This 4-year cluster randomised controlled trial of 365 boys and 362 girls (mean age 8.1 ± 0.3 yea... more This 4-year cluster randomised controlled trial of 365 boys and 362 girls (mean age 8.1 ± 0.3 years) from grade 2 in 29 primary schools investigated the effects of a specialist-taught physical education (PE) program on bone strength and body composition. All children received 150 min/week of common practice (CP) PE from general classroom teachers but in 13 schools 100 min/week of CP PE was replaced by specialized-led PE (SPE) by teachers who emphasized more vigorous exercise/games combined with static and dynamic postural activities involving muscle strength. Outcome measures assessed in grades 2, 4, and 6 included: total body bone mineral content (BMC), lean mass (LM) and fat mass (FM) by DXA, and radius and tibia (4% and 66% sites) bone structure, volumetric density and strength, and muscle cross-sectional area (CSA) by pQCT. After 4-years, gains in total body BMC, FM and muscle CSA were similar between the groups in both sexes, but girls in the SPE group experienced a greater gain in total body LM [mean (95%CI), 1.0kg (0.2, 1.9)]. Compared to CP, girls in the SPE group also had greater gains in cortical area (CoA) and cortical thickness (CoTh) at the mid-tibia [CoA, 5.0% (0.2, 1.9); CoTh 7.5% (2.4, 12.6)] and mid-radius [CoA, 9.3% (3.5, 15.1); CoTh 14.4% (6.1, 22.7)], while SPE boys had a 5.2% (0.4, 10.0) greater gain in mid-tibia CoTh. These benefits were due to reduced endocortical expansion. There were no significant benefits of SPE on total bone area, cortical density or bone strength at the mid-shaft sites, nor any appreciable effects at the distal skeletal sites. This study indicates that a specialist-led school-based PE program improves cortical bone structure, due to reduced endocortical expansion. This finding challenges the notion that periosteal apposition is the predominant response of bone to loading during the pre- and early-pubertal period. This article is protected by copyright. All rights reserved.
Transcranial direct current stimulation (tDCS) is a noninvasive technique that modulates the exci... more Transcranial direct current stimulation (tDCS) is a noninvasive technique that modulates the excitability of neurons within the motor cortex (M1). Although the aftereffects of anodal tDCS on modulating cortical excitability have been described, there is limited data describing the outcomes of different tDCS intensities on intracortical circuits. To further elucidate the mechanisms underlying the aftereffects of M1 excitability following anodal tDCS, we used transcranial magnetic stimulation (TMS) to examine the effect of different intensities on cortical excitability and short-interval intracortical inhibition (SICI). Using a randomized, counterbalanced, crossover design, with a one-week wash-out period, 14 participants (6 females and 8 males, 22-45 years) were exposed to 10 minutes of anodal tDCS at 0.8, 1.0, and 1.2 mA. TMS was used to measure M1 excitability and SICI of the contralateral wrist extensor muscle at baseline, immediately after and 15 and 30 minutes following cessation of anodal tDCS. Cortical excitability increased, whilst SICI was reduced at all time points following anodal tDCS. Interestingly, there were no differences between the three intensities of anodal tDCS on modulating cortical excitability or SICI. These results suggest that the aftereffect of anodal tDCS on facilitating cortical excitability is due to the modulation of synaptic mechanisms associated with long-term potentiation and is not influenced by different tDCS intensities.
Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society, Jan 17, 2015
There is ongoing debate regarding the optimal serum concentrations of 25-hydroxy-vitamin D for mu... more There is ongoing debate regarding the optimal serum concentrations of 25-hydroxy-vitamin D for musculoskeletal health, including osteoarthritis. The aim of this prospective cohort study was to determine whether serum 25-hydroxy-vitamin D concentrations were associated with the risk of hip arthroplasty for osteoarthritis. This study examined 9135 participants from the Australian Diabetes, Obesity and Lifestyle Study who had serum 25-hydroxy-vitamin D measured in 1999-2000 and were aged ≥40 years at the commencement of arthroplasty data collection. The incidence of hip arthroplasty for osteoarthritis during 2002-2011 was determined by linking cohort records to the Australian Orthopaedic Association National Joint Replacement Registry. Over an average 9.1 (standard deviation 2.7) years of follow-up, 201 hip arthroplasties for osteoarthritis were identified (males n=90; females n=111). In males, a one-standard-deviation increase in 25-hydroxy-vitamin D was associated with a 25% increase...
