Breast-feeding and formula feeding in healthy term infants and bone health at age 10 years

2013 ◽  
Vol 110 (6) ◽  
pp. 1061-1067 ◽  
Author(s):  
M. S. Fewtrell ◽  
K. Kennedy ◽  
Peter R. Murgatroyd ◽  
J. E. Williams ◽  
S. Chomtho ◽  
...  
Keyword(s):  
Bone Mass ◽  
Infant Formula ◽  
Breast Feeding ◽  
Bone Mineral ◽  
Bone Health ◽  
Infant Nutrition ◽  
Mineral Density ◽  
Short Term ◽  
Term Infants ◽  
Bone Mineral Apparent Density

Few studies have investigated the effects of infant nutrition on later bone health in term infants, although low sn-2 palmitate in infant formulas has been shown to result in the formation of stool fatty acid soaps, reduced Ca absorption and lower bone mass in the short term. To investigate the effect of (1) breast-feeding (BF) and (2) the type of infant formula (standard fat blend v. high-sn-2 fat blend) on bone mass at age 10 years, anthropometry and bone mass (from dual-energy X-ray absorptiometry (GE Lunar Prodigy); lumbar spine (LS) and total body less head; adjusted for size (bone mineral apparent density standard deviation score (SDS) and regression)) were measured in 10-year-old subjects born at term and either breast-fed (n 34) or randomised to a standard control formula (n 27) or a high-sn-2 palmitate formula (n 30) for the first 12 weeks of life. At follow-up, previously BF children were older but lighter (by 0·5 SDS, P= 0·03) than formula-fed children with a lower LS bone mineral density SDS (by 0·44, P= 0·03), but size-adjusted bone mass did not differ. There were no significant differences in bone mass between the formula-fed groups. These findings suggest that there is no significant effect of BF or high-sn-2 infant formula on size-adjusted bone mass in mid-childhood, and that the effects of infant nutrition on bone mass previously reported may be confined to the short term. A larger study would be required to exclude smaller effects.

scholarly journals Cross-sectional and Longitudinal Evaluation of Bone Mass in Children and Young Adults with Juvenile Idiopathic Arthritis: The Role of Bone Mass Determinants in a Large Cohort of Patients

2010 ◽  
Vol 37 (9) ◽  
pp. 1935-1943 ◽  
Author(s):  
STEFANO STAGI ◽  
LAURA MASI ◽  
SERENA CAPANNINI ◽  
ROLANDO CIMAZ ◽  
GIULIA TONINI ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Bone Mass ◽  
Bone Mineral ◽  
Large Cohort ◽  
Close Monitoring ◽  
Mineral Density ◽  
Cross Sectional ◽  
Bone Mineral Apparent Density ◽  
Longitudinal Evaluation ◽  
Enthesitis Related Arthritis

Objective.To assess the prevalence of reduced spine bone mineral apparent density (BMAD), and to identify the main predictors of reduced spine BMAD in a cross-sectional and longitudinal evaluation of the same large cohort of patients with juvenile idiopathic arthritis (JIA). There are few prospective data on bone mass evaluation in a large number of patients with JIA, and with enthesitis-related arthritis onset.Methods.Two hundred nineteen patients with JIA (median age 8.7 yrs, range 6.1–13.1 yrs; 104 oligoarticular JIA, 61 polyarticular, 20 systemic, and 34 enthesitis-related arthritis onset) were retrospectively evaluated. A dual-energy x-ray absorptiometry (DEXA) scan at the lumbar spine was performed in all subjects. Of these, 89 consecutive patients were followed up randomly and longitudinally with a second and a third DEXA evaluation. The data obtained were compared with 80 age-matched and sex-matched healthy subjects.Results.At the first DEXA, patients with JIA showed a reduced spine BMAD standard deviation score (SDS) in comparison to controls (p < 0.001). These results were confirmed when the subjects were divided into JIA subtypes (p < 0.005) with the exception of enthesitis-related arthritis onset. Spine BMAD SDS significantly correlated with JIA onset type (p < 0.01), age at JIA onset (p < 0.005), and flares (p = 0.008). The longitudinal evaluation showed that spine BMAD SDS did not significantly improve at the followup in comparison to controls, in all subsets with JIA except for systemic onset (p < 0.05). Spine BMAD correlated with sex (p < 0.01), systemic corticosteroid exposure (p < 0.01), the number of intraarticular corticosteroid injections (p < 0.01), the interval from last steroid injection (p < 0.05), erythrocyte sedimentation rate (p < 0.005), and C-reactive protein levels (p < 0.005).Conclusion.Patients with JIA have a low bone mass and, after a first increase due to therapy, do not reach a healthy condition over time despite our current more effective drugs. These patients have a high risk of osteoporosis in early adulthood. To reduce the risk and improve the bone mass, close monitoring of bone mineral density, better control of disease activity, physical activity, and intake of calcium and vitamin D are recommended. In patients with osteoporosis, therapeutic approaches including bisphosphonates should be considered.

