Moderate-to-vigorous physical activity modulates the association between serum 25-hydroxyvitamin D and bone stiffness in European children and adolescents

Lan Cheng; Hermann Pohlabeln; Maike Wolters; Wolfgang Ahrens; Alfonso Siani; Toomas Veidebaum; Michael Tornaritis; Dénes Molnár; Gabriele Eiben; Monica Hunsberger; Stefaan De Henauw; Luis A Moreno; Antje Hebestreit; IDEFICS and I.Family consortia

doi:10.1016/j.nutres.2024.10.003

Moderate-to-vigorous physical activity modulates the association between serum 25-hydroxyvitamin D and bone stiffness in European children and adolescents

Nutr Res. 2024 Oct 17:133:64-77. doi: 10.1016/j.nutres.2024.10.003. Online ahead of print.

Affiliations

¹ Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom.
² Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
³ Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany.
⁴ Institute of Food Sciences, National Research Council, Avellino, Italy.
⁵ Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia.
⁶ Research and Education Institute of Child Health, Strovolos, Cyprus.
⁷ Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary.
⁸ Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden.
⁹ Section for Epidemiology and Social Medicine (EPSO), The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
¹⁰ Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
¹¹ GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, Zaragoza, Spain.
¹² Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany. Electronic address: hebestr@leibniz-bips.de.

PMID: 39689437
DOI: 10.1016/j.nutres.2024.10.003

Abstract

It remains unclear how serum 25-hydroxyvitamin D (25(OH)D) concentrations relate to childhood bone health. We hypothesized that 25(OH)D was inversely associated with bone turnover biomarkers and positively associated with bone stiffness. Cross-sectional analyses were performed using data from participants (2-15-year-old, 51% boys) from the Identification and Prevention of Dietary- and Lifestyle-induced Health Effects in Children and Infants Study (IDEFICS)/I.Family cohort, comprising 3,638 serum 25(OH)D measurements collected in 2007-2008 and 2012-2013 across eight European countries. A biomarker of bone formation (serum osteocalcin), a biomarker of bone resorption (serum C-terminal telopeptides of type I collagen [CTx]), and stiffness index measured using calcaneal quantitative ultrasound were considered outcomes. Linear mixed-effects models were used to adjust for confounders (i.e., age, sex, parental education, time spent in sports club, dairy products consumption, sedentary behavior, height and weight z-scores), the cluster effect of country and repeated measurements. Interactions of calcium intake, moderate-to-vigorous physical activity (MVPA) and weight status with 25(OH)D on outcomes were tested. Only 1 in 3 participants reached the sufficient 25(OH) D concentration of 20 ng/mL. Sufficient 25(OH)D was associated with higher stiffness index if participants had MVPA ≥60 min/day (β = 12.14, P < .05). Moreover, 25(OH)D was inversely associated with CTx (β = -7.09, P < .05); this association was positive but not statistically significant among primary school children living with overweight/obesity. No interaction was observed for calcium intake. In conclusion, serum 25(OH)D and CTx were inversely associated. MVPA interacted with the positive association between 25(OH)D and bone stiffness, highlighting the importance of promoting MVPA guidelines in future vitamin D and bone health interventions.

Keywords: Bone health; Calcium intake; Child cohort; Physical activity; Vitamin D; Weight status.