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Published in: BMC Musculoskeletal Disorders 1/2019

Open Access 01-12-2019 | Research article

Nutritional factors associated with femoral neck bone mineral density in children and adolescents

Authors: Guo-Hau Gou, Feng-Jen Tseng, Sheng-Hao Wang, Pao-Ju Chen, Jia-Fwu Shyu, Ru-Yu Pan

Published in: BMC Musculoskeletal Disorders | Issue 1/2019

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Abstract

Background

Nutritional factors including vitamin D, magnesium, and fat are known to affect bone mineral accrual. This study aimed to evaluate associations between dietary nutrient intakes (both macronutrients and micronutrients) and bone mineral density (BMD) in children and adolescents.

Methods

Data for this cross-sectional, population-based study were derived from the National Health and Nutrition Examination Survey (NHANES). Participants aged from 8 to 19 years were included. The primary outcome was femoral neck BMD.

Results

Multivariate analyses revealed that for participants aged 8 to 11, daily sodium intake was significantly and positively associated with femoral neck BMD (B = 0.9 ×  10− 5, p = 0.031); in particular, subgroup analyses by sex found that in male participants aged 8–11, daily total cholesterol intake (B = 5.3 × 10− 5, p = 0.030) and calcium intake (B = − 2.0 × 10− 5, p < 0.05) were significantly associated with femoral neck BMD in a positive and negative manner, respectively, but neither were observed in female participants of this age group. In contrast, daily intakes of vitamin D and magnesium were significantly and positively associated with femoral neck BMD in female participants aged 8–11 (B = 246.8 × 10− 5 and 16.3 × 10− 5, p = 0.017 and 0.033, respectively). For participants aged 16 to 19, daily total fat intake was significantly and negatively associated with femoral neck BMD (B = − 58 × 10− 5, p = 0.048); further stratification by sex found that magnesium and sodium intakes were significantly and positively associated with femoral neck BMD only in females of this age group (B = 26.9 × 10− 5 and 2.1 × 10− 5, respectively; both p < 0.05). However, no significant associations between daily nutrient intakes and femoral neck BMD were identified in participants aged 12–15 before or after subgroup stratification.

