This Article  • Full text  • PDF  • Correction  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (3)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Adolescent Medicine  • Exercise  • Rheumatology  • Osteoporosis  • Randomized Controlled Trial  • Alert me on articles by topic  Social Bookmarking   What's this?

A Health Plan–Based Lifestyle Intervention Increases Bone Mineral Density in Adolescent Girls

Lynn L. DeBar, PhD, MPH; Cheryl Ritenbaugh, PhD, MPH; Mikel Aickin, PhD; Eric Orwoll, MD; Diane Elliot, MD; John Dickerson, MS; Nancy Vuckovic, PhD; Victor J. Stevens, PhD; Esther Moe, PhD; Lori M. Irving, PhD

Arch Pediatr Adolesc Med. 2006;160:1269-1276.

Objective  To test the efficacy of a health plan–based lifestyle intervention to increase bone mineral density in adolescent girls.

Design  Two-year randomized, controlled trial.

Setting  Large health maintenance organization.

Participants  Girls 14 to 16 years old with body mass index below the national median.

Intervention  Behavioral intervention (bimonthly group meetings, quarterly coaching telephone calls, and weekly self-monitoring) designed to improve diet and increase physical activity.

Main Outcome Measures  Total bone mineral density was measured by dual-energy x-ray absorptiometry. Behavioral outcomes included intake of calcium, vitamin D, soda, and fruits and vegetables; high-impact and strength-training physical activity; measures of strength and fitness; and biomarkers (osteocalcin and naltrexone).

Results  Compared with control subjects, girls in the intervention group had significantly higher bone mineral density in the spine and trochanter regions during the first study year, which was maintained during the second study year. The naltrexone biomarker demonstrated a greater relative decrease in the intervention group compared with the control group, with nonsignificant changes in osteocalcin consistent with more bone building in the intervention group. Participants in the intervention group reported significantly greater consumption of calcium in both study years, vitamin D in the first year, and fruits and vegetables in both years. We found no effect on soda consumption or target exercise rates.

Conclusions  A comprehensive health care–based lifestyle intervention can effectively improve dietary intake and increase bone mineral gains in adolescent girls. To our knowledge, this study is the first to significantly improve bone mass in adolescent girls in a non–school-based intervention.

Trial Registration  ClinicalTrials.gov Identifier: NCT00067600.

Author Affiliations: Center for Health Research, Kaiser Permanente Northwest, Portland, Ore (Drs DeBar, Vuckovic, and Stevens, and Mr Dickerson); University of Arizona College of Medicine, Tucson (Drs Ritenbaugh and Aickin); Oregon Health & Science University, Portland (Drs Orwoll, Elliot, and Moe); Washington State University, Vancouver (Dr Irving).
Deceased.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Using a Website to Build Community and Enhance Outcomes in a Group, Multi-Component Intervention Promoting Healthy Diet and Exercise in Adolescents
DeBar et al.
J Pediatr Psychol 2009;34:539-550.
ABSTRACT | FULL TEXT  

Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents
Wagner et al.
Pediatrics 2008;122:1142-1152.
ABSTRACT | FULL TEXT