We assessed the occurrence of traumatic fractures and health-care services (hospitalizations, medicine use, medical consultations, and exams) by phone contact every month for 12 months. Adolescents were divided into four groups according to sport characteristics: non-sport (n = 104), non-impact sport (swimming [n = 34]), martial arts (n = 49 [judo, karate, kung-Fu]) and impact sports (n = 98 [track-and-field, basketball, gymnastics, tennis, and baseball]). Results: The incidence of new fractures was 2.1%. The overall costs accounted during the 12-month follow-up were U$ 3,259.66. Swimmers (US$ 13.86) had higher health-care costs than non-sport (US$ 1.82), martial arts (US$ 2.23), and impact sports (US$ 2.32). Conclusion: swimming seems to be related to higher health-care costs among adolescents. Post-Graduation Program in Movement Science. Department of Physical Education Sao Paulo State University–UNESP Institute of Environment Health and Societies Brunel University Children’s Health and Exercise Research Centre Sport and Health Sciences University of Exeter Department of Physical Education São Paulo State University (UNESP) - Campus Bauru Human Movement Research Laboratory (MOVI-LAB) Laboratory of InVestigation in Exercise–LIVE. Department of Physical Education Sao Paulo State University–UNESP Post-Graduation Program in Movement Science. Department of Physical Education Sao Paulo State University–UNESP Department of Physical Education São Paulo State University (UNESP) - Campus Bauru Human Movement Research Laboratory (MOVI-LAB) Laboratory of InVestigation in Exercise–LIVE. Department of Physical Education Sao Paulo State University–UNESP

El conocimiento ha cambiado sustancialmente su naturaleza y su papel en la sociedad en el transcurso del siglo XX y ha conducido a la necesidad de modificar desde el comienzo de este nuevo siglo la relación establecida con él en el marco educativo, hecho que ha provocado un cambio profundo en nuestras concepciones sobre formación, instrucción y docencia, pero también y de forma muy especial en los planteamientos evaluadores. El presente artículo presenta la respuesta europea a este fenómeno que apuesta abiertamente por el tránsito desde los modelos educativos basados en la transmisión del conocimiento a los centrados en el desarrollo competencial. Se analiza la naturaleza de las competencias y la propuesta europea basada en ocho dominios competenciales, también se estudian la orientación de los nuevos enfoques curriculares surgidos a partir de ellas. Finalmente abordamos el trascendental papel que adopta en este nuevo marco la evaluación, al convertirse en pieza fundamental en los procesos de aprendizaje orientados al desarrollo competencial.Palabras clave: Competencias, currículo, aprendizaje, evaluación. In the course of the twentieth century, the nature of knowledge has evolved substantially within the society and its established relation with the educational sector has been modified from de beginning of the new century causing a deep change in our conceptions of training, instruction and teaching but especially of the evaluation process. This paper aims to present the European answer to this phenomenon, which pledges clearly the switch from current educational models, based on knowledge transmission, to new ones that focus on the development of competences. In this context, we analyze the nature of competence in parallel to the European proposal, which is based on the achievement of eight competences, and we present the new approaches to curriculum design and development that emerge from them. Finally, we present the transcendental role of evaluation in this new framework where it becomes a fundamental part of the learning processes for the development of competences.Keywords: Competences, curriculum, learning, evaluation.

This study aimed to identify the mediating effect of lean soft tissue (LST) in the association between somatic maturation and areal bone mineral density (aBMD) in adolescents by sex and sport participation. The sample included 558 adolescents (401 males, mean age of 14.0 years) that were practitioners of sports (11 sport modalities, n = 402) and a non-sport group (n = 157). Somatic maturation was assessed by using a validated peak height velocity prediction equation. Dual-energy X-ray absorptiometry (DXA) was used to assess aBMD (upper and lower limbs, spine and total body less head—TBLH) and LST. For both sexes, LST mediated the association between somatic maturation and aBMD at all skeletal sites (mediation percentage ranging from 36.3% to 75.4%). For sport and non-sport groups, the LST also mediated the association between somatic maturation and aBMD at all skeletal sites (mediation percentage ranging from 51.6% to 85.6%). The direct effect was observed in all groups, except for lower limbs and TBLH in the non-sport group. The association between somatic maturation and aBMD was mediated by LST in adolescents of both sexes and regardless of involvement in organized sports. Our findings highlighted the role of improving LST to mitigate the association of somatic maturation with aBMD., São Paulo Research Foundation (FAPESP) (FAPESP Process 2013/06963-5, 2015/13543-8, 2016/06920-2, 2017/09182-5, 2018/24164-6 and 2015/19710-3), FAPESP (2017/27234-2), FAPESP (2016/20354-0), “La Caixa” Foundation within the Junior Leader fellowship programme (ID 100010434; code LCF/BQ/PR19/11700007)

