Every Move Counts to Improve Bone Health at Clinical Sites in Young Pediatric Cancer Survivors: The iBoneFIT Project

Andres Marmol-Perez; Jairo H Migueles; Esther Ubago-Guisado; Jose J Gil-Cosano; Andrea Rodriguez-Solana; Andrés Redondo-Tébar; Francisco J Llorente-Cantarero; Idoia Labayen; Francisco B Ortega; Jonatan R Ruiz; Luis Gracia-Marco

doi:10.1249/MSS.0000000000003397

Every Move Counts to Improve Bone Health at Clinical Sites in Young Pediatric Cancer Survivors: The iBoneFIT Project

Med Sci Sports Exerc. 2024 Jan 31. doi: 10.1249/MSS.0000000000003397. Online ahead of print.

Authors

Andres Marmol-Perez¹, Jairo H Migueles, Esther Ubago-Guisado, Jose J Gil-Cosano², Andrea Rodriguez-Solana¹, Andrés Redondo-Tébar, Francisco J Llorente-Cantarero, Idoia Labayen³, Francisco B Ortega, Jonatan R Ruiz, Luis Gracia-Marco

Affiliations

¹ Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, SPAIN.
² Faculty of Health Sciences, Universidad Loyola Andalucía, Sevilla, SPAIN.
³ IS (IS-FOOD), Navarra's Health Research Institute (IdiSNA), Department of Health Sciences, Public University of Navarra, Navarra, SPAIN.

PMID: 38306313
DOI: 10.1249/MSS.0000000000003397

Abstract

Purpose: We aimed to examine the associations of 24-hour movement behaviors (moderate-to-vigorous physical activity [MVPA], light physical activity [LPA], sedentary behavior [SB] and sleep) with age-, sex- and race-specific areal bone mineral density (aBMD) Z-score parameters at clinical sites in young pediatric cancer survivors.

Methods: This cross-sectional multicenter study was carried out within the iBoneFIT framework in which 116 young pediatric cancer survivors (12.1 ± 3.3 years old; 42% female) were recruited. We obtained anthropometric and body composition data (i.e., body mass, stature, body mass index and region-specific lean mass), time spent in movement behaviors over at least seven consecutive 24-hour periods (wGT3x-BT accelerometer, ActiGraph) and aBMD Z-score parameters (age-, sex- and race-specific total at the body, total hip, femoral neck and lumbar spine). Survivors were classified according to somatic maturity (pre or peri/post-pubertal depending on the estimated years from peak height velocity). The adjusted models' coefficients were used to predict the effect of reallocating time proportionally across behaviors on the outcomes.

Results: In pre-pubertal young pediatric cancer survivors, reallocating time to MVPA from LPA, SB and sleep was significantly associated with higher aBMD at total body (B = 1.765, P = .005), total hip (B = 1.709, P = .003) and lumbar spine (B = 2.093, P = .001). In peri/post-pubertal survivors, reallocating time to LPA from MVPA, SB and sleep was significantly associated with higher aBMD at all sites (B = 2.090 to 2.609, P = .003 to .038). Reallocating time to SB from MVPA or LPA was significantly associated with lower aBMD at most sites in pre-pubertal and peri/post-pubertal survivors, respectively. Finally, reallocating time to sleep from MVPA, LPA and SB was significantly associated with lower aBMD at total body (B = -2.572, P = .036) and total hip (B = -3.371, P = .015).

Conclusions: These findings suggest that every move counts and underline the benefits of increasing MVPA or LPA, when low MVPA levels are present, for bone regeneration following pediatric cancer treatment completion.