Examining the effects of a community-based physical activity program on moderate to vigorous physical activity and skeletal health in growing girls Public Deposited

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  • Girls on the Run (GOTR) is a community-based running program that encourages social, mental, emotional and physical development in young girls through the process of training for a 5k running event. Previous reports have shown that GOTR has positive effects on self-esteem and dietary behaviors; whether GOTR influences levels of physical activity and bone health outcomes is unknown. Purpose: To determine if participation in GOTR is associated with achieving the recommended moderate to vigorous physical activity (MVPA) of 60 minutes per day for children and positive skeletal development in 8-12 year-old girls. Methods: Girls (n=31; 9.8±1.4 yrs) were recruited from ten different GOTR Willamette Valley sites to form the intervention group. Girls who did not participate in GOTR or other organized physical activity formed the control group (n=9; 9.6±0.73 yrs). All girls completed a standard health history questionnaire at baseline. Weight, height, and time spent in MVPA were measured at baseline, 3, 6, and 9 months. MVPA was measured by accelerometry over a 7-day period at each time point. Bone mineral content (BMC (g)) and bone structural outcomes; assessed using DXA) and nutrient intakes (assessed using the Youth Adolescent Food Frequency Questionnaire) were evaluated at baseline and 9-months. To evaluate whether GOTR participants were meeting the physical activity minimum recommendations of 60 minutes/day of MVPA, one sample t-tests were applied at each time point evaluating the mean MVPA against a criterion test value of 60 (minutes). To determine whether the mean MVPA varied across time points within the intervention group, and whether there were differences in MVPA between groups across time, we used repeated measures analysis of variance; adjusting for multiple comparisons. To determine baseline differences between groups in BMC and structural outcomes, analysis of covariance (ANCOVA) was used adjusting for age, height, weight, maturation status (years from peak ht. velocity), nutrient intakes and MVPA. The ANCOVA was repeated at 9-months adding initial bone values to determine differences in BMC and structural outcomes between groups at follow-up. Results: At baseline there were no differences in MVPA between groups. However, GOTR participants had higher BMC (g) at the femoral neck (FN) site compared to controls (mean + SE; 2.69 + 0.07 vs. 2.33 + 0.13; p=0.02) and a larger estimated cross sectional area (cm² ) at the narrow neck region of the hip (mean + SE; 2.01 + 0.05 vs. 1.76 + 0.10;p=0.03); there were no baseline differences at any other bone site (p>0.05). At 9-months, GOTR participants had higher FN BMC (p=0.048) and higher trochanteric BMC (p=0.039) compared to controls after adjusting for growth, calcium, vitamin D, activity and initial BMC values. There were no group differences in BMC or structural outcomes at any other bone site (P>0.05). Conclusions: While participating in GOTR, our sample of 8-12 year-old girls had MVPA levels greater than the minimum recommended 60 minutes per day of MVPA, but these levels did not persist after the program ended. After adjusting for growth, maturation, calcium, vitamin D, MVPA, and initial BMC values, we found that GOTR participants exhibited higher FN and trochanteric BMC compared to controls. Thus there appears to be a positive association between participation in GOTR and skeletal development at the hip in growing girls. We expected positive changes in bone would be related to a sustained increase in MVPA. However, this was not the case. Statistical models revealed that MVPA did not explain any of the variability in bone outcomes. It is possible that while the accelerometers captured the general intensity of activities performed, they likely do not sufficiently assess the bone loading nature of activity. In summary, we found that participation in GOTR was associated with higher levels of MVPA and resulted in positive changes in BMC at the hip among young girls participating in the program. Evidence now exists to warrant a broader investigation of this program and its potential to improve health outcomes in young girls.
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