Made available in DSpace on 2021-06-25T10:14:23Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-12-01 Purpose Considering the different loading and training characteristics of the sports practiced during growth, it is important to specify and categorize the bone and soft tissue adaptations in adolescent athletes. This study aimed to categorize 10 different loading sports and a nonsport group and identify the differences in bone density and soft tissues. Methods The sample included 625 adolescents (10 to 17 yr of age) of 10 sports (soccer, basketball, volleyball, track and field, judo, karate, kung fu, gymnastics, baseball, and swimming) and a nonsport group. Dual-energy x-ray absorptiometry assessed areal bone mineral density (aBMD), bone mineral apparent density (BMAD), and soft tissues (lean soft tissue and fat mass). The results were adjusted for sex, peak height velocity status, lean soft tissue, fat mass, and weekly training volume. Results The comparisons among groups showed that soccer had the highest whole-body aBMD (mean ± SEM: 1.082 ± 0.007 g·cm-2) and lower limb aBMD (1.302 ± 0.010 g·cm-2). Gymnastics presented the highest upper limb aBMD (0.868 ± 0.012 g·cm-2) and whole-body BMAD (0.094 ± 0.001 g·cm-3). Swimming presented the lowest aBMD values in all skeletal sites (except at the upper limbs) and whole-body BMAD. The soft tissue comparisons showed that soccer players had the highest lean soft tissue (43.8 ± 0.7 kg). The lowest fat mass was found in gymnasts (8.04 ± 1.0 kg). Conclusion The present study investigated and categorized for the first time 10 different sports according to bone density and soft tissue profiles. Soccer and gymnastics sport groups were found to have the highest bone density in most body segments, and both sports were among the groups with the lowest fat mass. Laboratory of Investigation in Exercise (LIVE) Department of Physical Education Sao Paulo State University (UNESP) Children's Health and Exercise Research Centre Sport and Health Sciences University of Exeter Laboratory of Investigation in Exercise (LIVE) Department of Physical Education Sao Paulo State University (UNESP)

OBJECTIVES: Research investigating the longitudinal effects of the most popular sports on bone development in adolescent males is scarce. The aim is to investigate the effect of 12-month participation in osteogenic and non-osteogenic sports on bone development.DESIGN: A 12-month study was conducted in adolescent males involved in football, swimming and cycling and compared with an active control group.METHODS: 116 adolescent males (13.1±0.1years at baseline): 37 footballers, 37 swimmers, 28 cyclists and 14 active controls were followed for 12 months. Bone mineral content (BMC) was measured by dual-energy X-ray absorptiometry, and bone stiffness was measured by quantitative ultrasound. Bone outcomes at 12 months were adjusted for baseline bone status, age, height, lean mass and moderate to vigorous physical activity.RESULTS: Footballers had higher improvement in adjusted BMC at the total body, total hip, shaft, Ward's triangle, legs and bone stiffness compared to cyclists (6.3-8.0%). Footballers had significantly higher adjusted BMC at total body, shaft and legs compared to swimmers (5.4-5.6%). There was no significant difference between swimmers and cyclists for any bone outcomes. Swimming and cycling participation resulted in non-significant lower bone development at most sites of the skeleton compared to controls (-4.3 to -0.6%).CONCLUSIONS: Football participation induces significantly greater improvements in BMC and bone stiffness over 12 months compared to cycling and swimming.CLINICAL TRIAL REGISTRATION: ISRCTN17982776.

