Maximizing bone mineral mass gain during growth for the prevention of fractures in the adolescents and the elderly

Rizzoli, René; Bianchi, Maria Luisa; Garabédian, M; McKay, Heather; Moreno, Luís A.

doi:10.1016/j.bone.2009.10.005

Cited by 539 publications

(439 citation statements)

References 160 publications

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“…In contrast, numerous reports have shown the negative impact of low intake of calcium/dairy products on girls' trabecular bone after menarche. (1)(2)(3)(4)(5)(6) Our results suggest that low vitamin D status [25(OH)D levels 40 nmol/L] may impair lumbar spine mineralization, even during the late-pubertal or postmenarcheal period, when associated with low calcium intake ( 600 mg/day). Age and pubertal maturation, height, and BMI are known to markedly influence lumbar spine area, BMC, and aBMD.…”

Section: Discussionmentioning

confidence: 76%

“…(1)(2)(3)(4)(5)(6) But data on a possible impact of low vitamin D status are less convincing. (7,8) Indeed, associations between low 25-hydroxyvitamin D [25(OH)D] levels, below 25 to 30 nmol/L (9) or 40 to 45 nmol/L, (10,11) and impaired bone mineralization have been observed at appendicular sites (ie, tibia and forearm) in girls during growth but not at trabecular bone sites (eg, hip, femoral neck, or lumbar spine) (9,12,13) or only during the early phase of puberty in severely vitamin D-deficient girls with 25(OH)D levels below 20 nmol/L.…”

Section: Introductionmentioning

confidence: 99%

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Adverse interaction of low-calcium diet and low 25(OH)D levels on lumbar spine mineralization in late-pubertal girls

Esterle

Nguyen

Walrant-Debray

et al. 2010

Journal of Bone and Mineral Research

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No consensus has been reached on the serum 25-hydroxyvitamin D [25(OH)D] levels required to ensure optimal bone health around menarche. We searched for a possible interaction of 25(OH)D levels and calcium intake on lumbar spine mineralization and on biologic features of bone metabolism in healthy late-pubertal girls. Lumbar spine parameters (ie, area, mineral content, and density) and calcium intake were evaluated in 211 healthy white adolescent girls at pubertal stages IV-V (11 to 16.9 years), together with biologic markers of calcium and bone metabolism and with International External Quality Assessment Scheme for Vitamin D Metabolite (DEQAS)-validated serum 25(OH)D levels. A high prevalence of 25(OH)D levels 30 nmol/L (41%), 40 nmol/L (61%), and 50 nmol/L (70%) was found during winter-spring. Parathyroid hormone (PTH) levels were inversely associated with 25(OH)D levels ( p ¼ .0021). In contrast, lumbar spine mineral content and density were not associated with 25(OH)D, excepted when calcium intake was below 600 mg/day ( p ¼ .0081). Girls with such low calcium intake and 25(OH)D levels of 40 nmol/L or less (9% of the cohort) had a 0.4 to 0.7 SD lower mean areal bone mineral density Z-score than girls with higher calcium intake and/or higher 25(OH)D status. The adverse association between lumbar spine mineralization and combined calcium deficiency-low 25(OH)D levels remained significant in the 91 girls who could be followed over 4 years after their initial evaluation. We conclude that low 25(OH)D levels ( 40 nmol/L) are observed frequently during winterspring in late-pubertal European girls, which may exacerbate the negative impact of calcium deficiency on lumbar spine mineralization. ß

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Section: Discussionmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Adverse interaction of low-calcium diet and low 25(OH)D levels on lumbar spine mineralization in late-pubertal girls

Esterle

Nguyen

Walrant-Debray

et al. 2010

Journal of Bone and Mineral Research

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“…11 % increase in girls and 13 % in boys involved in sports competition or hard training. According to Rizzoli et al, a 10 % increase in peak bone mass corresponds to a gain of 1 SD BMD in adulthood, and a fracture risk reduction of up to 50% [6].…”

Section: Discussionmentioning

confidence: 99%

“…Intermediate and late sexual maturation were associated with substantial lower BMD levels compared to menarche age <12.5 years. One SD reduction in BMD values can lead to more than a doubled fracture risk in the elderly [6]. Therefore, longitudinal data will be highly important for following the possible adverse effect of late sexual maturity -will it level out?…”