Background: Falls are a major public health concern with at least one third of people aged 65 yea... more Background: Falls are a major public health concern with at least one third of people aged 65 years and over falling at least once per year, and half of these will fall repeatedly, which can lead to injury, pain, loss of function and independence, reduced quality of life and even death. Although the causes of falls are varied and complex, the age-related loss in muscle power has emerged as a useful predictor of disability and falls in older people. In this population, the requirements to produce explosive and rapid movements often occurs whilst simultaneously performing other attention-demanding cognitive or motor tasks, such as walking while talking or carrying an object. The primary aim of this study is to determine whether dual-task functional power training (DT-FPT) can reduce the rate of falls in community-dwelling older people. Methods/Design: The study design is an 18-month cluster randomised controlled trial in which 280 adults aged ≥65 years residing in retirement villages, who are at increased risk of falling, will be randomly allocated to: 1) an exercise programme involving DT-FPT, or 2) a usual care control group. The intervention is divided into 3 distinct phases: 6 months of supervised DT-FPT, a 6-month 'step down' maintenance programme, and a 6-month follow-up. The primary outcome will be the number of falls after 6, 12 and 18 months. Secondary outcomes will include: lower extremity muscle power and strength, grip strength, functional assessments of gait, reaction time and dynamic balance under single-and dual-task conditions, activities of daily living, quality of life, cognitive function and falls-related self-efficacy. We will also evaluate the cost-effectiveness of the programme for preventing falls.
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, Jan 31, 2015
The aim of this population-based, prospective cohort study was to investigate long-term associati... more The aim of this population-based, prospective cohort study was to investigate long-term associations between dietary calcium intake and fractures, non-fatal cardiovascular disease (CVD), and death from all causes. Participants were from the Melbourne Collaborative Cohort Study which was established in 1990-1994. A total of 41,514 men and women (∼99% aged 40-69 years at baseline) were followed-up for a mean (SD) of 12 (1.5) years. Primary outcome measures were time to death from all causes (n = 2,855), CVD-related deaths (n = 557), cerebrovascular disease-related deaths (n = 139), incident non-fatal CVD (n = 1,827), incident stroke events (n = 537) and incident fractures (n = 788). 12,097 participants (aged ≥50 years) were eligible for fracture analysis and 34,468 for non-fatal CVD and mortality analyses. Mortality was ascertained by record linkage to registries. Fractures and CVD were ascertained from interview ∼13 years after baseline. Quartiles of baseline energy-adjusted calcium ...
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2015
While previous studies have reported detrimental associations of sedentary behaviours with cardio... more While previous studies have reported detrimental associations of sedentary behaviours with cardiometabolic disorders and mortality, in this study, we report that higher levels of sitting time were associated with a greater risk of sarcopenia, with increased television (TV) viewing negatively associated with lean mass, independent of physical activity. Sedentary behaviour has been linked to cardiometabolic disorders and mortality, but little is known about its effects on musculoskeletal health and function. This study investigated the relationship between total sitting and TV viewing time on sarcopenia and its determinants (muscle mass, strength and function) in older adults. This cross-sectional study included 162 community-dwelling men and women aged 60 to 86 years who had complete assessment of total body and regional lean mass (LM) and fat mass (dual-energy X-ray absorptiometry (DXA)), lower limb muscle strength, power and functional performance. Sarcopenia was defined as the low...
Journal of musculoskeletal & neuronal interactions, 2013
While it is widely acknowledged that bones adapt to the site-specific prevalent loading environme... more While it is widely acknowledged that bones adapt to the site-specific prevalent loading environment, reasonable ways to estimate skeletal loads are not necessarily available. For long bone shafts, muscles acting to bend the bone may provide a more appropriate surrogate of the loading than muscles expected to cause compressive loads. Thus, the aim of this study was to investigate whether mid-thigh muscle cross-sectional area (CSA) was a better predictor of tibial mid-shaft bone strength than mid-tibia muscle CSA in middle aged and older men. 181 Caucasian men aged 50-79 years (mean±SD; 61±7 years) participated in this study. Mid-femoral and mid-tibial bone traits cortical area, density weighted polar moment of area and muscle CSA [cm(2)] were assessed with computed tomography. Tibial bone traits were positively associated with both the mid-femur (r=0.44 to 0.46, P<0.001) and the mid-tibia muscle CSA (r=0.35 to 0.37, P<0.001). Multivariate regression analysis, adjusting for age,...