Adolescence is a crucial period for bone development, and exercise can enhance bone acquisition during this period of life. However, it is not known how the different loading sports practiced can affect bone acquisition in adolescent male athletes. Therefore, the purpose of the present study was to determine the 1-year longitudinal bone acquisition among adolescent males involved in osteogenic (football) and non-osteogenic (swimming and cycling) sports and to compare with active controls. A total of 116 adolescent males aged 12 to 14 years at baseline were followed for 1 year: 37 swimmers, 37 footballers, 28 cyclists, and 14 active controls. Bone mineral content (BMC) was assessed using dual-energy X-ray absorptiometry (DXA); cross-sectional area (CSA), cross-sectional moment of inertia (CSMI), and section modulus (Z) at the femoral neck was assessed using hip structural analysis (HSA); and bone texture of the lumbar spine was assessed using trabecular bone score (TBS). Serum N-terminal propeptide of procollagen type I (PINP), isomer of the Carboxi-terminal telopeptide of type 1 collagen (CTX-I), total serum calcium, and 25 hydroxyvitamin D [25(OH)D] were analyzed. Footballers had significantly higher adjusted BMC at the lumbar spine (7.0%) and femoral neck (5.0%) compared with cyclists, and significantly greater BMC at the lumbar spine (6.9%) compared with swimmers. Footballers presented significantly greater TBS (4.3%) compared with swimmers, and greater CSMI (10.2%), CSA (7.1%), Z (8.9%) and TBS (4.2%) compared with cyclists. No differences were noted between cyclists and swimmers, both groups had similar bone acquisition compared with controls. PINP was significantly higher in footballers and controls compared with cyclists and swimmers (3.3% to 6.0%), and 25(OH)D was significantly higher in footballers and cyclists compared with swimmers and controls (9.9% to 13.1%). These findings suggest that bone acquisition is higher in adolescent male footballers compared with swimmers and cyclists at the femoral neck and lumbar spine sites of the skeleton. © 2017 American Society for Bone and Mineral Research.

Aim This study investigated the associations between fitness indices and bone outcomes in young males. Methods Data were collected between autumn and winter 2014-2015 on 121 males with a mean age of 13.1 ±0.1 years: 41 swimmers, 37 footballers, 29 cyclists and 14 non-athletes. Participants were recruited from athletic clubs and schools across South West England. Lean mass, areal bone mineral density and hip structural estimates were measured using dual-energy X-ray absorptiometry. The relationships between bone outcomes and the vertical jump, standing long jump and the 20m shuttle run test were analysed using three regression models: model one was adjusted by age and stature, model two added vigorous physical activity and model three then added lean mass. Results The boys’ performance in the vertical jump and standing long jump was positively associated with the majority of bone outcomes in models one and two, but most of these disappeared in model three. The 20m shuttle run test was positively associated with most bone outcomes in all three models. Lean mass played a key role in the association between muscular fitness and bone outcomes. Conclusion Vigorous physical activity did not explain the associations between fitness and bone outcomes, but lean mass did. This article is protected by copyright. All rights reserved.

The determinants of areal bone mineral density (aBMD) and hip geometry estimates in adolescent athletes are poorly understood. This study aimed to identify the determinants of aBMD and hip geometry estimates in adolescent male athletes.One hundred twenty-one men (13.1 ± 0.1 yr) were measured: 41 swimmers, 37 footballers, 29 cyclists, and 14 controls. Dual energy X-ray absorptiometry measured aBMD at lumbar spine, femoral neck and total body. Hip structural analysis evaluated hip geometry estimates at the femoral neck. Multiple linear regression examined the contribution of the sports practised, stature, lean and fat mass, serum calcium and vitamin D, moderate to vigorous physical activity, vertical jump and cardiorespiratory fitness with aBMD and hip geometry estimates.Region-specific lean mass was the strongest positive predictor of aBMD (β = 0.614-0.931) and football participation was the next strongest predictor (β = 0.304-0.579). Stature (β = 0.235-0.380), fat mass (β = 0.189), serum calcium (β = 0.103), serum vitamin D (β = 0.104-0.139), and vertical jump (β = 0.146-0.203) were associated with aBMD across various specific sites. All hip geometry estimates were associated with lean mass (β = 0.370 - 0.568) and stature (β = 0.338-0.430). Football participation was associated with hip cross-sectional area (β = 0.322) and moderate to vigorous physical activity (β = 0.140-0.142). Cardiorespiratory fitness (β = 0.183-0.207) was associated with section modulus and cross-sectional moment of inertia.Region-specific lean mass is the strongest determinant of aBMD and hip geometry estimates in adolescent male athletes. Football participation and stature were important determinants for aBMD and hip geometry estimates, whereas the contribution of the other predictors was site specific.

