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 practices participating in European Prospective Investigation into Cancer (EPIC Norfolk). Results Self reported time spent in high impact physical activity was strongly and positively associated with ultrasound attentuation by the heel bone, independently of age, weight, and other cofounding factors. Men who reported participating in greater than or equal to2 hours/week of high impact activity had 9.5% higher ultrasound attenuation than men who reported no activity of this type. Women who reported any high impact activity had 3.4% higher ultrasound attentuation than those who reported none. In women this effect was similar in size to that of age difference of four years. Moderate impact activity had no effect. However, climbing stairs was strongly independently associated wit ultrasound attenuation in women. There was a significant 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, interventions to promote participation in high impact activities may help preserve bone density and reduce the risk of fracture. However, in older people such interventions may be inappropriate as the could increase the likelihood of falls.