Journal of musculoskeletal & neuronal interactions, 2011
Cortical porosity, particularly at the endocortical region, is recognised to play a central role ... more Cortical porosity, particularly at the endocortical region, is recognised to play a central role in the pathogenesis of bone fragility. Therefore, the purpose of this study was to: 1) demonstrate how cortical volumetric BMD (vBMD) distribution can be analysed from (p)QCT images and 2) highlight the clinical significance of assessing regional density distribution of cortical bone. We used pQCT to compare mid-tibial cortical volumetric BMD distribution of 20 young (age 24(SD2) years, mass 77(11) kg, height 178(6) cm) and 25 elderly (72(4) years, 75(9) kg, 172(5) cm) men. Radial and polar cortical vBMD distributions were analysed using a custom built open source analysis tool which allowed the cortex to be divided into three concentric cortical divisions and in 36 cortical sectors originating from the centroid of the bone. Mean vBMD did not differ between the groups (1135(16) vs. 1130(28) mg/cm, P = 0.696). In contrast, there was a significant age-group by radial division interaction f...
This prospective controlled intervention study over 12 months evaluated the effect of exercise on... more This prospective controlled intervention study over 12 months evaluated the effect of exercise on muscular function, physical ability, and body composition in pre-pubertal boys. Sixty-eight boys aged 6-8 years, involved in a general school-based exercise program of 40 min per school day (200 min/week), were compared with 46 age-matched boys who participated in the general Swedish physical education curriculum of mean 60 min/week. Baseline and annual changes of body composition were measured by dual energy X-ray absorptiometry (DXA), stature, and body mass by standard equipments, isokinetic peak torque (PT) of the knee extensors, and flexors at 60 and 180 deg/sec by computerized dynamometer (Biodex) and vertical jump height (VJH) by a computerized electronic mat. The annual gain in stature and body mass was similar between the groups whereas the increase in total body and regional lean mass (P < .001) and fat mass (P < .001) was greater in the exercise group. The one-year gain ...
Background: Bioelectrical impedance (BIA) represents a simple, inexpensive and non-invasive metho... more Background: Bioelectrical impedance (BIA) represents a simple, inexpensive and non-invasive method that is often used to assess fat-mass (FM) and fat-free mass (FFM) in large population-based cohorts. Objective: The aim of this study was to describe the reference ranges and examine the influence of age and gender on FM, FFM and skeletal muscle mass (SMM) as well as height-adjusted estimates of FM [fat mass index (FMI)], FFM [fat-free mass index (FFMI)] and SMM [SMM index (SMI)] in a national, population-based cohort of Australian adults. Design and Participants: The analytical sample included a total of 8,582 adults aged 25-91 years of Europid origin with complete data involved in the cross-sectional 1999-2000 Australian, Diabetes, Obesity and Lifestyle (AusDiab) Study. Measurements: Bioelectrical impedance analysis was used to examine components of body composition. Demographic information was derived from a household interview. Results: For both genders, FFM, SMM and SMI decreased linearly from the age of 25 years, with the exception that in men SMI was not related to age and FFM peaked at age 38 years before declining thereafter. The relative loss from peak values to ≥75 years in FFM (6-8%) and SMM (11-15%) was similar between men and women. For FM and FMI, there was a curvilinear relationship with age in both genders, but peak values were detected 6-7 years later in women with a similar relative loss thereafter. For FFMI there was no change with age in men and a modest increase in women. Conclusion: In Australian adults there is heterogeneity in the age of onset, pattern and magnitude of changes in the different measures of muscle and fat mass derived from BIA, but overall the agerelated losses were similar between men and women.
To investigate whether growth was adversely affected in 137 young competitive female artistic gym... more To investigate whether growth was adversely affected in 137 young competitive female artistic gymnasts involved in different training volumes. This was a 2-yr prospective cohort study in which height, sitting height, leg length, weight, skinfolds, and pubertal status were measured in competitive advanced (20-27 h x wk(-1)) and intermediate (7.5-22 h x wk(-1)) training level female gymnasts every 6-12 months. Biological parameters of the adolescent growth curve were estimated using the Preece-Baines growth model. Growth rates were estimated for both groups from the mixed-longitudinal data. Estimated ages at peak height velocity (PHV) (13-13.5 yr) and mean PHV (6.2-6.4 cm x yr(-1)) for the advanced- and intermediate-level gymnasts suggest that these gymnasts were later maturing and experienced a blunting of the growth spurt relative to reference values for U.S. youth. Comparison of growth velocities by pubertal status revealed that height velocity was lower in the advanced- versus the...
