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The effect on behavior and bone mineral density of individualized bone mineral density feedback and educational interventions in premenopausal women: a randomized controlled trial


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Winzenberg, TM and Oldenburg, B and Frendin, S and de Wit, L and Riley, M and Jones, G (2006) The effect on behavior and bone mineral density of individualized bone mineral density feedback and educational interventions in premenopausal women: a randomized controlled trial. BMC Public Health, 6 (1). p. 12. ISSN 1471-2458

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Background: Limited information is available on ways to influence osteoporosis risk in premenopausal women. This
study tested four hypotheses regarding the effects of individualized bone density (BMD) feedback and different
educational interventions on osteoporosis preventive behavior and BMD in pre-menopausal women, namely: that
women are more likely to change calcium intake and physical activity if their BMD is low; that group education will be
more efficacious at changing behavior than an information leaflet; that BMD feedback and group education have
independent effects on behavior and BMD; and, that women who improve their physical activity or calcium intake will
have a change in bone mass over 2 years that is better than those who do not alter their behavior.
Methods: We performed a 2-year randomized controlled trial of BMD feedback according to T-score and either an
osteoporosis information leaflet or small group education in a population-based random sample of 470 healthy women
aged 25–44 years (response rate 64%). Main outcome measures were dietary calcium intake, calcium supplement use,
smoking behavior, physical activity, endurance fitness, lower limb strength and BMD. We used paired t-tests, one-way
ANOVA and linear regression techniques for data analysis.
Results: Women who had feedback of low BMD had a greater increase in femoral neck BMD than those with normal
BMD (1.6% p.a. vs. 0.7% p.a., p = 0.0001), but there was no difference in lumbar spine BMD change between these groups
(0.1% p.a. vs. 0.08% p.a., p = 0.9). Both educational interventions had similar increases in femoral neck BMD (Leaflet =
+1.0% p.a., Osteoporosis self-management course = + 1.3% p.a., p = 0.4). Femoral neck BMD change was only significantly
associated with starting calcium supplements (1.3 % p.a, 95%CI +0.49, +2.17) and persistent self-reported change in
physical activity levels (0.7% p.a., 95%CI +0.22, +1.22).
Conclusion: Individualized BMD feedback combined with a minimal educational intervention is effective at increasing
hip but not spine bone density in premenopausal women. The changes in behavior through which this was mediated are
potentially important in the prevention of other diseases, thus measuring BMD at a young age may have substantial public
health benefits, particularly if these changes are sustained.

Item Type: Article
Journal or Publication Title: BMC Public Health
Page Range: p. 12
ISSN: 1471-2458
Identification Number - DOI: 10.1186/1471-2458-6-12
Additional Information:

open access article

Date Deposited: 23 Sep 2008 04:46
Last Modified: 18 Nov 2014 03:50
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