Conclusion

The study found that associations of specific nutrition-related variables with BMD of the femoral neck is dependent upon age and gender.
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Literature
1.
go back to reference Javaid MK, Cooper C. Prenatal and childhood influences on osteoporosis. Best Pract Res Clin Endocrinol Metab. 2002;16:349–67.CrossRefPubMed Javaid MK, Cooper C. Prenatal and childhood influences on osteoporosis. Best Pract Res Clin Endocrinol Metab. 2002;16:349–67.CrossRefPubMed
2.
go back to reference Bachrach LK. Acquisition of optimal bone mass in childhood and adolescence. Trends Endocrinol Metab. 2001;12:22–8.CrossRefPubMed Bachrach LK. Acquisition of optimal bone mass in childhood and adolescence. Trends Endocrinol Metab. 2001;12:22–8.CrossRefPubMed
3.
go back to reference Maggioli C, Stagi S. Bone modeling, remodeling, and skeletal health in children and adolescents: mineral accrual, assessment and treatment. Ann Pediatr Endocrinol Metab. 2017;22:1–5.CrossRefPubMedPubMedCentral Maggioli C, Stagi S. Bone modeling, remodeling, and skeletal health in children and adolescents: mineral accrual, assessment and treatment. Ann Pediatr Endocrinol Metab. 2017;22:1–5.CrossRefPubMedPubMedCentral
4.
go back to reference Alghadir AH, Gabr SA, Rizk AA. Physical fitness, adiposity, and diets as surrogate measures of bone health in schoolchildren: a biochemical and cross-sectional survey analysis. J Clin Densitom. 2018;21:406–19.CrossRefPubMed Alghadir AH, Gabr SA, Rizk AA. Physical fitness, adiposity, and diets as surrogate measures of bone health in schoolchildren: a biochemical and cross-sectional survey analysis. J Clin Densitom. 2018;21:406–19.CrossRefPubMed
5.
go back to reference El Hage R, Moussa E, El Hage Z, Theunynck D, Jacob C. Influence of age and morphological characteristics on whole body, lumbar spine, femoral neck and 1/3 radius bone mineral apparent density in a group of Lebanese adolescent boys. J Bone Miner Metab. 2011;29:477–83.CrossRefPubMed El Hage R, Moussa E, El Hage Z, Theunynck D, Jacob C. Influence of age and morphological characteristics on whole body, lumbar spine, femoral neck and 1/3 radius bone mineral apparent density in a group of Lebanese adolescent boys. J Bone Miner Metab. 2011;29:477–83.CrossRefPubMed
6.
go back to reference Kang MJ, Hong HS, Chung SJ, Lee YA, Shin CH, Yang SW. Body composition and bone density reference data for Korean children, adolescents, and young adults according to age and sex: results of the 2009-2010 Korean National Health and nutrition examination survey (KNHANES). J Bone Miner Metab. 2016;34:429–39.CrossRefPubMed Kang MJ, Hong HS, Chung SJ, Lee YA, Shin CH, Yang SW. Body composition and bone density reference data for Korean children, adolescents, and young adults according to age and sex: results of the 2009-2010 Korean National Health and nutrition examination survey (KNHANES). J Bone Miner Metab. 2016;34:429–39.CrossRefPubMed
7.
go back to reference Marin-Puyalto J, Maestu J, Gomez-Cabello A, Latt E, Remmel L, Purge P, et al. Frequency and duration of vigorous physical activity bouts are associated with adolescent boys’ bone mineral status: a cross-sectional study. Bone. 2019;120:141–7.CrossRefPubMed Marin-Puyalto J, Maestu J, Gomez-Cabello A, Latt E, Remmel L, Purge P, et al. Frequency and duration of vigorous physical activity bouts are associated with adolescent boys’ bone mineral status: a cross-sectional study. Bone. 2019;120:141–7.CrossRefPubMed
8.
go back to reference Rizzoli R, Bianchi ML, Garabedian M, McKay HA, Moreno LA. Maximizing bone mineral mass gain during growth for the prevention of fractures in the adolescents and the elderly. Bone. 2010;46:294–305.CrossRefPubMed Rizzoli R, Bianchi ML, Garabedian M, McKay HA, Moreno LA. Maximizing bone mineral mass gain during growth for the prevention of fractures in the adolescents and the elderly. Bone. 2010;46:294–305.CrossRefPubMed
9.
go back to reference Anderson JJ, Rondano P, Holmes A. Roles of diet and physical activity in the prevention of osteoporosis. Scand J Rheumatol Suppl. 1996;103:65–74.CrossRefPubMed Anderson JJ, Rondano P, Holmes A. Roles of diet and physical activity in the prevention of osteoporosis. Scand J Rheumatol Suppl. 1996;103:65–74.CrossRefPubMed
