Handball participation and bone mineral accrual during growth: A 1-year longitudinal controlled study in young male athletes.

Multidirectional sports such as handball may provide beneficial mechanical stimuli, but longitudinal evidence in male children remains limited. This study examined one-year differences in bone mineral density (BMD), bone mineral content (BMC), and bone area (BA) between male children engaged in regular handball practice and age-matched controls. This non-randomized longitudinal study included 72 healthy male children aged 10-12 years: handball group (HG, n = 36) and control group (CG, n = 36). Whole-body and regional bone outcomes were assessed using dual-energy X-ray absorptiometry. Between-group differences at follow-up were evaluated using ANCOVA, while longitudinal changes were examined using linear mixed-effects models. Handball players exhibited greater adjusted BMD at follow-up than controls, with the largest effect at the lumbar spine (adjusted mean difference = 0.034 g/cm2; 95% CI: 0.012-0.056; η2p = 0.14). Higher BMD was also observed at the whole body, total hip, lower limbs, femoral neck, and selected upper-limb sites. Adjusted BMC was greater at the lumbar spine, total hip, lower limbs, and selected radial regions. Increases in lean mass were positively associated with BMD gains at the whole body, hip, and femoral neck, whereas associations with BMC were more localized and those with BA were limited. These findings suggest that handball participation is associated with greater skeletal mineral accrual during growth.