Vitamin D status and physical activity interact to improve bone mass in adolescents. The HELENA Study

Osteoporos Int. 2012 Aug;23(8):2227-37. doi: 10.1007/s00198-011-1884-7. Epub 2012 Jan 12.


The effects of vitamin D concentrations on bone mineral content in adolescents are still unclear. Vitamin D and physical activity (PA) may interact to determine bone mineral content (BMC) in two possible directions; 25(OH)D sufficiency levels improve BMC only in active adolescents, or PA increases BMC in individuals with replete vitamin D levels.

Introduction: The effects of suboptimal 25-hydroxycholecalciferol (25(OH)D) concentrations on BMC in adolescents are still unclear. The main aim of this study was to evaluate the influence of 25(OH)D on BMC in adolescents, considering the effect of body composition, sex, age, Tanner stage, season, calcium and vitamin D intakes, physical fitness and PA.

Methods: Serum 25(OH)D concentrations, anthropometric measurements, dual energy X-ray absorptiometry measurements, calcium and vitamin D intakes, PA and physical fitness were obtained in 100 Spanish adolescents (47 males), aged 12.5-17.5 years, within the framework of the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. Relations were examined using ANCOVA and regression analyses including BMC as dependent variable.

Results: Linear regression of BMC suggested that 25(OH)D concentrations independently influenced total and leg BMC after controlling for age, sex, lean mass, seasonality and calcium intake (B = 0.328, p < 0.05, and B = 0.221, p < 0.05, respectively) in the physically active group. No significant influence of 25(OH)D concentrations on BMC was observed in the inactive group. Significant effect was shown between the interaction of 25(OH)D and PA on BMC for the total body and legs (both p < 0.05).

Conclusions: Vitamin D and PA may interact to determine BMC. 25(OH)D sufficiency levels improve bone mass only in active adolescents, or PA has a positive influence on BMC in individuals with replete vitamin D levels.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon
  • Adolescent
  • Adolescent Nutritional Physiological Phenomena
  • Body Composition / physiology
  • Body Weights and Measures
  • Bone Density / physiology*
  • Bone and Bones / physiology*
  • Calcifediol / blood*
  • Child
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Motor Activity / physiology*
  • Risk Factors
  • Seasons
  • Surveys and Questionnaires
  • Vitamin D / administration & dosage


  • Vitamin D
  • Calcifediol