Association between Body Composition, Physical Activity, Food Intake and Bone Status in German Children and Adolescents

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.

Analysis of the Association between Fat Mass Distribution and Bone Mass in Chinese Male Adolescents at Different Stages of Puberty

“…Bone mass was tested by quantitative ultrasound (QUS), a method of estimating bone status by measuring the velocity and attenuation of ultrasound. QUS is particularly adaptable to evaluating bone mass in epidemiological studies with a relatively large number of healthy children and adolescents, due to its portable, low-cost, and radiation-free advantages, compared to the gold standard method of dual-energy X-ray absorptiometry (DXA) [ 22 , 23 , 24 ]. Studies revealed that the calcaneal QUS is a useful surrogate method for bone mass assessment and has a moderate to excellent correlation (r = 0.60–0.84) with DXA in the pediatric population [ 25 , 26 ].…”

Characteristics of healthy German children and adolescents across tertiles of calcaneal stiffness index

“…However, when we look in detail at our study participants´ characteristics, we do have to state that most of them were healthy, normal weight, breastfed, and vitamin D supplemented during infancy, and stayed outside on a regular basis. Their diet can be regarded as adequate [further details about their diet can be found elsewhere (Heydenreich et al 2020)]. Therefore, it can be supposed that their lifestyle is favorable for bone health.…”

“…Four hundred and eighty-six schoolchildren from six secondary schools of different school types in or close by to Schwäbisch Gmünd, Germany, and their respective parents participated in the study. Further information about recruitment process can be found elsewhere (Heydenreich et al 2020). Measurements were conducted between June 2010 and July 2011.…”

“…A higher BoneHEI reflects a healthier diet for the bone. Detailed information about the calculation of the BoneHEI can be found elsewhere (Schweter 2015;Heydenreich et al 2020).…”

“…The identification of these risk factors can help to develop prevention programs specifically targeted to the needs of girls and boys with low bone mass. In the literature, numerous risk factors for low bone parameters in children and adolescents are reported (Jones et al 2013;Farrar et al 2016;Alghadir et al 2018;Heydenreich et al 2020). However, the authors often used correlation analysis for the identification of a few risk factors.…”