Bone outcomes and technical measurement issues of bone health among children and adolescents: Considerations for nutrition and physical activity intervention trials

Weight-bearing physical activity and calcium intake are two important behavioral influences for bone health. Physical-activity and calcium-intake intervention trials with youth have been implemented to evaluate their efficacy and effectiveness to decrease the risk for subsequent osteoporosis and fractures. Technical aspects of bone measurement have not been routinely reported in published trials of youth, even though they can have an impact on study findings and interpretation. This paper provides an overview of the outcome variables reported, and technical issues - such as software and bone detection, growth, and movement - that affect bone mass measurements among children and adolescents. It describes the implications of these issues for the interpretation of intervention effects observed in intervention trials, and provides recommendations for future research.