Centro de Investigação Em Desporto, Educação Física, Exercício E Saúde (CIDEFES), Universidade Lusófona, Lisbon, Portugal.
Clínica Universitária de Pediatria, Faculdade de Medicina, Universidade de Lisboa Av. Prof. Egas Moniz, 1649-035, Lisbon, Portugal.
Eur J Pediatr. 2024 Sep;183(9):3969-3978. doi: 10.1007/s00431-024-05659-4. Epub 2024 Jun 27.
The present study aimed to explore the influence of diet and physical activity (PA) changes on bone mineral content (BMC) and density (BMD) alterations in adolescents with obesity undergoing a weight loss program.
Six-month longitudinal data from 71 adolescents (aged 15.1 [± 1.6] years; 57.7% girls) with a BMI z-score of 3.03 (± 0.78), previously recruited for the PAC-MAnO trial, were analyzed using Generalized Estimation Equations for over time changes and linear regressions with BMC, BMD and BMD z-score as dependent variables, adjusting for confounders (including type of exercise- aerobic vs. combined).
Adjusting for confounders, changes in carbohydrate (CH) and protein content showed to positively and negatively predict BMD z-score variance, respectively (β = 0.44, 95%CI: 0.01, 0.04, p < .001); β = -0.57, 95%CI: -0.06, -0.03, p < .001), yet no associations were found between PA and bone-related parameters. Combined exercise showed better results on BMC compared to aerobic exercise (β = 0.09, 95%CI: 0.05 to 0.13, p < .001).
Increased CH content, instead of protein, may be associated with BMD improvements in adolescents with obesity. Type of exercise may moderate the impact of PA on bone health.
Clinicaltrials.gov NCT02941770. What is Known • Adolescents with obesity may be at a higher risk of osteopenia/osteoporosis • Obesity and inadequate diet and physical activity (PA) may have an adverse effect on bone metabolism What is New • Improvements in adiposity and muscle mass and increased diet carbohydrate content are associated with bone mineral density (BMD) improvements • Type of exercise (i.e., combined training vs. aerobic) may moderate the impact of PA on BMD, and calcium intake may mediate this impact.
本研究旨在探讨在接受减肥计划的肥胖青少年中，饮食和体力活动（PA）变化对骨矿物质含量（BMC）和密度（BMD）变化的影响。
对之前参加 PAC-MAnO 试验的 71 名青少年（年龄 15.1[±1.6]岁；57.7%为女孩）的 6 个月纵向数据进行分析，这些青少年的 BMI z 分数为 3.03（±0.78）。使用广义估计方程分析随时间的变化，并用 BMC、BMD 和 BMD z 分数作为因变量进行线性回归，调整混杂因素（包括运动类型-有氧运动与综合运动）。
调整混杂因素后，碳水化合物（CH）和蛋白质含量的变化分别正向和负向预测 BMD z 分数的方差（β=0.44，95%CI：0.01，0.04，p<0.001）；β=-0.57，95%CI：-0.06，-0.03，p<0.001），但 PA 与骨骼相关参数之间没有关联。与有氧运动相比，综合运动对 BMC 的效果更好（β=0.09，95%CI：0.05 至 0.13，p<0.001）。
在肥胖青少年中，CH 含量的增加而不是蛋白质含量的增加可能与 BMD 的改善有关。运动类型可能会调节 PA 对骨骼健康的影响。
Clinicaltrials.gov NCT02941770。 已知情况 • 肥胖青少年可能有更高的骨质疏松/骨量减少风险 • 肥胖和饮食不足及体力活动不足可能对骨代谢产生不利影响。 新发现 • 肥胖和饮食不足及体力活动不足可能对骨代谢产生不利影响。 • 体脂和肌肉质量的改善以及饮食中碳水化合物含量的增加与 BMD 改善有关 • 运动类型（即综合训练与有氧运动）可能会调节 PA 对 BMD 的影响，钙的摄入可能会调节这种影响。