scholarly journals Associations of breast-feeding patterns and introduction of solid foods with childhood bone mass: The Generation R Study

2016 ◽  
Vol 115 (6) ◽  
pp. 1024-1032 ◽  
Author(s):  
Edith H. van den Hooven ◽  
Mounira Gharsalli ◽  
Denise H. M. Heppe ◽  
Hein Raat ◽  
Albert Hofman ◽  
...  
Keyword(s):  
Bone Mass ◽  
Breast Feeding ◽  
Bone Mineral ◽  
Mineral Content ◽  
Vitamin D Supplementation ◽  
Mineral Density ◽  
Feeding Patterns ◽  
Solid Foods ◽  
Total Body ◽  
Breast Fed

AbstractBreast-feeding has been associated with later bone health, but results from previous studies are inconsistent. We examined the associations of breast-feeding patterns and timing of introduction of solids with bone mass at the age of 6 years in a prospective cohort study among 4919 children. We collected information about duration and exclusiveness of breast-feeding and timing of introduction of any solids with postnatal questionnaires. A total body dual-energy X-ray absorptiometry scan was performed at 6 years of age, and bone mineral density (BMD), bone mineral content (BMC), area-adjusted BMC (aBMC) and bone area (BA) were analysed. Compared with children who were ever breast-fed, those never breast-fed had lower BMD (−4·62 mg/cm2; 95 % CI −8·28, −0·97), BMC (−8·08 g; 95 % CI −12·45, −3·71) and BA (−7·03 cm2; 95 % CI −12·55, −1·52) at 6 years of age. Among all breast-fed children, those who were breast-fed non-exclusively in the first 4 months had higher BMD (2·91 mg/cm2; 95 % CI 0·41, 5·41) and aBMC (3·97 g; 95 % CI 1·30, 6·64) and lower BA (−4·45 cm2; 95 % CI −8·28, −0·61) compared with children breast-fed exclusively for at least 4 months. Compared with introduction of solids between 4 and 5 months, introduction <4 months was associated with higher BMD and aBMC, whereas introduction between 5 and 6 months was associated with lower aBMC and higher BA. Additional adjustment for infant vitamin D supplementation did not change the results. In conclusion, results from the present study suggest that ever breast-feeding compared with never breast-feeding is associated with higher bone mass in 6-year-old children, but exclusive breast-feeding for 4 months or longer was not positively associated with bone outcomes.

scholarly journals Normative Data for Bone Mass in Healthy Term Infants from Birth to 1 Year of Age

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Sina Gallo ◽  
Catherine A. Vanstone ◽  
Hope A. Weiler
Keyword(s):  
Bone Mass ◽  
Bone Mineral ◽  
Whole Body ◽  
First Year ◽  
Mineral Density ◽  
Term Infants ◽  
Appropriate For Gestational Age ◽  
A Prospective Study ◽  
First Year Of Life ◽  
Dxa Scans

For over 2 decades, dual-energy X-ray absorptiometry (DXA) has been the gold standard for estimating bone mineral density (BMD) and facture risk in adults. More recently DXA has been used to evaluate BMD in pediatrics. However, BMD is usually assessed against reference data for which none currently exists in infancy. A prospective study was conducted to assess bone mass of term infants (37 to 42 weeks of gestation), weight appropriate for gestational age, and born to healthy mothers. The group consisted of 33 boys and 26 girls recruited from the Winnipeg Health Sciences Center (Manitoba, Canada). Whole body (WB) as well as regional sites of the lumbar spine (LS 1–4) and femur was measured using DXA (QDR 4500A, Hologic Inc.) providing bone mineral content (BMC) for all sites and BMD for spine. During the year, WB BMC increased by 200% (76.0±14.2versus227.0±29.7 g), spine BMC by 130% (2.35±0.42versus5.37±1.02 g), and femur BMC by 190% (2.94±0.54versus8.50±1.84 g). Spine BMD increased by 14% (0.266±0.044versus0.304±0.044 g/cm2) during the year. This data, representing the accretion of bone mass during the first year of life, is based on a representative sample of infants and will aid in the interpretation of diagnostic DXA scans by researchers and health professionals.