Background: In a previous 2-y randomized controlled trial, we showed that calcium- and vitamin D3... more Background: In a previous 2-y randomized controlled trial, we showed that calcium- and vitamin D3-fortified milk stopped or slowed bone loss at several clinically relevant skeletal sites in older men. Objective: The present study aimed to determine whether the skel- etal benefits of the fortified milk were sustained after withdrawal of the supplementation. Design:One hundred nine men50 y old who
Regular exercise and adequate nutrition, particularly dietary calcium, vitamin D, and protein, ar... more Regular exercise and adequate nutrition, particularly dietary calcium, vitamin D, and protein, are prescribed as strategies to optimize peak bone mass and maintain bone and muscle health throughout life. Although the mechanism of action of exercise and nutrition on bone and muscle health are different-exercise has a site-specific modifying effect, whereas nutrition has a permissive generalized effect-there is evidence that combining calcium (or calcium rich dairy foods) or dietary protein with exercise can have a synergetic effect on bone mass and muscle health, respectively. However, many questions still remain as to whether there is a threshold level for these nutrients to optimize the exercise-induced gains. Further studies are also needed to investigate whether other dietary factors, such as vitamin D, soy isoflavones or omega-3 fatty acids, or a multinutrient supplement, can enhance the effects of exercise on bone and muscle health.
Osteoporosis imposes a tremendous burden on Australia: 1.2 million Australians have osteoporosis ... more Osteoporosis imposes a tremendous burden on Australia: 1.2 million Australians have osteoporosis and 6.3 million have osteopenia. In the 2007–08 financial year, 82 000 Australians suffered fragility fractures, of which > 17 000 were hip fractures. In the 2000–01 financial year, direct costs were estimated at $1.9 billion per year and an additional $5.6 billion on indirect costs. Osteoporosis was designated a National Health Priority Area in 2002; however, implementation of national plans has not yet matched the rhetoric in terms of urgency. Building healthy bones throughout life, the Osteoporosis Australia strategy to prevent osteoporosis throughout the life cycle, presents an evidence-informed set of recommendations for consumers, health care professionals and policymakers. The strategy was adopted by consensus at the Osteoporosis Australia Summit in Sydney, 20 October 2011. Primary objectives throughout the life cycle are: to maximise peak bone mass during childhood and adolesc...
Transcranial direct current stimulation (tDCS) is a noninvasive technique that modulates the exci... more Transcranial direct current stimulation (tDCS) is a noninvasive technique that modulates the excitability of neurons within the motor cortex (M1). Although the aftereffects of anodal tDCS on modulating cortical excitability have been described, there is limited data describing the outcomes of different tDCS intensities on intracortical circuits. To further elucidate the mechanisms underlying the aftereffects of M1 excitability following anodal tDCS, we used transcranial magnetic stimulation (TMS) to examine the effect of different intensities on cortical excitability and short-interval intracortical inhibition (SICI). Using a randomized, counterbalanced, crossover design, with a one-week wash-out period, 14 participants (6 females and 8 males, 22-45 years) were exposed to 10 minutes of anodal tDCS at 0.8, 1.0, and 1.2 mA. TMS was used to measure M1 excitability and SICI of the contralateral wrist extensor muscle at baseline, immediately after and 15 and 30 minutes following cessatio...
Age-related neurodegeneration may interfere with the ability to respond to cross-limb transfer, w... more Age-related neurodegeneration may interfere with the ability to respond to cross-limb transfer, whereby bilateral performance improvements accompany unilateral practice. We investigated whether transcranial direct current stimulation (tDCS) would facilitate this phenomena in older adults. 12 young and 12 older adults underwent unilateral visuomotor tracking (VT), with anodal or sham-tDCS over the ipsilateral motor cortex. Transcranial magnetic stimulation (TMS) assessed motor evoked potentials (MEPs) and short interval intracortical inhibition (SICI). Performance was quantified through a VT error. Variables were assessed bilaterally at baseline and post-intervention. The trained limb improved performance, facilitated MEPs and released SICI in both age groups. In the untrained limb, VT improved in young for both sham and anodal-tDCS conditions, but only following anodal-tDCS for the older adults. MEPs increased in all conditions, except the older adult&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s receiving sham. SICI was released in both tDCS conditions for young and old. Following a VT task, older adults still display use-dependent plasticity. Although no significant age-related differences between the outcome measures, older adults exhibited significant cross-limb transfer of performance following anodal-tDCS, which was otherwise absent following motor practice alone. These findings provide clinical implications for conditions restricting the use of one limb, such as stroke.
Objectives: To examine whether combined vitamin D and calcium supplementation improves insulin se... more Objectives: To examine whether combined vitamin D and calcium supplementation improves insulin sensitivity, insulin secretion, b-cell function, inflammation and metabolic markers.