Soft tissues, such as fat mass (FM) and lean mass (LM), play an important role in bone development but this is poorly understood in highly active youths. The objective of this study was to determine whether FM or LM is a stronger predictor of areal bone mineral density (aBMD) and hip geometry estimates in a group of physically active boys after adjusting for height, chronological age, moderate-to-vigorous physical activity (MVPA), FM, and LM. Participants included 121 boys (13.1 ± 1.0 years) from the PRO-BONE study. Bone mineral content (BMC) and aBMD were measured at total body, femoral neck and lumbar spine using dual-energy X-ray absorptiometry (DXA), and hip structural analysis was used to estimate bone geometry at the femoral neck. Body composition was assessed using DXA. The relationships of FM and LM with bone outcomes were analysed using simple and multiple linear regression analyses. Pearson correlation coefficients showed that total body (less head) aBMD was significantly correlated with LM but not FM. Multiple linear regression analyses showed that FM, after accounting for height, age, MVPA and LM had no significant relationship with aBMD or hip geometry estimates, except for arms aBMD. By contrast, there were positive associations between LM and most aBMD and hip geometry estimates, after accounting height, age, MVPA and FM. The results of this study suggest that LM, and not FM, is the stronger predictor of aBMD and hip geometry estimates in physically active boys. ClinicalTrials.gov ISRCTN17982776.

Background: New approaches on paediatric cancer treatment aim to maintain long-term health. As a result of radiotherapy, chemotherapy or surgery, paediatric cancer survivors tend to suffer from any chronic health condition. Endocrine dysfunction represents one of the most common issues and affects bone health. Exercise is key for bone mass accrual during growth, specifically plyometric jump training. The iBoneFIT study will investigate the effect of a 9-month online exercise programme on bone health in paediatric cancer survivors. This study will also examine the effect of the intervention on body composition, physical fitness, physical activity, calcium intake, vitamin D, blood samples quality of life and mental health. Methods: A minimum of 116 participants aged 6 to 18 years will be randomized into an intervention (n = 58) or control group (n = 58). The intervention group will receive an online exercise programme and diet counselling on calcium and vitamin D. In addition, five behaviour change techniques and a gamification design will be implemented in order to increase the interest of this non-game programme. The control group will only receive diet counselling. Participants will be assessed on 3 occasions: 1) at baseline; 2) after the 9 months of the intervention; 3) 4 months following the intervention. The primary outcome will be determined by dual energy X-ray absorptiometry (DXA) and the hip structural analysis, trabecular bone score and 3D-DXA softwares. Secondary outcomes will include anthropometry, body composition, physical fitness, physical activity, calcium and vitamin D intake, blood samples, quality of life and mental health., La Caixa Foundation 100010434 LCF/BQ/PR19/11700007, University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES), Junta de Andalucía SOMM17/6107/UGR, European Union (EU) SOMM17/6107/UGR

Context Primary hyperparathyroidism (PHPT) has been related to bone loss. Dual-energy x-ray absorptiometry (DXA) cannot distinguish between trabecular and cortical bone compartments but the recently developed three-dimensional (3D)-DXA software might overcome this issue. Objective To examine the differences in DXA-derived areal bone mineral density (aBMD) and 3D-DXA parameters at the hip site between patients with PHPT and a healthy control group. Design Cross-sectional pilot study Setting Hospital Patients 80 adults (59.5 ± 9.1 yrs), 40 with PHPT and 40 age- and sex-matched healthy controls. Measures aBMD (g/cm2) of the femoral neck, trochanter, shaft, and total hip was assessed using DXA. Cortical surface (sBMD, mg/cm2), cortical volumetric BMD (vBMD, mg/cm3), trabecular vBMD (mg/cm3), integral vBMD (mg/cm3) and cortical thickness (mm) was assessed using 3D-DXA software. Results Mean-adjusted values showed lower aBMD (7.5%-12.2%, effect size: 0.51-1.01) in the PHPT group compared with the control group (all P < 0.05). 3D-DXA revealed bone impairment (3.7%-8.5%, effect size: 0.47-0.65) in patients with PHPT, mainly in cortical parameters (all P < 0.05). However, differences in trabecular vBMD were not statistically significant (P = 0.055). The 3D mapping showed lower cortical sBMD, cortical vBMD, and cortical thickness at the trochanter and diaphysis in the PHPT group (P < 0.05) compared with the control group. In both groups, the presence of osteopenia or osteoporosis is related to lower cortical bone. Conclusions aBMD and cortical 3D parameters are impaired in patients with PHPT versus healthy controls. The vBMD of the trabecular compartment seems to be affected, although to a lesser extent.