10.
go back to reference Bailey DA, Martin AD, McKay HA, Whiting S, Mirwald R. Calcium accretion in girls and boys during puberty: a longitudinal analysis. J Bone Miner Res. 2000;15:2245–50.CrossRefPubMed Bailey DA, Martin AD, McKay HA, Whiting S, Mirwald R. Calcium accretion in girls and boys during puberty: a longitudinal analysis. J Bone Miner Res. 2000;15:2245–50.CrossRefPubMed
11.
go back to reference Viljakainen HT. Factors influencing bone mass accrual: focus on nutritional aspects. Proc Nutr Soc. 2016;75:415–9.CrossRefPubMed Viljakainen HT. Factors influencing bone mass accrual: focus on nutritional aspects. Proc Nutr Soc. 2016;75:415–9.CrossRefPubMed
12.
go back to reference Weaver CM, Gordon CM, Janz KF, Kalkwarf HJ, Lappe JM, Lewis R, et al. The National Osteoporosis Foundation's position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations. Osteoporos Int. 2016;27:1281–386.CrossRefPubMedPubMedCentral Weaver CM, Gordon CM, Janz KF, Kalkwarf HJ, Lappe JM, Lewis R, et al. The National Osteoporosis Foundation's position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations. Osteoporos Int. 2016;27:1281–386.CrossRefPubMedPubMedCentral
13.
go back to reference Zhou W, Langsetmo L, Berger C, Poliquin S, Kreiger N, Barr SI, et al. Longitudinal changes in calcium and vitamin D intakes and relationship to bone mineral density in a prospective population-based study: the Canadian multicentre osteoporosis study (CaMos). J Musculoskelet Neuronal Interact. 2013;13:470–9.PubMed Zhou W, Langsetmo L, Berger C, Poliquin S, Kreiger N, Barr SI, et al. Longitudinal changes in calcium and vitamin D intakes and relationship to bone mineral density in a prospective population-based study: the Canadian multicentre osteoporosis study (CaMos). J Musculoskelet Neuronal Interact. 2013;13:470–9.PubMed
14.
go back to reference Langsetmo L, Poliquin S, Hanley DA, Prior JC, Barr S, Anastassiades T, et al. Dietary patterns in Canadian men and women ages 25 and older: relationship to demographics, body mass index, and bone mineral density. BMC Musculoskelet Disord. 2010;11:20.CrossRefPubMedPubMedCentral Langsetmo L, Poliquin S, Hanley DA, Prior JC, Barr S, Anastassiades T, et al. Dietary patterns in Canadian men and women ages 25 and older: relationship to demographics, body mass index, and bone mineral density. BMC Musculoskelet Disord. 2010;11:20.CrossRefPubMedPubMedCentral
15.
go back to reference Movassagh EZ, Baxter-Jones ADG, Kontulainen S, Whiting S, Szafron M, Vatanparast H. Vegetarian-style dietary pattern during adolescence has long-term positive impact on bone from adolescence to young adulthood: a longitudinal study. Nutr J. 2018;17:36.CrossRefPubMedPubMedCentral Movassagh EZ, Baxter-Jones ADG, Kontulainen S, Whiting S, Szafron M, Vatanparast H. Vegetarian-style dietary pattern during adolescence has long-term positive impact on bone from adolescence to young adulthood: a longitudinal study. Nutr J. 2018;17:36.CrossRefPubMedPubMedCentral
16.
go back to reference Kim JH, Yun S, Hwang SS, Shim JO, Chae HW, Lee YJ, et al. The 2017 Korean National Growth Charts for children and adolescents: development, improvement, and prospects. Korean J Pediatr. 2018;61:135–49.CrossRefPubMedPubMedCentral Kim JH, Yun S, Hwang SS, Shim JO, Chae HW, Lee YJ, et al. The 2017 Korean National Growth Charts for children and adolescents: development, improvement, and prospects. Korean J Pediatr. 2018;61:135–49.CrossRefPubMedPubMedCentral
17.
go back to reference Broadney MM, Shareef F, Marwitz SE, Brady SM, Yanovski SZ, DeLany JP, et al. Evaluating the contribution of differences in lean mass compartments for resting energy expenditure in African American and Caucasian American children. Pediatr Obes. 2018;13:413–20.CrossRefPubMedPubMedCentral Broadney MM, Shareef F, Marwitz SE, Brady SM, Yanovski SZ, DeLany JP, et al. Evaluating the contribution of differences in lean mass compartments for resting energy expenditure in African American and Caucasian American children. Pediatr Obes. 2018;13:413–20.CrossRefPubMedPubMedCentral
18.