This 4-year cluster randomised controlled trial of 365 boys and 362 girls (mean age 8.1 ± 0.3 yea... more This 4-year cluster randomised controlled trial of 365 boys and 362 girls (mean age 8.1 ± 0.3 years) from grade 2 in 29 primary schools investigated the effects of a specialist-taught physical education (PE) program on bone strength and body composition. All children received 150 min/week of common practice (CP) PE from general classroom teachers but in 13 schools 100 min/week of CP PE was replaced by specialized-led PE (SPE) by teachers who emphasized more vigorous exercise/games combined with static and dynamic postural activities involving muscle strength. Outcome measures assessed in grades 2, 4, and 6 included: total body bone mineral content (BMC), lean mass (LM) and fat mass (FM) by DXA, and radius and tibia (4% and 66% sites) bone structure, volumetric density and strength, and muscle cross-sectional area (CSA) by pQCT. After 4-years, gains in total body BMC, FM and muscle CSA were similar between the groups in both sexes, but girls in the SPE group experienced a greater gain in total body LM [mean (95%CI), 1.0kg (0.2, 1.9)]. Compared to CP, girls in the SPE group also had greater gains in cortical area (CoA) and cortical thickness (CoTh) at the mid-tibia [CoA, 5.0% (0.2, 1.9); CoTh 7.5% (2.4, 12.6)] and mid-radius [CoA, 9.3% (3.5, 15.1); CoTh 14.4% (6.1, 22.7)], while SPE boys had a 5.2% (0.4, 10.0) greater gain in mid-tibia CoTh. These benefits were due to reduced endocortical expansion. There were no significant benefits of SPE on total bone area, cortical density or bone strength at the mid-shaft sites, nor any appreciable effects at the distal skeletal sites. This study indicates that a specialist-led school-based PE program improves cortical bone structure, due to reduced endocortical expansion. This finding challenges the notion that periosteal apposition is the predominant response of bone to loading during the pre- and early-pubertal period. This article is protected by copyright. All rights reserved.
Transcranial direct current stimulation (tDCS) is a noninvasive technique that modulates the exci... more Transcranial direct current stimulation (tDCS) is a noninvasive technique that modulates the excitability of neurons within the motor cortex (M1). Although the aftereffects of anodal tDCS on modulating cortical excitability have been described, there is limited data describing the outcomes of different tDCS intensities on intracortical circuits. To further elucidate the mechanisms underlying the aftereffects of M1 excitability following anodal tDCS, we used transcranial magnetic stimulation (TMS) to examine the effect of different intensities on cortical excitability and short-interval intracortical inhibition (SICI). Using a randomized, counterbalanced, crossover design, with a one-week wash-out period, 14 participants (6 females and 8 males, 22-45 years) were exposed to 10 minutes of anodal tDCS at 0.8, 1.0, and 1.2 mA. TMS was used to measure M1 excitability and SICI of the contralateral wrist extensor muscle at baseline, immediately after and 15 and 30 minutes following cessation of anodal tDCS. Cortical excitability increased, whilst SICI was reduced at all time points following anodal tDCS. Interestingly, there were no differences between the three intensities of anodal tDCS on modulating cortical excitability or SICI. These results suggest that the aftereffect of anodal tDCS on facilitating cortical excitability is due to the modulation of synaptic mechanisms associated with long-term potentiation and is not influenced by different tDCS intensities.
Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society, Jan 17, 2015
There is ongoing debate regarding the optimal serum concentrations of 25-hydroxy-vitamin D for mu... more There is ongoing debate regarding the optimal serum concentrations of 25-hydroxy-vitamin D for musculoskeletal health, including osteoarthritis. The aim of this prospective cohort study was to determine whether serum 25-hydroxy-vitamin D concentrations were associated with the risk of hip arthroplasty for osteoarthritis. This study examined 9135 participants from the Australian Diabetes, Obesity and Lifestyle Study who had serum 25-hydroxy-vitamin D measured in 1999-2000 and were aged ≥40 years at the commencement of arthroplasty data collection. The incidence of hip arthroplasty for osteoarthritis during 2002-2011 was determined by linking cohort records to the Australian Orthopaedic Association National Joint Replacement Registry. Over an average 9.1 (standard deviation 2.7) years of follow-up, 201 hip arthroplasties for osteoarthritis were identified (males n=90; females n=111). In males, a one-standard-deviation increase in 25-hydroxy-vitamin D was associated with a 25% increase...