The prevalence of osteoporosis and fragility fractures is expected to increase due to the increasing life expectancy of the population worldwide. Determinants of osteoporosis include the genetic predisposition and environmental factors, such as exercise and diet, which can affect peak bone mass attainment. Peak bone mass is achieved between the second and third decade of life, with 80–90% acquired by late adolescence followed by a decrease of ~1% annually from the fifth decade of life. Weight-bearing exercise has an important role on bone development and maintenance of skeletal bone mass due to the mechanical loads produced and the repetitive forces applied on the skeleton. Football includes a wide variety of intermittent high-intensity movements which produce large ground reaction forces. Cross-sectional, longitudinal and randomised controlled trials provide evidence that football exercise can have positive effects on bone development and structure in both male and female children and adolescents. During adulthood, football participation can maintain and improve bone health in young, middle-aged and older men and women, including various clinical patient groups with evidence indicating structural, cellular and clinically relevant bone adaptations. The skeletal benefits are site-specific and adaptations are observed particularly at the skeletal regions stimulated by mechanical loads. In summary, it is concluded that football participation is an effective strategy to promote bone health during childhood, adolescence and in adulthood.

Aim: The purpose of the present study was to (1) investigate the cross-sectional (baseline) and longitudinal (12 months) effects of football (weight-bearing sport), swimming and cycling (non-weight-bearing sports), and an active control group on bone turnover markers in adolescent males and (2) examine the effect of a 9-month progressive jumping intervention programme on bone turnover in the sports groups of adolescent males. Materials & Methods: A total of 105 adolescent males (30 footballers, 37 swimmers, 26 cyclists, and 12 active controls), aged 12 to 14 years at baseline, were measured at baseline (T0), after 1 year of sport-specific training (T1) and following a 9-month progressive jumping intervention programme (T2). Bone turnover was measured using serum N-terminal propeptide of procollagen type I (PINP) as bone formation marker and isomer of the carboxy-terminal telopeptide of type 1 collagen (CTX-I) as bone resorption marker. Bone turnover rate and balance were estimated using the multiple of medians logarithmic equations of PINP and CTX-I. Results: At T0 there were no significant differences between groups in any of the biochemical markers. At T1 PINP was significantly higher in footballers than swimmers (3.3%) and cyclists (6.0%). Cyclists had significantly lower PINP (5.1%) and CTX-I (14.8%) than controls. In swimmers, there was a significant decrease in PINP (5.8%) and a significant increase in CTX-I (9.8%) from T0 to T1. In cyclists, PINP significantly decreased (7.2%) and CTX-I non-significantly increased (4.3%) from T0 to T1. At T2, PINP was reduced in all non-intervention sport groups (4.4% in swimmers, 3.3% in footballers, and 4.2% in cyclists). CTX-I was reduced by 3.8% in swimmers and cyclists who did not perform the intervention. Conclusions: The present study showed that at baseline there were no differences between groups in bone turnover, but after 1 year of sport-specific training bone turnover was significantly improved in footballers and controls compared to swimmers and cyclists. Following the 9-month jumping intervention bone turnover significant declined in the intervention groups of cycling and swimming. By contrast, bone formation significantly decreased in footballers and the control groups, and bone resorption significantly decreased in the non-intervention groups of cycling and swimming.

