Abstract
Background: Undernutrition and physical inactivity are both associated with lower bone mass.Objective: This study aimed to investigate the combined effects of early-life undernutrition and urbanized lifestyles in later life on bone mass accrual in young adults from a rural community in India that is undergoing rapid socioeconomic development.Design: This was a prospective cohort study of participants of the Hyderabad Nutrition Trial (1987–1990), which offered balanced protein-calorie supplementation to pregnant women and preschool children younger than 6 y in the intervention villages. The 2009–2010 follow-up study collected data on current anthropometric measures, bone mineral density (BMD) measured by dual-energy X-ray absorptiometry, blood samples, diet, physical activity, and living standards of the trial participants (n = 1446, aged 18–23 y).Results: Participants were generally lean and had low BMD [mean hip BMD: 0.83 (women), 0.95 (men) g/cm2; lumbar spine: 0.86 (women), 0.93 (men) g/cm2]. In models adjusted for current risk factors, no strong evidence of a positive association was found between BMD and early-life supplementation. On the other hand, current lean mass and weight-bearing physical activity were positively associated with BMD. No strong evidence of an association was found between BMD and current serum 25-hydroxyvitamin D or dietary intake of calcium, protein, or calories.Conclusions: Current lean mass and weight-bearing physical activity were more important determinants of bone mass than was early-life undernutrition in this population. In transitional rural communities from low-income countries, promotion of physical activity may help to mitigate any potential adverse effects of early nutritional disadvantage.
Highlights
Urbanization has been linked to the rise of many noncommunicable diseases (NCDs)4, including osteoporosis [1]
We present the analyses of life-course determinants of bone mass of young adults in this transitional rural community
No strong evidence of an association was found between bone mineral density (BMD) and early-life supplementation
Summary
Urbanization has been linked to the rise of many noncommunicable diseases (NCDs), including osteoporosis [1]. In rural India, rapid socioeconomic development is resulting in drastic changes in diet and activity patterns, which are key determinants of bone mass in young adults. Objective: This study aimed to investigate the combined effects of early-life undernutrition and urbanized lifestyles in later life on bone mass accrual in young adults from a rural community in India that is undergoing rapid socioeconomic development. In models adjusted for current risk factors, no strong evidence of a positive association was found between BMD and early-life supplementation. Current lean mass and weight-bearing physical activity were positively associated with BMD. Conclusions: Current lean mass and weight-bearing physical activity were more important determinants of bone mass than was early-life undernutrition in this population.
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