Background: Falls are a major public health concern with at least one third of people aged 65 yea... more Background: Falls are a major public health concern with at least one third of people aged 65 years and over falling at least once per year, and half of these will fall repeatedly, which can lead to injury, pain, loss of function and independence, reduced quality of life and even death. Although the causes of falls are varied and complex, the age-related loss in muscle power has emerged as a useful predictor of disability and falls in older people. In this population, the requirements to produce explosive and rapid movements often occurs whilst simultaneously performing other attention-demanding cognitive or motor tasks, such as walking while talking or carrying an object. The primary aim of this study is to determine whether dual-task functional power training (DT-FPT) can reduce the rate of falls in community-dwelling older people. Methods/Design: The study design is an 18-month cluster randomised controlled trial in which 280 adults aged ≥65 years residing in retirement villages, who are at increased risk of falling, will be randomly allocated to: 1) an exercise programme involving DT-FPT, or 2) a usual care control group. The intervention is divided into 3 distinct phases: 6 months of supervised DT-FPT, a 6-month 'step down' maintenance programme, and a 6-month follow-up. The primary outcome will be the number of falls after 6, 12 and 18 months. Secondary outcomes will include: lower extremity muscle power and strength, grip strength, functional assessments of gait, reaction time and dynamic balance under single-and dual-task conditions, activities of daily living, quality of life, cognitive function and falls-related self-efficacy. We will also evaluate the cost-effectiveness of the programme for preventing falls.
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, Jan 31, 2015
The aim of this population-based, prospective cohort study was to investigate long-term associati... more The aim of this population-based, prospective cohort study was to investigate long-term associations between dietary calcium intake and fractures, non-fatal cardiovascular disease (CVD), and death from all causes. Participants were from the Melbourne Collaborative Cohort Study which was established in 1990-1994. A total of 41,514 men and women (∼99% aged 40-69 years at baseline) were followed-up for a mean (SD) of 12 (1.5) years. Primary outcome measures were time to death from all causes (n = 2,855), CVD-related deaths (n = 557), cerebrovascular disease-related deaths (n = 139), incident non-fatal CVD (n = 1,827), incident stroke events (n = 537) and incident fractures (n = 788). 12,097 participants (aged ≥50 years) were eligible for fracture analysis and 34,468 for non-fatal CVD and mortality analyses. Mortality was ascertained by record linkage to registries. Fractures and CVD were ascertained from interview ∼13 years after baseline. Quartiles of baseline energy-adjusted calcium ...
Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2015
While previous studies have reported detrimental associations of sedentary behaviours with cardio... more While previous studies have reported detrimental associations of sedentary behaviours with cardiometabolic disorders and mortality, in this study, we report that higher levels of sitting time were associated with a greater risk of sarcopenia, with increased television (TV) viewing negatively associated with lean mass, independent of physical activity. Sedentary behaviour has been linked to cardiometabolic disorders and mortality, but little is known about its effects on musculoskeletal health and function. This study investigated the relationship between total sitting and TV viewing time on sarcopenia and its determinants (muscle mass, strength and function) in older adults. This cross-sectional study included 162 community-dwelling men and women aged 60 to 86 years who had complete assessment of total body and regional lean mass (LM) and fat mass (dual-energy X-ray absorptiometry (DXA)), lower limb muscle strength, power and functional performance. Sarcopenia was defined as the low...
Journal of musculoskeletal & neuronal interactions, 2013
While it is widely acknowledged that bones adapt to the site-specific prevalent loading environme... more While it is widely acknowledged that bones adapt to the site-specific prevalent loading environment, reasonable ways to estimate skeletal loads are not necessarily available. For long bone shafts, muscles acting to bend the bone may provide a more appropriate surrogate of the loading than muscles expected to cause compressive loads. Thus, the aim of this study was to investigate whether mid-thigh muscle cross-sectional area (CSA) was a better predictor of tibial mid-shaft bone strength than mid-tibia muscle CSA in middle aged and older men. 181 Caucasian men aged 50-79 years (mean±SD; 61±7 years) participated in this study. Mid-femoral and mid-tibial bone traits cortical area, density weighted polar moment of area and muscle CSA [cm(2)] were assessed with computed tomography. Tibial bone traits were positively associated with both the mid-femur (r=0.44 to 0.46, P<0.001) and the mid-tibia muscle CSA (r=0.35 to 0.37, P<0.001). Multivariate regression analysis, adjusting for age,...