scholarly journals Bone density and metabolism in subjects with microdeletion of chromosome 22q11 (del22q11)

2010 ◽  
Vol 163 (2) ◽  
pp. 329-337 ◽  
Author(s):  
Stefano Stagi ◽  
Elisabetta Lapi ◽  
Eleonora Gambineri ◽  
Cristina Manoni ◽  
Maurizio Genuardi ◽  
...  
Keyword(s):  
Bone Mass ◽  
Bone Mineral ◽  
Young Patients ◽  
Serum Levels ◽  
Close Monitoring ◽  
Total Calcium ◽  
Mineral Density ◽  
Bone Mineral Apparent Density ◽  
Bone Specific Alkaline Phosphatase ◽  
Chromosome 22Q11

IntroductionAlthough hypoparathyroidism with hypocalcaemia is one of the most frequent clinical features of monoallelic microdeletion of chromosome 22q11 (22q11DS), bone mass and metabolism have not yet been assessed in these patients.DesignThis study aimed to evaluate bone mass and metabolism in a cohort of patients, both children and adults, with 22q11DS.MethodsIn twenty-eight patients with 22q11DS (median age 12.5, range 6.1–42.8 years), serum levels of ionised and total calcium, phosphate, parathyroid hormone (PTH), 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, osteocalcin and bone-specific alkaline phosphatase (BSAP), and urinary deoxypyridinoline concentrations were evaluated. In these patients, bone mineral density (BMD) was evaluated by dual-energy X-ray absorptiometry (DXA) examination, and volumetric BMD (bone mineral apparent density (BMAD)) was calculated.The data obtained from paediatric and adult patients were compared with two age-, sex- and body size-matched healthy subject control groups.ResultsPatients with 22q11DS showed a reduced BMAD Z-score compared with controls (P<0.001). These patients also had significantly lower ionised (P<0.001) and total calcium (P<0.05) levels as well as lower PTH levels (P<0.05), compared with the controls. In particular, children and young patients with 22q11DS had significantly lower serum osteocalcin levels (P<0.001), BSAP levels (P<0.001) and urinary deoxypyridinoline concentrations (P<0.001) than controls. These results were not confirmed in adults.Finally, patients with hypoparathyroidism and/or hypocalcaemia at the time of the study showed significantly lower ionised (P<0.001) and total calcium levels (P<0.001), PTH levels (P<0.05), BSAP levels (P<0.001), osteocalcin levels (P<0.001) and urinary deoxypyridinoline concentrations (P<0.001), compared with patients without hypoparathyroidism and/or hypocalcaemia. Nonetheless, the BMAD Z-score did not show substantial differences between these two groups.ConclusionsSubjects with 22q11DS have a significant reduction in bone mass that appears to be more severe in adults who have already attained peak bone mass than in children who are still growing. Therefore, we suggest a close monitoring of bone mass and metabolism in 22q11DS patients.

Tea flavonoids for bone health: from animals to humans

2016 ◽  
Vol 64 (7) ◽  
pp. 1151-1157 ◽  
Author(s):  
Chwan-Li Shen ◽  
Ming-Chien Chyu
Keyword(s):  
Bone Mineral Density ◽  
Clinical Trials ◽  
Bone Loss ◽  
Bone Mass ◽  
Bone Mineral ◽  
Bone Health ◽  
Fragility Fractures ◽  
Tea Consumption ◽  
Mineral Density ◽  
Risk Of Fracture

Osteoporosis is a skeletal disease characterized by a deterioration of bone mass and bone quality that predisposes an individual to a higher risk of fragility fractures. Emerging evidence has shown that the risk for low bone mass and osteoporosis-related fractures can be reduced by nutritional approaches aiming to improve bone microstructure, bone mineral density, and strength. Tea and its flavonoids, especially those of black tea and green tea, have been suggested to protect against bone loss and to reduce risk of fracture, due to tea's antioxidant and anti-inflammatory properties. Based on the results of animal studies, moderate intake of tea has shown to benefit bone health as shown by mitigation of bone loss and microstructural deterioration as well as improvement of bone strength and quality. Epidemiological studies have reported positive, insignificant, and negative impacts on bone mineral density at multiple skeletal sites and risk of fracture in humans with habitual tea consumption. There are limited human clinical trials that objectively and quantitatively assessed tea consumption and bone efficacy using validated outcome measures in a population at high risk for osteoporosis, along with safety monitoring approach. This review summarizes the current state of knowledge of laboratory animal research, epidemiological observational studies, and clinical trials assessing the skeletal effects of tea and its active flavonoids, along with discussion of relevant future directions in translational research.