Exercise is an effective approach for developing bone mass and adolescence is a key period to optimize bone health. However, sports-specific training may have different effects on bone outcomes. This study examined the differences on bone outcomes between osteogenic (football) and nonosteogenic (swimming and cycling) sports and a control group in male adolescents.One hundred twenty one males (13.1 ± 0.1 yr) were measured: 41 swimmers, 37 footballers, 29 cyclists, and 14 controls. Dual energy X-ray absorptiometry measured bone mineral density (BMD) and bone mineral content at lumbar spine, right and left hip, and total body. Hip Structural Analysis evaluated bone geometry at the femoral neck. Quantitative ultrasound evaluated bone stiffness at both feet.Footballers had significantly higher BMD at total body less head (7%-9%), total hip (12%-21%), and legs (7%-11%) compared with all groups and significantly higher BMD at the femoral neck than controls (14%). Cyclists had higher BMD at the trochanter (10%) and bone mineral content at the arms (10%) compared with controls. Geometrical analysis showed that footballers had significantly higher cross-sectional area (8%-19%) compared with all groups, cross-sectional moment of inertia (17%) compared with controls and section modulus compared with cyclists (11%) and controls (21%). Footballers had significantly higher bone stiffness compared with all groups (10%-20%) at the dominant foot and (12%-13%) at the nondominant foot compared with swimmers and controls.Adolescent male footballers exhibited higher bone density, geometry, and stiffness compared with swimmers, cyclists and controls. Although swimmers and cyclists had higher bone outcomes compared with controls, these differences were not significant.

Summary This study demonstrates that a 9-month jumping intervention can improve bone mass gains and physical fitness performance in adolescent males participating in non-osteogenic sports, such as swimming and cycling. Purpose To examine the effect of a jumping intervention on bone mass, bone stiffness and fitness parameters in adolescents involved in different sports. Methods Ninety-three adolescent male swimmers (SWI), footballers (FOO) and cyclists (CYC) were randomised to intervention (INT) and sport (INT-SWI = 19, INT-FOO = 15, INT-CYC = 14) or sport only (CON-SWI = 18, CON-FOO = 15, CON-CYC = 12) groups. The 9-month jumping intervention consisted of 3 levels (12 weeks each) of 20 repetitions per set of counter movement jumps (CMJ) using adjustable weight vests (level 1 = 20 CMJ jumps/set, 0 kg, 3 sets/day, 3 times/week; level 2 = 20 CMJ jumps/set, 2 kg, 4 sets/day, 3 times/week; level 3 = 20 CMJ jumps/set, 5 kg, 4 sets/day, 4 times/week). Total body bone mineral content (BMC) at total body less head (TBLH) was measured using dual-energy X-ray absorptiometry and bone stiffness using quantitative ultrasound. Fitness was assessed using the 20-m shuttle run (20mSRT), CMJ and standing long jump (SLJ) tests. Results INT-SWI had significantly higher increase in BMC legs and bone stiffness compared to CON-SWI (4.2–12.7%). INT-CYC had significantly higher increase in BMC at TBLH and legs and bone stiffness compared to CON-CYC (5.0–12.3%). There were no significant differences between INT-FOO and CON-FOO in any bone outcomes (0.9–3.9%). The increase in CMJ performance was significantly higher in INT-SWI (3.1 cm) and INT-CYC (3.2 cm) compared to CON-SWI and CON-CYC groups, respectively. Conclusions A 9-month jumping intervention can improve bone mass, bone stiffness and muscular fitness in adolescent males participating in non-osteogenic sports, such as swimming and cycling. Clinical Trial Registration ISRCTN17982776.

Summary: We identified the determinants of 12-month changes of areal bone mineral density (aBMD), hip geometry and trabecular bone score (TBS) in adolescent male athletes. Changes in region-specific lean mass and the type of sport are the most consistent determinants in this population. Purpose: This study aims to identify the determinants of 12-month changes of areal bone mineral density (aBMD), hip geometry and trabecular bone score (TBS) in adolescent male athletes. Methods: The sample was 104 adolescent males aged 12-14 years at baseline that were followed over 12 months: 39 swimmers, 37 footballers (or soccer players) and 28 cyclists. Dual-energy X-ray absorptiometry measured aBMD at the whole body, lumbar spine and dual hip. Hip geometry estimates at the femoral neck were measured using hip structural analysis. Lumbar spine texture was measured by TBS. Results: Multivariate regression models significantly explained 38-60% of the variance in the aBMD changes, 36-62% in the hip geometry estimates changes and 45% in the TBS changes Delta region-specific lean mass was the most consistent predictor of changes in aBMD outcomes (beta=0.591 to 0.696), followed by cycling participation (beta=-0.233 to -0.262), swimming participation (beta=-0.315 to -0.336) and Delta MVPA (beta=0.165). Cycling participation was the most consistent predictor of changes in hip geometry estimates (beta=-0.174 to -0.268), followed by Delta region-specific lean mass (beta=0.587) and Delta cardiorespiratory fitness (beta=0.253). Finally, cycling and swimming participation (beta=-0.347 to -0.453), Delta region-specific lean mass (beta=0.848) and Delta stature (beta=0.720) were predictors of change in TBS. Conclusions: Changes in region-specific lean mass and the type of sport are the most consistent determinants of 12-month changes in aBMD, hip geometry estimates and TBS in adolescent male athletes.