Section: Discussionmentioning

confidence: 99%

“…Research on fracture risk has primarily focused on bone mass in the elderly. However, there is a growing awareness of the importance of bone mass during growth, as a compensation for the later inevitable bone loss and prevention of fractures in the elderly [6]. Studies on the achievement of peak bone mass and factors that may influence it are scarce, and few population-based studies have been published.…”

Section: Introductionmentioning

confidence: 99%

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The Tromsø Study: Fit Futures: a study of Norwegian adolescents’ lifestyle and bone health

et al. 2014

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Summary Bone mass achievement predicts later fracture risk. This population-based study describes bone mineral density levels (BMD) and associated factors in Norwegian adolescents. Compared with international reference ranges, BMD levels appear higher and physical activity levels are positively associated with BMD.Purpose Norway has one of the highest reported incidences of osteoporotic fractures. Maximization of peak bone mass may prevent later fractures. This population-based study compared BMD levels of Norwegian adolescents with international reference ranges and explored associated factors.Methods All first year upper secondary school students, aged 15-19 years in the Tromsø region were invited to the Fit Futures study in 2010-2011. Over 90% of the invited participants attended, 508 girls and 530 boys. BMD was measured at total hip, femoral neck and total body by dual x-ray absorptiometry.Lifestyle variables were collected by self-administered questionnaires and interviews. All analyses were performed sex stratified, using linear regression models.Results In girls mean BMD (SD) was 1.060 (0.124), 1.066 (0.123) and 1.142 (0.077) g/cm² at the total hip, femoral neck and total body respectively. In boys corresponding values were 1.116 (0.147), 1.103 (0.150) and 1.182 (0.097), with significant higher values than the Lunar pediatric reference at 16 years of age In girls, height and self-reported intensive physical activity of more than four hours a week and early sexual maturation were positively associated with BMD at both femoral sites (p<0.047). Among boys age, height, body mass index, physical activity and alcohol intake were positively (p<0.038), whereas early stages of sexual maturation and smoking was negatively (p<0.047) related to BMD.Conclusions Despite the heavy fracture burden, Norwegian adolescents´ BMD levels are higher than agematched Caucasians. Physical activity is associated with 1 SD increased BMD levels in those involved in competition or hard training.

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Milk Consumption During Teenage Years and Risk of Hip Fractures in Older Adults

et al. 2014

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Importance Milk consumption during adolescence is recommended to promote peak bone mass and thereby reduce fracture risk in later life. However, its role in hip fracture prevention is not established and high consumption may adversely influence risk by increasing height. Objective To determine whether milk consumption during teenage years influences risk of hip fracture in older adults and to investigate the role of attained height in this association. Design Prospective cohort study over 22 years of follow-up Setting United States Participants Over 96,000 Caucasian postmenopausal women from the Nurses’ Health Study and men age 50 and older from the Health Professionals Follow-up Study Exposures Frequency of consumption of milk and other foods during ages 13–18 and attained height were reported at baseline. Current diet, weight, smoking, physical activity, medication use, and other risk factors for hip fractures were reported on biennial questionnaires. Main Outcome Measures Cox proportional hazards models were used to calculate relative risks (RR) of first incident hip fracture from low-trauma events per glass (8 fl oz or 240 mL) of milk consumed per day during teenage years. Results Over follow-up, 1226 hip fractures were identified in women and 490 in men. After controlling for known risk factors and current milk consumption, each additional glass of milk per day during teenage years was associated with a significant 9% higher risk of hip fracture in men (RR=1.09, 95% CI 1.01–1.17). The association was attenuated when height was added to the model (RR=1.06, 95% CI 0.98–1.14). Teenage milk consumption was not associated with hip fractures in women (RR=1.00, 95% CI 0.95–1.05 per glass per day). Conclusion and Relevance Greater milk consumption during teenage years was not associated with a lower risk of hip fracture in older adults. The positive association observed in men was partially mediated through attained height.

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Maximizing bone mineral mass gain during growth for the prevention of fractures in the adolescents and the elderly

Cited by 539 publications

References 160 publications

Adverse interaction of low-calcium diet and low 25(OH)D levels on lumbar spine mineralization in late-pubertal girls

Adverse interaction of low-calcium diet and low 25(OH)D levels on lumbar spine mineralization in late-pubertal girls

The Tromsø Study: Fit Futures: a study of Norwegian adolescents’ lifestyle and bone health

Milk Consumption During Teenage Years and Risk of Hip Fractures in Older Adults

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