go back to reference Ward K. Musculoskeletal phenotype through the life course: the role of nutrition. Proc Nutr Soc. 2012;71:27–37.CrossRefPubMed Ward K. Musculoskeletal phenotype through the life course: the role of nutrition. Proc Nutr Soc. 2012;71:27–37.CrossRefPubMed
19.
go back to reference Zhu K, Oddy WH, Holt P, Ping-Delfos WCS, Mountain J, Lye S, et al. Tracking of vitamin D status from childhood to early adulthood and its association with peak bone mass. Am J Clin Nutr. 2017;106:276–83.CrossRefPubMed Zhu K, Oddy WH, Holt P, Ping-Delfos WCS, Mountain J, Lye S, et al. Tracking of vitamin D status from childhood to early adulthood and its association with peak bone mass. Am J Clin Nutr. 2017;106:276–83.CrossRefPubMed
20.
go back to reference McGartland CP, Robson PJ, Murray LJ, Cran GW, Savage MJ, Watkins DC, et al. Fruit and vegetable consumption and bone mineral density: the Northern Ireland young hearts project. Am J Clin Nutr. 2004;80:1019–23.CrossRefPubMed McGartland CP, Robson PJ, Murray LJ, Cran GW, Savage MJ, Watkins DC, et al. Fruit and vegetable consumption and bone mineral density: the Northern Ireland young hearts project. Am J Clin Nutr. 2004;80:1019–23.CrossRefPubMed
21.
go back to reference van den Hooven EH, Ambrosini GL, Huang RC, Mountain J, Straker L, Walsh JP, et al. Identification of a dietary pattern prospectively associated with bone mass in Australian young adults. Am J Clin Nutr. 2015;102:1035–43.CrossRefPubMed van den Hooven EH, Ambrosini GL, Huang RC, Mountain J, Straker L, Walsh JP, et al. Identification of a dietary pattern prospectively associated with bone mass in Australian young adults. Am J Clin Nutr. 2015;102:1035–43.CrossRefPubMed
22.
go back to reference Vatanparast H, Baxter-Jones A, Faulkner RA, Bailey DA, Whiting SJ. Positive effects of vegetable and fruit consumption and calcium intake on bone mineral accrual in boys during growth from childhood to adolescence: the University of Saskatchewan Pediatric Bone Mineral Accrual Study. Am J Clin Nutr. 2005;82:700–6.CrossRefPubMed Vatanparast H, Baxter-Jones A, Faulkner RA, Bailey DA, Whiting SJ. Positive effects of vegetable and fruit consumption and calcium intake on bone mineral accrual in boys during growth from childhood to adolescence: the University of Saskatchewan Pediatric Bone Mineral Accrual Study. Am J Clin Nutr. 2005;82:700–6.CrossRefPubMed
23.
go back to reference Neville CE, Robson PJ, Murray LJ, Strain JJ, Twisk J, Gallagher AM, et al. The effect of nutrient intake on bone mineral status in young adults: the Northern Ireland young hearts project. Calcif Tissue Int. 2002;70:89–98.CrossRefPubMed Neville CE, Robson PJ, Murray LJ, Strain JJ, Twisk J, Gallagher AM, et al. The effect of nutrient intake on bone mineral status in young adults: the Northern Ireland young hearts project. Calcif Tissue Int. 2002;70:89–98.CrossRefPubMed
24.
go back to reference Looker AC, Borrud LG, Hughes JP, Fan B, Shepherd JA, Melton LJ 3rd. Lumbar spine and proximal femur bone mineral density, bone mineral content, and bone area: United States, 2005–2008. Vital Health Stat 11. 2012;251:1–132. Looker AC, Borrud LG, Hughes JP, Fan B, Shepherd JA, Melton LJ 3rd. Lumbar spine and proximal femur bone mineral density, bone mineral content, and bone area: United States, 2005–2008. Vital Health Stat 11. 2012;251:1–132.
25.
go back to reference Kim HY, Jung HW, Hong H, Kim JH, Shin CH, Yang SW, et al. The role of overweight and obesity on bone health in Korean adolescents with a focus on lean and fat mass. J Korean Med Sci. 2017;32:1633–41.CrossRefPubMedPubMedCentral Kim HY, Jung HW, Hong H, Kim JH, Shin CH, Yang SW, et al. The role of overweight and obesity on bone health in Korean adolescents with a focus on lean and fat mass. J Korean Med Sci. 2017;32:1633–41.CrossRefPubMedPubMedCentral
26.
go back to reference Carson JA, Manolagas SC. Effects of sex steroids on bones and muscles: similarities, parallels, and putative interactions in health and disease. Bone. 2015;80:67–78.CrossRefPubMedPubMedCentral Carson JA, Manolagas SC. Effects of sex steroids on bones and muscles: similarities, parallels, and putative interactions in health and disease. Bone. 2015;80:67–78.CrossRefPubMedPubMedCentral
