Nutrients, Diet, and Other Factors in Prenatal Life and Bone Health in Young Adults: A Systematic Review of Longitudinal Studies

Abstract

Optimizing skeletal health in early life has potential effects on bone health later in childhood and in adulthood. We aimed to evaluate the existing evidence that maternal exposures during pregnancy have an impact on the subsequent bone health among offspring in young adults aged between 16 and 30 years. The protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42019126890). The search was conducted up to 2 April 2019. We included seven observational prospective cohort studies that examined the association between maternal dietary factors, vitamin D concentration, age, preeclampsia, and smoking with any bone indices among offspring. The results indicated that high concentrations of maternal vitamin D; low fat intake; and high intakes of calcium, phosphorus, and magnesium may increase the bone mineral density in offspring at age 16. Evidence also suggests that the offspring of younger mothers may have a higher peak bone mass. It remains inconclusive whether there is an influence of preeclampsia or maternal smoking on bone health among young adults. Our assessment of internal validity warrants a cautious interpretation of these results, as all of the included studies were judged to have serious risks of bias. High-quality studies assessing whether prenatal prognostic factors are associated with bone health in young adults are needed.

The Impact of Maternal High-Fat Diet on Bone Microarchitecture in Offspring

“…Several studies have specifically addressed whether maternal obesity or maternal HFD during pregnancy affects bone development in offspring, both in utero and post-partum (33).…”

Maternal Diet, Nutritional Status, and Birth-Related Factors Influencing Offspring’s Bone Mineral Density: A Narrative Review of Observational, Cohort, and Randomized Controlled Trials

“…It is worth mentioning that according to some authors maternal smoking affects birth weight or weight gain later in life, and thus has an adverse indirect effect on bone parameters in offspring [65,66]. Moreover, a similar assumption was made in a recent systematic review by Jensen et al [29].…”

“…As mentioned in the study by Diogenes et al [16], infant BMD may decrease in the first months of life, which is a physiological effect, therefore the influence of maternal vitamin D supplementation in pregnancy might not be significant in the youngest children. In addition, this dependence may be supported by a recent systematic review, which reported that maternal 25(OH)D status may increase BMD in young adult offspring [29]. Another explanation is that the groups of mothers in the studies were not equal in terms of vitamin D status at the moment of enrollment to the trials.…”

“…However, it remains inconclusive whether and to what extent those factors may influence bone mineral density in children and if those changes are still apparent later in life. In addition, a recent systematic review [ 29 ] has raised a similar subject, but the authors included studies assessing BMD in young adults aged 16–30 years, so less is known about those associations in younger population. Moreover, the results of foregoing studies have been less consistent.…”

The relationship between healthy lifestyles and bone health

“…[ 22 ] A recent Bayesian network meta-analysis and meta-regression demonstrated that vitamin D supplementation does not affect risk of fractures, while supplementation with vitamin D together with calcium may have a beneficial effect for fracture prevention. [ 23 ] High concentrations of maternal vitamin D may increase the bone mineral density for adults, [ 24 ] the vitamin D dose needs to be further confirmed. Vegetables and fruits are considered major natural sources of vitamins, which may be beneficial for bone health.…”