scholarly journals Diet Quality in Relation to Fat, Lean, and Bone Mass in Children: A Population-based Study (P18-105-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Anh Nhi Nguyen ◽  
Arfan Ikram ◽  
Trudy Voortman
Keyword(s):  
Body Composition ◽  
Bone Mass ◽  
Dietary Intake ◽  
Bone Mineral ◽  
Diet Quality ◽  
Bone Health ◽  
Population Based ◽  
Quality Score ◽  
Dietary Guidelines ◽  
Mineral Density

Abstract Objectives Nutrition in early life is considered a crucial modifiable determinant of growth and development. Still, whether overall diet quality in childhood is related to body composition and bone health remains unclear. We aimed to examine associations of overall diet quality with detailed measures of fat, lean, and bone mass in childhood. Methods We included 3991 children from a large population-based prospective cohort in the Netherlands. Dietary intake was assessed using a food-frequency questionnaire at their age of 8 years, and a diet quality score (0–10) was calculated, measuring adherence to age-specific dietary guidelines. Height, weight, and detailed body composition of the children were measured at their age of 10 years. Body composition was assessed using dual-energy X-ray absorptiometry. We calculated sex- and age-specific SD-scores for body mass index (BMI), fat mass index (FMI), fat-free mass index (FFMI), bone mineral density (BMD), bone mineral content (BMC), and area-adjusted BMC (aBMC). Results Mean diet quality score of the children was 4.5 (±1.2) out of 10, and 12.4% of the children had overweight. After adjustment for socioeconomic and lifestyle factors, we observed that a higher diet quality was associated with a higher height, weight, and BMI in childhood. This positive association of diet quality with BMI was fully driven by a higher FFMI (0.07 SDS per 1 point higher diet quality, 95%CI: 0.05,0.10), and not FMI. For bone health, we observed associations of higher diet quality with higher BMD (0.05 SDS, 95%CI: 0.03,0.08) and BMC (0.06 SDS, 95%CI: 0.03,0.09), but not with aBMC. These associations were independent of diet quality in infancy and not driven by specific food components included in the diet quality score. Conclusions In this healthy population of children in Europe, we observed a high prevalence of overweight, whereas overall diet quality of the children was suboptimal. Our findings emphasize that an adequate diet in childhood is of high importance, not only for body composition, but also for bone health already at this young age. Dietary intake according to dietary guidelines in childhood may have a beneficial effect on growth and bone development, and may decrease the risk of obesity and osteoporosis later in life. Funding Sources This specific project did not receive any funding.

scholarly journals Bone Mineral Density, Body Composition, and Metabolic Health of Very Low Birth Weight Infants Fed in Hospital Following Current Macronutrient Recommendations during the First 3 Years of Life

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 1005
Author(s):  
Walter Mihatsch ◽  
Izaskun Dorronsoro Martín ◽  
Vicente Barrios-Sabador ◽  
María L. Couce ◽  
Gabriel Á. Martos-Moreno ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Health Outcome ◽  
Body Composition ◽  
Preterm Infants ◽  
Bone Mineral ◽  
Very Low Birth Weight ◽  
Metabolic Health ◽  
Mineral Density ◽  
Term Infants ◽  
Vlbw Infants

The present study longitudinally evaluated growth, bone mineral density, body composition, and metabolic health outcome in very low birth weight (VLBW) infants whose in-hospital target nutrient intake was within recent recommendations. From six months to three years, bone mineral density (dual-energy X-ray absorptiometry, DXA), body composition, and metabolic health outcome were compared with a reference group of term infants. The aim was to test whether in-hospital achieved weight gain until 36 weeks of gestation (light or appropriate for term equivalent age; LTEA or ATEA) predicts later growth, bone mineral density (BMD), abdominal obesity, or metabolic health outcomes such as insulin resistance, relative to term infants, during the first three years of life. Target in-hospital energy and protein intake was not achieved. Growth in weight, length and head circumference, mid arm circumference, adiposity, fat free mass (FFM), and bone mineralization in VLBW infants was less than those in term infants and influenced by nutritional status at discharge. Preterm infants had poorer motor and cognitive outcomes. Post-discharge body composition patterns indicate FFM proportional to height but lower fat mass index in LTEA preterm infants than term infants, with no evidence of increased truncal fat in preterm infants. The hypothesis of early BMD catch-up in VLBW infants after discharge was not supported by the present data. The clinical significance of these findings is unclear. The data may suggest a reduced obesity risk but an increased osteoporosis risk. Since postnatal growth restriction may have permanent negative health effects, LTEA VLBW infants would especially appear to benefit from targeted preventive interventions. Further follow-up of the infants is required.