27.
go back to reference Karlsland Akeson P, Akesson KE, Lind T, Hernell O, Silfverdal SA, Ohlund I. Vitamin D intervention and bone: a randomized clinical trial in fair- and dark-skinned children at northern latitudes. J Pediatr Gastroenterol Nutr. 2018;67:388–94.CrossRefPubMed Karlsland Akeson P, Akesson KE, Lind T, Hernell O, Silfverdal SA, Ohlund I. Vitamin D intervention and bone: a randomized clinical trial in fair- and dark-skinned children at northern latitudes. J Pediatr Gastroenterol Nutr. 2018;67:388–94.CrossRefPubMed
28.
go back to reference Esterle L, Sabatier JP, Guillon-Metz F, Walrant-Debray O, Guaydier-Souquieres G, Jehan F, et al. Milk, rather than other foods, is associated with vertebral bone mass and circulating IGF-1 in female adolescents. Osteoporos Int. 2009;20:567–75.CrossRefPubMed Esterle L, Sabatier JP, Guillon-Metz F, Walrant-Debray O, Guaydier-Souquieres G, Jehan F, et al. Milk, rather than other foods, is associated with vertebral bone mass and circulating IGF-1 in female adolescents. Osteoporos Int. 2009;20:567–75.CrossRefPubMed
29.
go back to reference Carpenter TO, DeLucia MC, Zhang JH, Bejnerowicz G, Tartamella L, Dziura J, et al. A randomized controlled study of effects of dietary magnesium oxide supplementation on bone mineral content in healthy girls. J Clin Endocrinol Metab. 2006;91:4866–72.CrossRefPubMed Carpenter TO, DeLucia MC, Zhang JH, Bejnerowicz G, Tartamella L, Dziura J, et al. A randomized controlled study of effects of dietary magnesium oxide supplementation on bone mineral content in healthy girls. J Clin Endocrinol Metab. 2006;91:4866–72.CrossRefPubMed
30.
go back to reference Corwin RL, Hartman TJ, Maczuga SA, Graubard BI. Dietary saturated fat intake is inversely associated with bone density in humans: analysis of NHANES III. J Nutr. 2006;136:159–65.CrossRefPubMed Corwin RL, Hartman TJ, Maczuga SA, Graubard BI. Dietary saturated fat intake is inversely associated with bone density in humans: analysis of NHANES III. J Nutr. 2006;136:159–65.CrossRefPubMed
31.
go back to reference Kwon YM, Kim GW, Yim HW, Paek YJ, Lee KS. Association between dietary fat intake and bone mineral density in Korean adults: data from Korea National Health and nutrition examination survey IV (2008 approximately 2009). Osteoporos Int. 2015;26:969–76.CrossRefPubMed Kwon YM, Kim GW, Yim HW, Paek YJ, Lee KS. Association between dietary fat intake and bone mineral density in Korean adults: data from Korea National Health and nutrition examination survey IV (2008 approximately 2009). Osteoporos Int. 2015;26:969–76.CrossRefPubMed
32.
go back to reference Fatahi S, Namazi N, Larijani B, Azadbakht L. The association of dietary and urinary sodium with bone mineral density and risk of osteoporosis: a systematic review and meta-analysis. J Am Coll Nutr. 2018;37:522–32.CrossRefPubMed Fatahi S, Namazi N, Larijani B, Azadbakht L. The association of dietary and urinary sodium with bone mineral density and risk of osteoporosis: a systematic review and meta-analysis. J Am Coll Nutr. 2018;37:522–32.CrossRefPubMed
33.
go back to reference Hoppe C, Molgaard C, Michaelsen KF. Bone size and bone mass in 10-year-old Danish children: effect of current diet. Osteoporos Int. 2000;11:1024–30.CrossRefPubMed Hoppe C, Molgaard C, Michaelsen KF. Bone size and bone mass in 10-year-old Danish children: effect of current diet. Osteoporos Int. 2000;11:1024–30.CrossRefPubMed
35.
go back to reference Pritschet L, Powell D, Horne Z. Marginally significant effects as evidence for hypotheses: changing attitudes over four decades. Psychol Sci. 2016;27:1036–42.CrossRefPubMed Pritschet L, Powell D, Horne Z. Marginally significant effects as evidence for hypotheses: changing attitudes over four decades. Psychol Sci. 2016;27:1036–42.CrossRefPubMed
Metadata
Title
Nutritional factors associated with femoral neck bone mineral density in children and adolescents
Authors
Guo-Hau Gou
Feng-Jen Tseng
Sheng-Hao Wang
Pao-Ju Chen
Jia-Fwu Shyu
Ru-Yu Pan
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2019
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-019-2901-9

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