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PURPOSE: As peak bone mineral accrual velocity occurs at menarche, optimization of circum-menarcheal exercise and diet may reduce future fracture risk. We evaluated a 3-year non-dominant upper extremity bone loading index, and key nutrients, as circum-menarcheal factors in development of post-menarcheal bone properties at the distal radius – a common fragility fracture site. METHODS: A previously published circum-menarcheal bone loading index was evaluated as a predictor of indices of theoretical bone compressive and torsional strength for 48 original BLI study participants with post-menarcheal radius peripheral quantitative computed tomography (pQCT) scans. Mean intakes of lactose, zinc, total fat, magnesium, protein, calcium and potassium were tested as predictors of dual energy X-ray absorptiometry bone mineral content at comparable sites. SPSS v27 generated descriptive statistics and multiple linear regression models, with gynecological age, height and whole-body non-bone lean mass as covariates; backward stepwise regressions initially entered all predictors, plus diet factors. RESULTS: Gynecological age, height, lean mass and 3yrBLI all provided significant explanatory value in the 4% IBS model, but only lean mass and 3yrBLI were significant factors in the 33% SSI model; 3yrBLI explained substantial variance in both models (p<0.002). For DXA models, total fat, lean mass and 3yrBLI were positive factors, whereas protein and calcium intakes were negative factors (p<0.15). CONCLUSIONS: Over 3 circum-menarcheal years, greater forearm bone loading exercise was associated with higher post-menarcheal bone mass and strength indices. Future studies should evaluate interactions among fat, protein and calcium intakes in exercise studies of tissue-specific bone growth.



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Exercise and Diet Patterns as Factors in Forearm Trabecular and Cortical Bone Development in Pubertal Girls