Program boosts bone health of lean teen girls

By Megan Rauscher

NEW YORK (Reuters Health) - A lifestyle intervention program increased bone mineral density over 2 years in a group of lean 14- to 16-year-old girls who were not building up their bones as much as they should at their age, researchers found.

Because 90 percent of peak bone mass is acquired by the age of 18, finding ways to maximize bone density in youth may decrease the occurrence of weak and brittle bones later in lief, they note in the Archives of Pediatrics and Adolescent Medicine.

A novel aspect of the so-called YOUTH program, which focuses on improving diet and boosting physical activity, is that it run by the local health maintenance organization, in this case Kaiser Permanente Northwest, rather than by schools.

Dr. Lynn DeBar from the Kaiser Permanente Center for Health Research in Portland, Oregon, told Reuters Health that by recognizing the importance of "emerging autonomy along with the centrality of peer-oriented activities," the YOUTH program empowers high school girls to take charge of their health.

The program encompasses an overnight retreat, bimonthly group educational "socials," membership in a fitness center, and a program website where teens can chat with other girls in the program, get advice from program staff, and monitor their individual progress.

Teens are encouraged to actively develop individualized strategies for healthy dietary and exercise practices by working with a "health coach" to set these individualized goals.

During a 2-year test period, girls in the program markedly increased their dietary intake of calcium, vitamin D, and fruits and vegetables and saw significant gains in bone mineral density at the spine and thigh bone region, compared with a control group of teenage girls who did not participate in the program.

There were no major increases in physical activity levels. However, this was an active group of girls before the intervention, with 69 percent of them participating in team sports, so it may have been a particularly difficult population in which to increase activity levels, the authors surmise.

"I think the key to the success of the program," DeBar told Reuters Health, "was to focus on having the teen participants, with a group of their peers, engage in lifestyle changes and activity that they saw as relevant and fun for their lives in the short run rather than just a means of preventing a later health condition (osteoporosis) that seems remote and not personally relevant to many teenagers."

SOURCE: Archives of Pediatrics and Adolescent Medicine, December 2006.