scholarly journals The Association between Bone Mineral Density and Periodontal Disease in Middle-Aged Adults

2021 ◽  
Vol 18 (6) ◽  
pp. 3321
Author(s):  
Hsin-Hua Chou ◽  
Sao-Lun Lu ◽  
Sen-Te Wang ◽  
Ting-Hsuan Huang ◽  
Sam Li-Sheng Chen
Keyword(s):  
Bone Mineral Density ◽  
Young Adults ◽  
Bone Mass ◽  
Periodontal Disease ◽  
Bone Mineral ◽  
Intervention Program ◽  
Past History ◽  
Low Bone Mass ◽  
Mineral Density ◽  
Periodontal Index

The association between osteoporosis and periodontal disease (PD) has been revealed by previous studies, but there have been few studies on the association in younger adults. We enrolled a total of 7298 adults aged 40 to 44 who underwent PD screening between 2003 and 2008. Data on quantitative ultrasound for the measurement of bone mineral density (BMD) were collected for the diagnostic criteria of osteopenia and osteoporosis. The Community Periodontal Index (CPI) was measured for defining PD. A multiple logistic regression model was used to assess the effect of low bone mass on the risk of PD. Of 7298 enrollees, 31% had periodontal pockets >3 mm, 36.2% had osteopenia, and 2.1% had osteoporosis. The 39.8% of PD prevalence was high in adults with osteoporosis, followed by 33.3% in osteopenia. A negative association was found between BMD and CPI value (p < 0.0001). Low bone mass was associated with the risk of PD (adjusted OR: 1.13; 95% CI:1.02–1.26) after adjusting the confounding factors, including age, gender, education level, overweight, smoking status, past history of osteoporosis, and diabetes mellitus. An association between BMD and PD among young adults was found. An intervention program for the prevention of PD and osteoporosis could be considered starting in young adults.

scholarly journals A Three-Year Longitudinal Study Comparing Bone Mass, Density, and Geometry Measured by DXA, pQCT, and Bone Turnover Markers in Children with PKU Taking L-Amino Acid or Glycomacropeptide Protein Substitutes

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2075
Author(s):  
Anne Daly ◽  
Wolfgang Högler ◽  
Nicola Crabtree ◽  
Nick Shaw ◽  
Sharon Evans ◽  
...  
Keyword(s):  
Amino Acid ◽  
Bone Density ◽  
Bone Turnover ◽  
Bone Mineral ◽  
Bone Turnover Markers ◽  
Blood Biochemistry ◽  
Reference Ranges ◽  
Mineral Density ◽  
Bone Mineral Apparent Density ◽  
Turnover Markers

In patients with phenylketonuria (PKU), treated by diet therapy only, evidence suggests that areal bone mineral density (BMDa) is within the normal clinical reference range but is below the population norm. Aims: To study longitudinal bone density, mass, and geometry over 36 months in children with PKU taking either amino acid (L-AA) or casein glycomacropeptide substitutes (CGMP-AA) as their main protein source. Methodology: A total of 48 subjects completed the study, 19 subjects in the L-AA group (median age 11.1, range 5–6 years) and 29 subjects in the CGMP-AA group (median age 8.3, range 5–16years). The CGMP-AA was further divided into two groups, CGMP100 (median age 9.2, range 5–16years) (n = 13), children taking CGMP-AA only and CGMP50 (median age 7.3, range 5–15years) (n = 16), children taking a combination of CGMP-AA and L-AA. Dual X-ray absorptiometry (DXA) was measured at enrolment and 36 months, peripheral quantitative computer tomography (pQCT) at 36 months only, and serum blood and urine bone turnover markers (BTM) and blood bone biochemistry at enrolment, 6, 12, and 36 months. Results: No statistically significant differences were found between the three groups for DXA outcome parameters, i.e., BMDa (L2–L4 BMDa g/cm2), bone mineral apparent density (L2–L4 BMAD g/cm3) and total body less head BMDa (TBLH g/cm2). All blood biochemistry markers were within the reference ranges, and BTM showed active bone turnover with a trend for BTM to decrease with increasing age. Conclusions: Bone density was clinically normal, although the median z scores were below the population mean. BTM showed active bone turnover and blood biochemistry was within the reference ranges. There appeared to be no advantage to bone density, mass, or geometry from taking a macropeptide-based protein substitute as compared with L-AAs.

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