Background: Although it is widely accepted that dietary calcium intake (CaI) and weight-bearing physical activity (WBA) increase bone mass accrual during growth, few prospective studies have followed children from early childhood to sexual maturity to evaluate this relationship.
Aims: To describe the relationship between CaI and WBA and total body bone mineral content (TBBMC) accrual in a large, multiracial cohort of children followed prospectively.
Methods: Five US centers recruited 2014 healthy children (ages 5–19 years) and measured them annually for up to 7 years. Subjects with at least two annual visits are included in this analysis (944 boys, 973 girls). Assessments included TBBMC, Tanner stage, WBA, and CaI. Multiple regression was used to model annual increases in TBBMC, controlled for annualized overall height growth, Tanner stages, and baseline TBBMC. The effect of adding WBA and CaI to the model was evaluated for four subgroups: nonblack boys and girls and black boys and girls.
Results: WBA had a positive association with adjusted annual increases in TBBMC in all subgroups (p < 0.05), while CaI was positively related to TBBMC increase in nonblack males and nonblack females.
Conclusion: These findings support the importance of public health efforts to increase physical activity in children and adolescents while assuring adequate calcium intake.
Dietary calcium intake Physical activity Children Adolescents Observational study Bone mass accrual Total body bone mineral content
Bone mineral content
Bone Mineral Density in Childhood Study
Dual Energy Absorptiometry
National Institute for Child health and Human Development
Randomized Clinical Trial
Sums of Squares
Total Body Bone Mineral Content
Weight Bearing Activity
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We acknowledge the study participants and their families for their dedication to this project. We thank the study staff members at each site who worked to achieve successful completion of this study.
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