Archives of Osteoporosis

, 13:31 | Cite as

Physical activity, but not sedentary time, influences bone strength in late adolescence

  • Vina PS. Tan
  • Heather M. Macdonald
  • Leigh Gabel
  • Heather A. McKayEmail author
Original Article



Physical activity is essential for optimal bone strength accrual, but we know little about interactions between physical activity, sedentary time, and bone outcomes in older adolescents. Physical activity (by accelerometer and self-report) positively predicted bone strength and the distal and midshaft tibia in 15-year-old boys and girls. Lean body mass mediated the relationship between physical activity and bone strength in adolescents.


To examine the influence of physical activity (PA) and sedentary time on bone strength, structure, and density in older adolescents.


We used peripheral quantitative computed tomography to estimate bone strength at the distal tibia (8% site; bone strength index, BSI) and tibial midshaft (50% site; polar strength strain index, SSIp) in adolescent boys (n = 86; 15.3 ± 0.4 years) and girls (n = 106; 15.3 ± 0.4 years). Using accelerometers (GT1M, Actigraph), we measured moderate-to-vigorous PA (MVPAAccel), vigorous PA (VPAAccel), and sedentary time in addition to self-reported MVPA (MVPAPAQ-A) and impact PA (ImpactPAPAQ-A). We examined relations between PA and sedentary time and bone outcomes, adjusting for ethnicity, maturity, tibial length, and total body lean mass.


At the distal tibia, MVPAAccel and VPAAccel positively predicted BSI (explained 6–7% of the variance, p < 0.05). After adjusting for lean mass, only VPAAccel explained residual variance in BSI. At the tibial midshaft, MVPAAccel, but not VPAAccel, positively predicted SSIp (explained 3% of the variance, p = 0.01). Lean mass attenuated this association. MVPAPAQ-A and ImpactPAPAQ-A also positively predicted BSI and SSIp (explained 2–4% of the variance, p < 0.05), but only ImpactPAPAQ-A explained residual variance in BSI after accounting for lean mass. Sedentary time did not independently predict bone strength at either site.


Greater tibial bone strength in active adolescents is mediated, in part, by lean mass. Despite spending most of their day in sedentary pursuits, adolescents’ bone strength was not negatively influenced by sedentary time.


Bone strength Sedentary Accelerometry pQCT Adolescent 



We gratefully acknowledge the HPSS Bone Health Study participants and their families along with the support of teachers and principals from participating schools. Our heartfelt gratitude to the main HPSS research team, from both UBC and UVIC, for their teamwork, recruitment efforts, and overall research management; to the Bone Health Study team—SoJung Kim and Paul Drexler for their dedicated and quality data collection efforts; Douglas Race, for accelerometer data management and participant scheduling; and especially to Dr. Danmei Liu for supervising and training bone imaging technicians and for her invaluable input in image acquisition and processing.


This study was funded by a Catalyst Grant from the Canadian Institutes of Health Research (227967). The authors declare no competing financial interests.

Compliance with ethical standards

The University of British Columbia’s Clinical and Behavioural Research Ethics Boards (H10-01917), University of Victoria’s Human Research Ethics Board (10-168), and participating school districts approved all study procedures.

Conflicts of interest


Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Supplementary material

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2018

Authors and Affiliations

  • Vina PS. Tan
    • 1
  • Heather M. Macdonald
    • 2
    • 3
  • Leigh Gabel
    • 3
    • 4
  • Heather A. McKay
    • 2
    • 3
    • 5
    Email author
  1. 1.School of Health Sciences, Health CampusUniversiti Sains MalaysiaKubang KerianMalaysia
  2. 2.Department of Family Practice, Faculty of MedicineUniversity of British ColumbiaVancouverCanada
  3. 3.Centre for Hip Health and MobilityVancouver Coastal Health Research InstituteVancouverCanada
  4. 4.McCaig Institute for Bone and Joint HealthUniversity of CalgaryCalgaryCanada
  5. 5.Department of Orthopedics, Faculty of MedicineUniversity of British ColumbiaVancouverCanada

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