Youth - A health plan-based lifestyle intervention increases bone mineral density in adolescent girls
Youth - A health plan-based lifestyle intervention increases bone mineral density in adolescent girls
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DOI：
10.1001/archpedi.160.12.1269
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发表时间：
2006-12-01
影响因子：
--
通讯作者：
Irving, Lori M.
中科院分区：
文献类型：
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作者：
DeBar, Lynn L.;Ritenbaugh, Cheryl;Irving, Lori M.
目的：为了测试基于健康计划的生活方式干预对增加青春期女孩骨密度的有效性。设计：两年随机对照试验。设置：大型健康维护组织。参与者：体重指数低于国家中位数的14至16岁女孩。干预：行为干预（双月小组会议，季度辅导电话，每周自我监测），旨在改善饮食和增加体力活动。主要结果测量：总骨密度测定双能X线吸收法。行为结果包括钙、维生素D、苏打水、水果和蔬菜的摄入量;高强度和力量训练的身体活动;力量和健康的测量;以及生物标志物（骨钙素和纳洛酮）。与对照组相比，在研究的第一年，干预组的女孩在脊柱和转子区域的骨矿物质密度显著较高，这在第二个研究年度得到了维持。与对照组相比，干预组的纳洛酮生物标志物显示出更大的相对下降，骨钙素的无显著变化与干预组的骨建设一致。干预组的参与者报告说，在两个研究年中，钙的摄入量显着增加，第一年维生素D的摄入量显着增加，两年内水果和蔬菜的摄入量显着增加。我们发现没有影响苏打水的消费量或目标运动rate.Conclusions：一个全面的卫生保健为基础的生活方式干预，可以有效地改善饮食摄入量和增加骨矿物质的收益在青春期女孩。据我们所知，这项研究是第一个在非学校干预中显着改善少女骨量的研究。
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.