| Osteoporosis is a serious skeletal disease causing an increase
in morbidity and mortality through its association with age-related
fractures. Although most effort in fracture prevention has been directed
at retarding the rate of age-related bone loss and reducing the frequency
and severity of trauma among elderly people, evidence is growing that
peak bone mass is an important contributor to bone strength during
later life. Indeed, there has been a large emphasis on the prevention
of osteoporosis through the optimization of peak bone mass during
childhood and adolescence. The prepubertal human skeleton is sensitive
to the mechanical stimulation elicited by exercise and there is increasing
evidence that regular weight-bearing exercise is an effective strategy
for enhancing bone mineral throughout growth. Physical activity or
participation in sports needs to start at prepubertal ages and be
maintained through pubertal development to obtain the maximal peak
bone mass achievable. High strain eliciting sports like gymnastics,
or participation in sports or weight bearing physical activity like
soccer, are strongly recommended to increase peak bone mass. Many
other factors also influence the accumulation of bone mineral during
childhood and adolescence, including heredity, gender, diet and endocrine
status. However, this review article will focus solely on the effects
of physical activity and exercise providing a summary of current knowledge
on the interplay between activity, exercise and bone mass development
during growth. Due to the selection bias and other confounding factors
inherent in cross-sectional studies, longitudinal and intervention
studies only will be reviewed for they provide a greater opportunity
to examine the influence of mechanical loading on bone mineral accretion
over time.
KEY
WORDS: Puberty, loading, growth, osteoporosis, exercise.
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