This chapter outlines the methods to assess growth and maturation. Biological maturation varies with the biological system that is selected and comprises the assessment of sexual, morphological, dental, or skeletal maturation. The chapter describes how measures of physical fitness and performance are impacted by growth and maturation. It also outlines the methods used to examine body weight status and composition. The chapter examines laboratory-based testing protocols to determine and interpret aerobic and anaerobic fitness in children and adolescents. Although more commonly used in the research setting, laboratory-based measures of physical fitness in children and adolescents have typically focused on developing protocols to measure aerobic and anaerobic fitness. Three of the key parameters of aerobic fitness are: maximal oxygen uptake, blood lactate threshold, and oxygen cost of exercise. The chapter presents field-based testing batteries for measuring physical fitness in children and adolescents.

Accepted manuscript version, licensed CC BY-NC-ND 4.0. Published version available at https://doi.org/10.1016/j.jsams.2018.08.009. Objectives: To describe differences in bone outcomes according to biological age in male athletes participating in osteogenic (OS) or non-osteogenic (NOS) sports. Design: Longitudinal (12-months). Methods: 104 adolescents (12–14 years) were measured at baseline and after 1y: OS group (n = 37 football or soccer players) and NOS group (n = 39 swimmers, n = 28 cyclists). Years from peak height velocity (PHV, −2 to +2) was used as a maturational landmark. Bone mineral content (BMC) was assessed using DXA. Hip structural analysis estimated cross-sectional area (CSA), cross-sectional moment of inertia (CSMI) and section modulus (Z) at the femoral neck (FN). Trabecular bone score (TBS) estimated lumbar spine (LS) texture. Quantitative ultrasound measured bone stiffness. Multilevel regression models adjusted by hours of training were fitted. Results: Compared to NOS, OS had significantly greater total body (less head) BMC from PHV to +2 years from PHV (from 9.5% to 11.3%, respectively); LS BMC from −1 years from PHV to PHV (from 9.8% to 9.9%); hip BMC (from 11.6% to 22.9%), FN BMC (from 12.0% to 15.9%), TBS (from 4.2% to 4.8%) and stiffness index (from 11.9% to 23.3%) from −1 years from PHV to +2 years from PHV; and CSA (from 8.4% to 18.8%), Z (from 5.5% to 22.9%) and CSMI (from 10.6% to 23.3%) from −2 years from PHV to +2 years from PHV. There was a significant trend for the between-group differences to increase with biological age except for LS BMC and TBS. Conclusions: These findings underline the differential bone response to different sports throughout the years surrounding PHV in male adolescent athletes.

Sports have different effects on bone development and effective interventions to improve bone health of adolescent athletes are needed. The purpose of the study was to investigate the effect of a 9-month jumping intervention on bone geometry and metabolism in adolescent male athletes.Ninety-three adolescent (14.1 yr old) male swimmers (SWI), footballers (FOO), and cyclists (CYC) were randomized to intervention and sport (INT-SWI = 19, INT-FOO = 15, and INT-CYC = 14) or sport only (CON-SWI = 18, CON-FOO = 15, and CON-CYC = 12) groups. Cross-sectional area, cross-sectional moment of inertia (CSMI), and section modulus (Z) at the femoral neck were assessed using hip structural analysis and trabecular texture of the lumbar spine using trabecular bone score. Bone mineral content (BMC) at femoral neck and lumbar spine was assessed using dual-energy x-ray absorptiometry. Serum N-terminal propeptide of procollagen type I, isomer of the carboxy-terminal telopeptide of type 1 collagen, total serum calcium, and 25-hydroxyvitamin D were analyzed.INT-CYC acquired significantly higher lumbar spine BMC (4.6%) and femoral neck BMC (9.8%) than CON-CYC. INT-CYC acquired significantly higher cross-sectional area (11.0%), CSMI (10.1%), and trabecular bone score (4.4%) than CON-CYC. INT-SWI acquired significantly higher femoral neck BMC (6.0%) and CSMI (10.9%) than CON-SWI. There were no significant differences between INT-FOO and CON-FOO in any bone outcomes. N-terminal propeptide of procollagen type I significantly decreased in CON-SWI, INT-FOO, CON-FOO, and CON-CYC. Carboxy-terminal telopeptide of type 1 collagen significantly decreased in CON-SWI and CON-CYC. The 25-hydroxyvitamin D significantly increased in INT-CYC, CON-CYC, INT-FOO, and CON-FOO.A 9-month jumping intervention improved bone outcomes in adolescent swimmers and cyclists, but not in footballers. This intervention might be used by sports clubs to improve bone health of adolescent athletes.

