Screen Time and Bone Status in Children and Adolescents: A Systematic Review

Introduction: Technological advances over the last 2 decades have led to an increase in the time spent by children and youth engaged in screen-based activities, and growing recognition of deleterious effects on health. In this systematic review of cohort and cross-sectional studies, we assess current data on the relationship between screen time and bone status in children and teenagers.Methods: We searched PUBMED and SCOPUS databases for studies of children and adolescents that assessed screen time and bone status, determined by measuring bone mineral content or density, bone stiffness index, bone speed of sound, bone broadband ultrasound attenuation, or frame index. Searches were limited to studies published between 1900 and 2020, and performed in accordance with Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The studies included were evaluated using the Newcastle-Ottawa quality assessment scale.Results: Ten cohort and cross-sectional studies including pediatric population were selected. The combined study population was 20,420 children/adolescents, of whom 18,444 participated in cross-sectional studies. Four studies assessed the effects of total screen time, seven the consequences of TV viewing time, and six the effects of recreational computer use on bone health. Our findings indicate an inverse association between total and weekly screen time and bone health in children and adolescents. In 57% of the studies included also a negative correlation between television viewing time and bone status was observed, while recreational computer time did not have a significant impact on bone health. According to the only four studies that included dietetic factors, no relevant differences were found between calcium intake and screen time or bone broadband ultrasound attenuation and bone speed of sound.Conclusions: Review of the literature of the past three decades provides strong support for comprehensive education of screen time on bone status. The findings of this systematic review support a negative association between screen time and bone status in children and adolescents, with a different impact when considering the different technological devices. As peak bone mass in adolescents is the strongest predictor of osteoporosis risk, strategies aimed at improving bone health should incorporate conscious use of digital technology.

The Role of Exercise in Prevention and Treatment of Osteopenia of Prematurity: An Update

Premature infants have an increased risk of osteopenia due to limited bone mass accretion in utero and a greater need for bone nutrients. Until recently, most efforts to prevent osteopenia of prematurity focused on nutritional changes. Recent studies indicate that passive range-of-motion exercise of the extremities may lead to beneficial effects on body weight, increased bone mineralization, increased bone formation markers and leptin levels, and attenuation of the natural postnatal decline in bone speed of sound. These results suggest that exercise may play an important role in the prevention and treatment of osteopenia of prematurity. This review summarizes our current knowledge on the role of exercise in the prevention and treatment of osteopenia of prematurity.

Quantitative Ultrasound Densitometry in University Level Cricket Fast Bowlers and Nonathletes

ABSTRACT Background Fast bowling in cricket is an important skill that imparts mechanical loads on limbs. The differential loading patterns involved in bowling affect the peripheral limb bone status. Objective To evaluate bone properties using quantitative ultrasound densitometry (QUS), among fast cricket bowlers in comparison with nonathletes. A secondary objective was designed to find correlation between QUS parameters and bonespecific physical activity questionnaire (BPAQ). Methodology A total of 80 subject, 40 fast cricket bowlers of both gender (20 male and 20 female) and 40 nonathletes (20 male and 20 female) were included in our study and all are aged between 20 and 25 years. Bone speed of sound (SOS) was measured bilaterally at the distal radius and the mid tibia using Sunlight OmnisenseTM device. Results There was a significant difference between dominant side and nondominant side radial SOS (p < 0.05) and tibial SOS (p < 0.05) in cricket bowlers favoring dominant radial bone SOS and nondominant tibial bone SOS which was not found in nonathletes. Significant difference in dominant radial bone SOS values (p < 0.05) and nondominant tibial bone SOS (p < 0.05) values existed between cricket bowlers and controls. Positive correlation was found between tibial SOS and past BPAQ in all subjects. Conclusion QUS parameters were significantly higher in young cricket bowlers with greater values observed in the dominant arm and leading foot, thus reflecting the osteogenic effect that occurs due to the nature of the game. Further BPAQ is significantly correlated with lower limb bone properties as measured by QUS at mid shaft tibia. How to cite this article Shenoy S, Parthasarathy S, Sandhu JS. Quantitative Ultrasound Densitometry in University Level Cricket Fast Bowlers and Nonathletes. J Postgrad Med Edu Res 2013;47(2):83-89.

Bone Speed of Sound and Physical Activity Levels of Overweight and Normal-Weight Girls and Adolescents

Bone properties, reflected by speed of sound (SOS), and physical activity levels were examined in overweight (OW) girls (n = 19) and adolescents (n = 22), in comparison with normal-weight (NW) girls (n = 21) and adolescents (n = 13). Moderate-to-vigorous physical activity (MVPA) was higher in NW than in OW in both age groups. Tibial SOS was lower in OW compared with NW in both age groups. MVPA correlated with tibial SOS, once age was partialed out. The results suggest that overweight girls and adolescents are characterized by low tibial SOS, which may be partially attributed to lower physical activity levels.

Bone Speed of Sound, Bone Turnover and IGF-I in Adolescent Synchronized Swimmers

This pilot study compared bone speed of sound (SOS), bone turnover and insulin-like growth factor 1 (IGF-1) between 20 Caucasian, postmenarcheal, adolescent synchronized swimmers (SS) and 20 aged- and maturity-matched nonswimmers (NS). Daily dietary intake and physical activity levels were also assessed. Bone SOS was measured by quantitative ultrasound. Blood samples were analyzed for osteocalcin, cross-linked N-teleopeptide of type I collagen (NTx), IGF-I and 25-OH vitamin D. Although no differences in bone SOS or turnover markers were observed between groups, the lower IGF-1 and vitamin D intake found in synchronized swimmers, in combination with their higher strenuous activity levels, should be further explored.