Patterns of physical activity and ultrasound attenuation by heel hone among Norfolk cohort of European Prospective Investigation of Cancer (EPIC Norfolk): population based study

Objectives To study associations between patterns of physical activity and ultrasound attenuation by the heel bone in men and women. Design Cross sectional, population based study. Setting Norfolk. Participants 2296 men and 2914 women aged 45-74 registered wit general prac tices participating in European Prospective Investigation into Cancer (EPIC Norfolk). Results Self reported time spent in high impact physical activity was stron gly and positively associated with ultrasound attentuation by the heel bone , independently of age, weight, and other cofounding factors. Men who repor ted participating in greater than or equal to2 hours/week of high impact ac tivity had 9.5% higher ultrasound attenuation than men who reported no acti vity of this type. Women who reported any high impact activity had 3.4% hig her ultrasound attentuation than those who reported none. In women this eff ect was similar in size to that of age difference of four years. Moderate i mpact activity had no effect. However, climbing stairs was strongly indepen dently associated wit ultrasound attenuation in women. There was a signific ant negative association in women between time spent watching television or video and heel bone ultrasound attenuation. Conclusions High impact physical activity is independently associated with ultrasound attenuation by the heel gone in men and women. As low ultrasound attenuation has been shown to predict increased risk of hip fracture, inte rventions to promote participation in high impact activities may help prese rve bone density and reduce the risk of fracture. However, in older people such interventions may be inappropriate as the could increase the likelihoo d of falls.