Purpose: The present study aims to investigate the association between dual-energy X-ray absorptiometry (DXA) and quantitative ultrasound (QUS) parameters and the intermethods agreement in active males. Methods: In this cross-sectional study, bone health (by DXA and calcaneal QUS), physical activity (by accelerometers), and anthropometrics measurements were assessed in 117 active adolescents (12–14 y old). Bivariate correlation coefficients were calculated to assess the relationships between DXA standard regions of interest and QUS parameters. Intraclass correlation coefficients and Bland–Altman plots were used to assess the level of agreement between bone mineral content regions derived from DXA and stiffness index. The measurements were z score transformed for comparison. Results: Most QUS parameters were positive and significantly correlated with DXA outcomes (stiffness index: r = .43–.52; broadband ultrasound attenuation: r = .50–.58; speed of sound: r = .25–.27) with the hip showing the highest correlations. Moreover, the present study found fair to good intraclass correlation coefficients of agreement (.60–.68) between DXA and QUS to assess bone health. The Bland–Altman analysis showed a limited percentage of outliers (3.2%–8.6%). Conclusion: QUS device could represent an acceptable alternative method to assess bone health in active adolescent males.

Purpose: To examine the intermethods agreement of dual-energy X-ray absorptiometry (DXA) and foot-to-foot bioelectrical impedance analysis (BIA) to assess the percentage of body fat (%BF) in young male athletes using air-displacement plethysmography (ADP) as the reference method. Methods: Standard measurement protocols were carried out in 104 athletes (40 swimmers, 37 footballers, and 27 cyclists, aged 12–14 y). Results: Age-adjusted %BF ADP and %BF BIA were significantly higher in swimmers than footballers. ADP correlates better with DXA than with BIA (r = .84 vs r = .60, P P r = .67–.79), though it was poor when BIA was compared with ADP (r = .26–.49). The ranges of agreement were wider when comparing BIA with ADP than DXA with ADP. Conclusion: DXA and BIA seem to underestimate %BF in young male athletes compared with ADP. Furthermore, the bias significantly increases with %BF in the BIA measurements. At the individual level, BIA and DXA do not seem to predict %BF precisely compared with ADP in young athletic populations.

Purpose: To investigate the effect of a complex, short-term strength/power training protocol on performance and body composition of elite early adolescent soccer players. Methods: Twenty-two players (14–15 y) were randomly assigned to (1) an experimental group (N = 12; participated in a 5-wk training protocol with traditional multijoint power resistance exercises, Olympic-style lifts, plyometric drills, and speed work; 4 times per week) or (2) a control group (N = 10). Strength and power performance (jumping, speed, change of direction, repeated sprint ability, endurance, isokinetic strength of knee flexors and extensors, maximal strength in various lifts, and speed-endurance) were evaluated pretraining and posttraining. Results: Cessation of training for 5 weeks in the control group induced a marked performance deterioration (∼5%–20%). Training not only prevented strength performance deterioration but also increased it (∼2%–30%). Endurance and repeated sprint ability declined to a smaller extent in experimental group compared with control group (15% vs 7.5%). Isometric strength and body composition remained unaltered in both groups. Conclusions: Results demonstrate that (1) young players exhibit a high level of trainability of their strength/power performance (but not endurance) in response to a short-term complex training protocol during early adolescence, (2) Olympic-style lifts are characterized by increased safety in this age group and appear to be highly effective, (3) lifts incorporating a hip thrust result in increased strength of both knee extensors and flexors, (4) cessation of training for only 5 weeks results in marked deterioration of strength/power and endurance performance, and (5) improvement of strength/power performance may be related to neural-based adaptation as body composition remained unaffected.