Abstract
Achieving a high bone mass during childhood and adolescence is important for the prevention of osteoporosis in later life. Herein, the purpose was to assess the relationship of various lifestyle factors and bone outcomes in school children. In 248 girls (13.4 ± 1.9 years, BMI: 20.2 ± 4.8 kg m−2) and 231 boys (13.6 ± 1.7 years, BMI: 19.3 ± 3.3 kg m−2), bone mass (stiffness index, SI; calcaneal quantitative ultrasonometry), body composition (bioelectrical impedance analysis), food intake (food frequency questionnaire), and physical activity level (PAL; standardized questionnaire) were assessed. The individual food intake of eight food groups was related to the German recommendations (Bone Healthy Eating Index, BoneHEI; 0–100 points). Relationships between SI and lifestyle factors (Spearman´s rank correlation) and the influence of the factors on the variance of SI (multiple linear regression) were tested (α = 0.05). SI correlated with age, BMI, absolute fat-free mass, relative fat mass, PAL, and puberty category score in both girls and boys (r = 0.18–0.56, p < 0.01), but not with BoneHEI (p > 0.05). Age, absolute fat-free mass, sex, and PAL explained 35% of the variance of SI (p < 0.0001): SI = −0.60 + 2.97∙age (years) + 0.65∙fat-free mass (kg) + 6.21∙sex (0 = male, 1 = female) + 17.55∙PAL. Besides age and sex, PAL and fat-free mass are important factors relating to bone health. School children should perform regular physical activity to improve their bone status.
Highlights
Osteoporotic fractures are an important cause of morbidity and mortality [1] and represent a high economic burden to society [2] as well as a reduced quality of life
Seven out of 486 volunteers were excluded from final analysis
In the present study age, absolute fat-free mass, sex, and physical activity level (PAL) were significantly related to bone outcomes
Summary
Osteoporotic fractures are an important cause of morbidity and mortality [1] and represent a high economic burden to society [2] as well as a reduced quality of life. The main cause of osteoporotic fractures is a reduced bone mass, which results from an age-related bone loss and/or failure to achieve optimal peak bone mass in the growing years [3]. Bone mass increases substantially during the first two decades of life and reaches a plateau (referred to as peak bone mass) in the late-teen or young-adult years [4]. Achieving a high peak bone mass in early life predicts a relatively higher bone mass, and greater fracture protection, late in life [5]. Lifestyle influences 20–40% of adult peak bone mass [7]. An important strategy to reduce the risk of osteoporosis or low bone mass in later life is the optimization of these factors known to influence peak bone mass and strength
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