Journal of musculoskeletal & neuronal interactions, 2011
Cortical porosity, particularly at the endocortical region, is recognised to play a central role ... more Cortical porosity, particularly at the endocortical region, is recognised to play a central role in the pathogenesis of bone fragility. Therefore, the purpose of this study was to: 1) demonstrate how cortical volumetric BMD (vBMD) distribution can be analysed from (p)QCT images and 2) highlight the clinical significance of assessing regional density distribution of cortical bone. We used pQCT to compare mid-tibial cortical volumetric BMD distribution of 20 young (age 24(SD2) years, mass 77(11) kg, height 178(6) cm) and 25 elderly (72(4) years, 75(9) kg, 172(5) cm) men. Radial and polar cortical vBMD distributions were analysed using a custom built open source analysis tool which allowed the cortex to be divided into three concentric cortical divisions and in 36 cortical sectors originating from the centroid of the bone. Mean vBMD did not differ between the groups (1135(16) vs. 1130(28) mg/cm, P = 0.696). In contrast, there was a significant age-group by radial division interaction f...
This prospective controlled intervention study over 12 months evaluated the effect of exercise on... more This prospective controlled intervention study over 12 months evaluated the effect of exercise on muscular function, physical ability, and body composition in pre-pubertal boys. Sixty-eight boys aged 6-8 years, involved in a general school-based exercise program of 40 min per school day (200 min/week), were compared with 46 age-matched boys who participated in the general Swedish physical education curriculum of mean 60 min/week. Baseline and annual changes of body composition were measured by dual energy X-ray absorptiometry (DXA), stature, and body mass by standard equipments, isokinetic peak torque (PT) of the knee extensors, and flexors at 60 and 180 deg/sec by computerized dynamometer (Biodex) and vertical jump height (VJH) by a computerized electronic mat. The annual gain in stature and body mass was similar between the groups whereas the increase in total body and regional lean mass (P < .001) and fat mass (P < .001) was greater in the exercise group. The one-year gain ...
Background: Bioelectrical impedance (BIA) represents a simple, inexpensive and non-invasive metho... more Background: Bioelectrical impedance (BIA) represents a simple, inexpensive and non-invasive method that is often used to assess fat-mass (FM) and fat-free mass (FFM) in large population-based cohorts. Objective: The aim of this study was to describe the reference ranges and examine the influence of age and gender on FM, FFM and skeletal muscle mass (SMM) as well as height-adjusted estimates of FM [fat mass index (FMI)], FFM [fat-free mass index (FFMI)] and SMM [SMM index (SMI)] in a national, population-based cohort of Australian adults. Design and Participants: The analytical sample included a total of 8,582 adults aged 25-91 years of Europid origin with complete data involved in the cross-sectional 1999-2000 Australian, Diabetes, Obesity and Lifestyle (AusDiab) Study. Measurements: Bioelectrical impedance analysis was used to examine components of body composition. Demographic information was derived from a household interview. Results: For both genders, FFM, SMM and SMI decreased linearly from the age of 25 years, with the exception that in men SMI was not related to age and FFM peaked at age 38 years before declining thereafter. The relative loss from peak values to ≥75 years in FFM (6-8%) and SMM (11-15%) was similar between men and women. For FM and FMI, there was a curvilinear relationship with age in both genders, but peak values were detected 6-7 years later in women with a similar relative loss thereafter. For FFMI there was no change with age in men and a modest increase in women. Conclusion: In Australian adults there is heterogeneity in the age of onset, pattern and magnitude of changes in the different measures of muscle and fat mass derived from BIA, but overall the agerelated losses were similar between men and women.
To investigate whether growth was adversely affected in 137 young competitive female artistic gym... more To investigate whether growth was adversely affected in 137 young competitive female artistic gymnasts involved in different training volumes. This was a 2-yr prospective cohort study in which height, sitting height, leg length, weight, skinfolds, and pubertal status were measured in competitive advanced (20-27 h x wk(-1)) and intermediate (7.5-22 h x wk(-1)) training level female gymnasts every 6-12 months. Biological parameters of the adolescent growth curve were estimated using the Preece-Baines growth model. Growth rates were estimated for both groups from the mixed-longitudinal data. Estimated ages at peak height velocity (PHV) (13-13.5 yr) and mean PHV (6.2-6.4 cm x yr(-1)) for the advanced- and intermediate-level gymnasts suggest that these gymnasts were later maturing and experienced a blunting of the growth spurt relative to reference values for U.S. youth. Comparison of growth velocities by pubertal status revealed that height velocity was lower in the advanced- versus the...
