domingo, 5 de enero de 2014

Preventing Chronic Disease | Racial and Ethnic Differences in Physical Activity and Bone Density: National Health and Nutrition Examination Survey, 2007–2008 - CDC

full-text ►
Preventing Chronic Disease | Racial and Ethnic Differences in Physical Activity and Bone Density: National Health and Nutrition Examination Survey, 2007–2008 - CDC


PCD Logo

Racial and Ethnic Differences in Physical Activity and Bone Density: National Health and Nutrition Examination Survey, 2007–2008

Elizabeth Vásquez, DrPH; Benjamin A. Shaw, PhD; Lenore Gensburg; Daniel Okorodudu, MD; Leonor Corsino, MD, MHS

Suggested citation for this article: Vásquez E, Shaw BA, Gensburg L, Okorodudu D, Corsino L. Racial and Ethnic Differences in Physical Activity and Bone Density: National Health and Nutrition Examination Survey, 2007–2008. Prev Chronic Dis 2013;10:130183. DOI: http://dx.doi.org/10.5888/pcd10.130183External Web Site Icon.
PEER REVIEWED

Abstract

Introduction
Participation in regular physical activity (PA) may help maintain bone health as people age. However, most American adults do not engage in the recommended minimum levels of PA, and there are racial/ethnic differences in PA participation. This study aimed to determine whether current physical activity is related to bone density in a racially/ethnically diverse sample after controlling for age, sex, body mass index, poverty–income ratio, tobacco use, vitamin D and calcium intake, and use of osteoporosis medications.
Methods
We obtained data on femoral bone mineral density for 2,819 adults aged 40 to 80 years who self-reported their race/ethnicity on the 2007–2008 National Health and Nutrition Examination Survey. Data on PA levels were obtained by self-report. We used linear regression models to examine the association between PA and bone density for each racial/ethnic group.
Results
A greater percentage of non-Hispanic blacks (60.9%) and Hispanics (53.3%) reported low levels of PA than non-Hispanic whites (45.3%, P < .001). Non-Hispanic blacks (16.3%) and Hispanics (18.5%) had a lower prevalence of osteopenia than non-Hispanic whites (25.5%; P = .01) but were similar in the prevalence of normal and osteoporosis categories when compared with whites. There was a 0.031 g/cm2 difference in bone density between those in the high PA versus the low PA category (P = .003). This association remained (β = 0.027, P < .001) after adjusting for race/ethnicity, sex, body mass index, poverty–income ratio, tobacco use, and use of osteoporosis medications.
Conclusion
Despite lower levels of activity, blacks and Hispanics were not more likely to have osteoporosis, and high levels of activity were significantly associated with higher bone density even when controlling for race/ethnicity and confounders. The lack of consistency in bone density differences suggests that the cause of the differences maybe multifactorial.


Author Information

Corresponding Author: Elizabeth Vásquez, DrPH, University at Albany, State University of New York (SUNY), School of Public Health, One University Place, GEC 125 Rensselaer, NY 12144. Telephone: 518-408-2362. E-mail: egrubert@albany.edu.
Author Affiliations: Benjamin A. Shaw, Lenore Gensburg, University at Albany, SUNY, Rensselaer, New York; Daniel Okorodudu, Leonor Corsino, Duke University Medical Center, Durham, North Carolina.

