Honors Theses and Capstones

Date of Award

Spring 2020

Project Type

Senior Honors Thesis

College or School



Agriculture, Nutrition, and Food Systems

Program or Major

Nutrition: Dietetics

Degree Name

Bachelor of Science

First Advisor

Gretchen Arnold

Second Advisor

Jesse Morrell


Objective: Identifying individuals with low bone ultrasound attenuation (BUA) z-scores under the age of 30 can allow for improvements of bone health through increased intake of calcium and vitamin D, physical activity, and avoidance of excessive alcohol or caffeine intake. The goal of this study was to assess changes in bone health and observe related risk factors among female college students.

Participants and Methods: Female students (n=38) enrolled in the Nutrition Program at the University of New Hampshire (UNH) who participated in the College Health and Nutrition Assessment Survey (CHANAS) were recruited to participate in a follow-up study during the fall 2019 semester. Subjects completed a bone health questionnaire and repeat bone ultrasonography measurements approximately 2.5 years after their first measurement. Bone ultrasound attenuation (BUA) z-scores from bilateral calcaneus bone were used to assess bone health. Subjects were categorized as low or normal bone status according to World Health Organization z-score criteria. Data are presented as means ± SD; changes in z-scores over time were assessed by a paired t-test; group differences were examined using independent t-tests.

Results: No significant differences in bone status were observed between 1st and 2nd measurements (-0.72 ± 0.10 vs. -0.90 ± 0.86, p=0.08). At the follow-up visit, 19 participants were classified as having normal bone (-0.22 ± 0.53) and 19 participants had low bone (-1.59 ± 0.43). Subjects with normal bone status participated in more vigorous or moderate physical activity compared to subjects with low bone status (9.4 ± 7.6 vs. 6.03 ± 5.3 hours/week, p=0.07), but this observation was not statistically significant. Alcohol intake, milk intake, and body mass index were not different between groups.

Conclusion: Among female college students, bone status as measured by ultrasound did not significantly change over time, however, findings suggest physical activity may be related to improved bone health. Alcohol intake, milk intake, or body mass index did not differ between students with normal vs. low bone status. Further research should be conducted to measure changes in bone health over time in a similar population using a larger number of participants.