Background: In a previous 2-y randomized controlled trial, we showed that calcium- and vitamin D3... more Background: In a previous 2-y randomized controlled trial, we showed that calcium- and vitamin D3-fortified milk stopped or slowed bone loss at several clinically relevant skeletal sites in older men. Objective: The present study aimed to determine whether the skel- etal benefits of the fortified milk were sustained after withdrawal of the supplementation. Design:One hundred nine men50 y old who
Regular exercise and adequate nutrition, particularly dietary calcium, vitamin D, and protein, ar... more Regular exercise and adequate nutrition, particularly dietary calcium, vitamin D, and protein, are prescribed as strategies to optimize peak bone mass and maintain bone and muscle health throughout life. Although the mechanism of action of exercise and nutrition on bone and muscle health are different-exercise has a site-specific modifying effect, whereas nutrition has a permissive generalized effect-there is evidence that combining calcium (or calcium rich dairy foods) or dietary protein with exercise can have a synergetic effect on bone mass and muscle health, respectively. However, many questions still remain as to whether there is a threshold level for these nutrients to optimize the exercise-induced gains. Further studies are also needed to investigate whether other dietary factors, such as vitamin D, soy isoflavones or omega-3 fatty acids, or a multinutrient supplement, can enhance the effects of exercise on bone and muscle health.
Osteoporosis imposes a tremendous burden on Australia: 1.2 million Australians have osteoporosis ... more Osteoporosis imposes a tremendous burden on Australia: 1.2 million Australians have osteoporosis and 6.3 million have osteopenia. In the 2007–08 financial year, 82 000 Australians suffered fragility fractures, of which > 17 000 were hip fractures. In the 2000–01 financial year, direct costs were estimated at $1.9 billion per year and an additional $5.6 billion on indirect costs. Osteoporosis was designated a National Health Priority Area in 2002; however, implementation of national plans has not yet matched the rhetoric in terms of urgency. Building healthy bones throughout life, the Osteoporosis Australia strategy to prevent osteoporosis throughout the life cycle, presents an evidence-informed set of recommendations for consumers, health care professionals and policymakers. The strategy was adopted by consensus at the Osteoporosis Australia Summit in Sydney, 20 October 2011. Primary objectives throughout the life cycle are: to maximise peak bone mass during childhood and adolesc...
Transcranial direct current stimulation (tDCS) is a noninvasive technique that modulates the exci... more Transcranial direct current stimulation (tDCS) is a noninvasive technique that modulates the excitability of neurons within the motor cortex (M1). Although the aftereffects of anodal tDCS on modulating cortical excitability have been described, there is limited data describing the outcomes of different tDCS intensities on intracortical circuits. To further elucidate the mechanisms underlying the aftereffects of M1 excitability following anodal tDCS, we used transcranial magnetic stimulation (TMS) to examine the effect of different intensities on cortical excitability and short-interval intracortical inhibition (SICI). Using a randomized, counterbalanced, crossover design, with a one-week wash-out period, 14 participants (6 females and 8 males, 22-45 years) were exposed to 10 minutes of anodal tDCS at 0.8, 1.0, and 1.2 mA. TMS was used to measure M1 excitability and SICI of the contralateral wrist extensor muscle at baseline, immediately after and 15 and 30 minutes following cessatio...
Age-related neurodegeneration may interfere with the ability to respond to cross-limb transfer, w... more Age-related neurodegeneration may interfere with the ability to respond to cross-limb transfer, whereby bilateral performance improvements accompany unilateral practice. We investigated whether transcranial direct current stimulation (tDCS) would facilitate this phenomena in older adults. 12 young and 12 older adults underwent unilateral visuomotor tracking (VT), with anodal or sham-tDCS over the ipsilateral motor cortex. Transcranial magnetic stimulation (TMS) assessed motor evoked potentials (MEPs) and short interval intracortical inhibition (SICI). Performance was quantified through a VT error. Variables were assessed bilaterally at baseline and post-intervention. The trained limb improved performance, facilitated MEPs and released SICI in both age groups. In the untrained limb, VT improved in young for both sham and anodal-tDCS conditions, but only following anodal-tDCS for the older adults. MEPs increased in all conditions, except the older adult&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s receiving sham. SICI was released in both tDCS conditions for young and old. Following a VT task, older adults still display use-dependent plasticity. Although no significant age-related differences between the outcome measures, older adults exhibited significant cross-limb transfer of performance following anodal-tDCS, which was otherwise absent following motor practice alone. These findings provide clinical implications for conditions restricting the use of one limb, such as stroke.
Objectives: To examine whether combined vitamin D and calcium supplementation improves insulin se... more Objectives: To examine whether combined vitamin D and calcium supplementation improves insulin sensitivity, insulin secretion, b-cell function, inflammation and metabolic markers.
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