References

  1. Osteoporosis: an evidence-based guide to prevention and management. Cummings S, Cosman F, Jamal S, editors. Philadelphia (PA): American College of Physicians; 2002.
  2. Barrett-Connor E, Siris ES, Wehren LE, Miller PD, Abbott TA, Berger ML, et al. Osteoporosis and fracture risk in women of different ethnic groups. J Bone Miner Res 2005;20(2):185–94. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  3. Lewiecki EM, Baim S, Siris ES. Osteoporosis care at risk in the United States. Osteoporos Int 2008;19(11):1505–9. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  4. Siris ES, Brenneman SK, Barrett-Connor E, Miller PD, Sajjan S, Berger ML, et al. The effect of age and bone mineral density on the absolute, excess, and relative risk of fracture in postmenopausal women aged 50–99: results from the National Osteoporosis Risk Assessment (NORA). Osteoporos Int 2006;17(4):565–74. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  5. Gass M, Dawson-Hughes B. Preventing osteoporosis-related fractures: an overview. Am J Med 2006;119(4, Suppl 1):S3–11. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  6. Gremeaux V, Gayda M, Lepers R, Sosner P, Juneau M, Nigam A. Exercise and longevity. Maturitas 2012;73(4):312–7. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  7. Centers for Disease Control and Prevention. Trends in leisure-time physical inactivity by age, sex, and race/ethnicity — United States, 1994–2004. MMWR Morb Mortal Wkly Rep 2005;54(39):991–4. PubMedExternal Web Site Icon
  8. Centers for Disease Control and Prevention. Prevalence of regular physical activity among adults — United States, 2001 and 2005. MMWR Morb Mortal Wkly Rep 2007;56(46):1209–12. PubMedExternal Web Site Icon
  9. An older and more diverse nation by midcentury. US Census Bureau; 2008. http://www.census.gov/newsroom/releases/archives/population/cb08-123.html. Accessed November 4, 2013.
  10. State and county quickfacts: United States. US Census Bureau; 2013. http://quickfacts.census.gov/qfd/states/00000.html. Accessed November 4, 2013.
  11. Beck B, Shaw J, Snow C. Physical activity and osteoporosis. In: Marcus R, Feldman D, Kelsey J, editors. Osteoporosis. San Diego (CA): Academy Press; 2001. p. 669–94.
  12. Layne JE, Nelson ME. The effects of progressive resistance training on bone density: a review. Med Sci Sports Exerc 1999;31(1):25–30. CrossRefExternal Web Site IconPubMedExternal Web Site Icon
  13. Puntila E, Kroger H, Lakka T, Honkanen R, Tuppurainen M. Physical activity in adolescence and bone density in peri- and postmenopausal women: a population-based study. Bone 1997;21(4):363–7. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  14. US Department of Health and Human Services, Centers for Disease Control and Prevention. National Health and Nutrition Examination Survey data. Hyattsville (MD): National Center for Health Statistics; 2011 http://www.cdc.gov/nchs/nhanes.htm. Accessed November 4, 2013.
  15. The National Health and Nutrition Examination Survey. Centers for Disease Control and Prevention; 2013. http://www.cdc.gov/nchs/nhanes.htm. Accessed November 12, 2013.
  16. Kanis JA, McCloskey EV, Johansson H, Oden A, Melton LJ 3d, Khaltaev N. A reference standard for the description of osteoporosis. Bone 2008;42(3):467–75. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  17. Bull FC, Maslin TS, Armstrong T. Global physical activity questionnaire (GPAQ): nine country reliability and validity study. J Phys Act Health 2009;6(6):790–804. PubMedExternal Web Site Icon
  18. Living wage 2001 press release. Alternatives Federal Credit Union. http://www.alternatives.org/2011livingwagepressrelease.html. Accessed November 12, 2013.
  19. About BMI for adults. Centers for Disease Control and Prevention; 2011. http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html. Accessed November 12, 2013.
  20. Blanton CA, Moshfegh AJ, Baer DJ, Kretsch MJ. The USDA Automated Multiple-Pass Method accurately estimates group total energy and nutrient intake. J Nutr 2006;136(10):2594–9. PubMedExternal Web Site Icon
  21. Hughes JP, McDowell MA, Brody DJ. Leisure-time physical activity among US adults 60 or more years of age: results from NHANES 1999–2004. J Phys Act Health 2008;5(3):347–58. PubMedExternal Web Site Icon
  22. Puntila E, Kroger H, Lakka T, Tuppurainen M, Jurvelin J, Honkanen R. Leisure-time physical activity and rate of bone loss among peri- and postmenopausal women: a longitudinal study. Bone 2001;29(5):442–6. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  23. Looker AC, Melton LJ 3d, Harris TB, Borrud LG, Shepherd JA. Prevalence and trends in low femur bone density among older US adults: NHANES 2005–2006 compared with NHANES III. J Bone Miner Res 2010;25(1):64–71. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  24. Finkelstein JS, Brockwell SE, Mehta V, Greendale GA, Sowers MR, Ettinger B, et al. Bone mineral density changes during the menopause transition in a multiethnic cohort of women. J Clin Endocrinol Metab 2008;93(3):861–8. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  25. Looker AC, Melton LJ 3d, Borrud LG, Shepherd JA. Changes in femur neck bone density in US adults between 1988–1994 and 2005–2008: demographic patterns and possible determinants. Osteoporos Int 2012;23(2):771–80. PubMedExternal Web Site Icon
  26. Wallace LS, Ballard JE, Holiday DB, Wells HE. Comparison between 60 matched pairs of postmenopausal black and white women: analysis of risk factors related to bone mineral density. Maturitas 2005;52(3-4):356–63. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  27. Moore C, Murphy MM, Keast DR, Holick MF. Vitamin D intake in the United States. J Am Diet Assoc 2004;104(6):980–3. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  28. Looker AC, Melton LJ 3d, Harris T, Borrud L, Shepherd J, McGowan J. Age, gender, and race/ethnic differences in total body and subregional bone density. Osteoporos Int 2009;20(7):1141–9. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  29. Schoenborn CA, Adams PF, Barnes PM, Vickerie JL, Schiller JS. Health behaviors of adults: United States, 1999–2001. Vital Health Stat 10 2004;(219):1–79. PubMedExternal Web Site Icon
  30. Morey MC, Sloane R, Pieper CF, Peterson MJ, Pearson MP, Ekelund CC, et al. Effect of physical activity guidelines on physical function in older adults. J Am Geriatr Soc 2008;56(10):1873–8. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon
  31. Boonen S, Rizzoli R, Meunier PJ, Stone M, Nuki G, Syversen U, et al. The need for clinical guidance in the use of calcium and vitamin D in the management of osteoporosis: a consensus report. Osteoporos Int 2004;15(7):511–9. CrossRefExternal Web Site Icon PubMedExternal Web Site Icon

No hay comentarios: