scholarly journals Influence of Mediterranean Diet Adherence and Physical Activity on Bone Health in Celiac Children on a Gluten-Free Diet

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1636
Author(s):  
Teresa Nestares ◽  
Rafael Martín-Masot ◽  
Carlos de Teresa ◽  
Rocío Bonillo ◽  
José Maldonado ◽  
...  

We aimed to assess the influence of the Mediterranean Diet adherence and physical activity (PA) on body composition, with a particular focus on bone health, in young patients with celiac disease (CD). The CD group (n = 59) included children with CD with a long (>18 months, n = 41) or recent (<18 months, n = 18) adherence to a gluten-free diet (GFD). The non-celiac group (n = 40) included non-celiac children. After adjusting for potential confounders, the CD group showed lower body weight (p = 0.034), lean mass (p = 0.003), bone mineral content (p = 0.006), and bone Z-score (p = 0.036) than non-celiac children, even when the model was further adjusted for adherence to a GFD for at least 18 months. Among CD children, spending greater time in vigorous physical activity was associated with higher lean mass (p = 0.020) and bone mineral density with evidence of statistical significance (p = 0.078) regardless of the time they followed a GFD. In addition, a greater Mediterranean Diet adherence was associated with a higher bone Z-score (p = 0.020). Moreover, lean mass was strongly associated with bone mineral density and independently explained 12% of its variability (p < 0.001). These findings suggest the importance of correctly monitoring lifestyle in children with CD regarding dietary habits and PA levels to improve lean mass and, consequently, bone quality in this population.

Author(s):  
Andrea T. Duran ◽  
Kathleen S. Wilson ◽  
Diobel M. Castner ◽  
Jared M. Tucker ◽  
Daniela A. Rubin

AbstractThe aim of the study was to determine if physical activity (PA) is associated with bone health in children with Prader-Willi syndrome (PWS).Participants included 23 children with PWS (age: 11.0±2.0 years). PA, measured by accelerometry, was categorized into light, moderate, vigorous and moderate plus vigorous intensities. Hip, total body minus the head (body), bone mineral content (BMC), bone mineral density (BMD) and BMD z-score (BMDModerate PA and select covariates explained the most variance in hip BMC (84.0%), BMD (61.3%) and BMDPA of at least moderate intensity appears important for BMC and BMD in children with PWS.


2020 ◽  
Author(s):  
Chung Yuan Chang ◽  
Kanimolli Arasu ◽  
Soon Yee Wong ◽  
Shu Hwa Ong ◽  
Wai Yew Yang ◽  
...  

Abstract Background: Modifiable lifestyle factors and body composition can affect the attainment of peak bone mass during childhood. This study performed a cross-sectional analysis of the determinants of bone health among pre-adolescent Malaysian children with habitually low calcium intakes and vitamin D status in Kuala Lumpur (PREBONE-Kids Study). Methods: Body composition, bone mineral density (BMD), and bone mineral content (BMC) at the lumbar spine (LS) and total body (TB) were assessed using dual-energy X-ray absorptiometry (DXA). Calcium intake was assessed using 1-week diet history, MET (metabolic equivalent of task) score using cPAQ questionnaire, and serum 25(OH) vitamin D using LC-MS/MS. Results: The mean calcium intake was 348.8 ± 180.1 mg/day and mean serum 25-OH vitamin D level was 43.9 ± 14.5nmol/L. In boys, lean mass (LM) was significantly associated with LSBMC (β = 0.539, p<0.001), LSBMD (β=0.607, p<0.001), TBBMC (β=0.675, p<0.001) and TBBMD (β= 0.481, p<0.01). Height was significantly associated with LSBMC (β =0.346, p<0.001) and TBBMC (β =0.282, p<0.001) while fat mass (FM) (β=0.261, p=0.034) and MET score (β =0.163, p=0.026) were significant predictors of TBBMD. Among girls, LM was significantly associated with LSBMC (β = 0.620, p<0.001), LSBMD (β=0.700, p<0.001), TBBMC (β=0.542, p<0.001) and TBBMD (β= 0.747, p<0.001). Calcium intake was a significant predictor of LSBMC (β=0.102, p=0.034), TBBMC (β=0.122, p<0.001) and TBBMD (β=0.196, p=0.002) in girls. Lean mass (LM) was weakly correlated with MET scores (r = 0.205, p = 0.001) but not protein (r = 0.055, p = 0.393) or energy intake (r = 0.101, p = 0.117). MET score (β = 0.207, p = 0.043) was a significant predictor of LM in boys but no factor was found to predict LM in girls. Conclusion: LM is the major determinant of BMC and BMD among pre-adolescent Malaysian children and physical activity is a significant predictor of LM in boys. Encouraging physical activity, calcium intake and optimum diets that build lean body mass should be the focus for developing public health guidance to ensure optimal bone health status during rapid growth.


2011 ◽  
Vol 43 ◽  
pp. S204-S205
Author(s):  
V. Passananti ◽  
A. Santonicola ◽  
P. Andreozzi ◽  
A. Ranaudo ◽  
C. Ciacci

2020 ◽  
Vol 105 (4) ◽  
pp. e1397-e1407 ◽  
Author(s):  
Selveta S van Santen ◽  
Daniel S Olsson ◽  
Marry M van den Heuvel-Eibrink ◽  
Mark Wijnen ◽  
Casper Hammarstrand ◽  
...  

Abstract Context Pituitary hormonal deficiencies in patients with craniopharyngioma may impair their bone health. Objective To investigate bone health in patients with craniopharyngioma. Design Retrospective cross-sectional study. Setting Dutch and Swedish referral centers. Patients Patients with craniopharyngioma (n = 177) with available data on bone health after a median follow-up of 16 years (range, 1-62) were included (106 [60%] Dutch, 93 [53%] male, 84 [48%] childhood-onset disease). Main outcome measures Fractures, dual X-ray absorptiometry-derived bone mineral density (BMD), and final height were evaluated. Low BMD was defined as T- or Z-score ≤-1 and very low BMD as ≤-2.5 or ≤-2.0, respectively. Results Fractures occurred in 31 patients (18%) and were more frequent in men than in women (26% vs. 8%, P = .002). Mean BMD was normal (Z-score total body 0.1 [range, -4.1 to 3.5]) but T- or Z-score ≤-1 occurred in 47 (50%) patients and T-score ≤-2.5 or Z-score ≤-2.0 in 22 (24%) patients. Men received less often treatment for low BMD than women (7% vs. 18%, P = .02). Female sex (OR 0.3, P = .004) and surgery (odds ratio [OR], 0.2; P = .01) were both independent protective factors for fractures, whereas antiepileptic medication was a risk factor (OR, 3.6; P = .03), whereas T-score ≤-2.5 or Z-score ≤-2.0 was not (OR, 2.1; P = .21). Mean final height was normal and did not differ between men and women, or adulthood and childhood-onset patients. Conclusions Men with craniopharyngioma are at higher risk than women for fractures. In patients with craniopharyngioma, a very low BMD (T-score ≤-2.5 or Z-score ≤-2.0) seems not to be a good predictor for fracture risk.


Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3890-3890
Author(s):  
Ellen Fung ◽  
Yan Xu ◽  
Janet Kwiatkowski ◽  
Sylvia Titi Singer ◽  
Ashutosh Lal ◽  
...  

Abstract Optimal nutritional status is imperative for achieving the genetic potential for growth and development in children as well as for robust immune function and bone health in adults. Patients with thalassemia (Thal) are known to have abnormal growth, altered development and immune function and deficits in bone mass. For children, weight and height is commonly used to assess overall nutritional status, whereas for adults, body composition is a gross marker of an individual’s overall nutritional health. Nutritional status and body composition has not been explored in patients with Thal. To examine this, we have assessed body composition (fat, lean) and bone density by dual energy x-ray absorptiometry (DXA, Hologic Delphi A) in 370 subjects enrolled in a cross-sectional study of the Thal Clinical Research Network (TCRN), a North American collaborative research group. In addition to DXA, weight and height were measured, medical history obtained and a brief calcium food frequency and physical activity questionnaire completed. The total sample was divided into 2 groups: (TxThal) 257 transfused thalassemia major and E-beta thal patients (23.7 ± 11 yr, 131 male), and (NTxThal) 113 never or minimally transfused patients with other thalassemia syndromes (21.3 ± 13 yr, 50 male). Body mass index (BMI) was calculated (kg/m2) and cutoffs determined for children (<17=underweight, ≥30 obese) and adults (<18.5=underweight, ≥30 obese). As expected there was a high correlation between BMI and fat and lean mass by DXA (r=0.7 to 0.86, p<0.001). 6.2% of adults and 39.3% of children were classified as underweight by BMI and nearly 1/3 of children with Thal had abnormally low percentage body fat; while only 3.4% of adults and 2.2% of children were considered obese. Compared to median data from NHANES, adult patients with Thal are much leaner (BMI: 22.8±0.4) compared to contemporary adult Americans (28.1±0.2, p<0.0001). TxThal had more total body fat mass (14.3 vs 11.4 g, p<0.0001) and percentage body fat (27.3% vs. 24.9% p=0.007) compared to NTxThal. As has been observed in epidemiological studies of healthy subjects, calcium intake was inversely related to fat mass (p=0.009) as well as lean mass (p=0.007) after controlling for the effects of age, gender and diagnosis. Current physical activity level was a strong predictor of reduced body fat (p=0.007), whereas hemoglobin level was positively related to lean mass (p=0.001). Moreover, body fat was a positive predictor for height Z-score (p<0.0001). Low bone mass (BMD Z-Score <−2.0) was found in 50% of subjects, and BMD Z-score was moderately correlated with height Z-score (p<0.0001) and weight Z-score (p<0.0001). Though the majority of patients with Thal were classified as having a healthy body composition with very few obese patients, nearly 40% of the children in this sample were underweight. NTxThal appear at particular risk for underweight. These results suggest that an adequate amount of body fat is necessary for optimal growth and bone health in patients with Thal, and that calcium intake is associated with optimal body composition. These preliminary findings support the need for more careful study of nutritional status and its relationship to overall health in patients with thalassemia.


2017 ◽  
Vol 26 (5) ◽  
pp. 461-466 ◽  
Author(s):  
Jing Xiang ◽  
Yongjie Chen ◽  
Yupeng Wang ◽  
Shaofei Su ◽  
Xinyu Wang ◽  
...  

2019 ◽  
Author(s):  
Celia L Gregson ◽  
April Hartley ◽  
Edith Majonga ◽  
Grace Mchugh ◽  
Nicola Crabtree ◽  
...  

AbstractBackgroundPerinatally-acquired HIV infection commonly causes stunting in children, but how this affects bone and muscle development is unclear. We investigated differences in bone and muscle mass and muscle function between children with HIV (CWH) and uninfected children.SettingCross-sectional study of CWH (6–16 years) receiving antiretroviral therapy (ART) for >6 months and children in the same age-group testing HIV-negative at primary health clinics in Zimbabwe.MethodsFrom Dual-energy X-ray Absorptiometry (DXA) we calculated total-body less-head (TBLH) Bone Mineral Content (BMC) for lean mass adjusted-for-height (TBLH-BMCLBM) Z-scores, and lumbar spine (LS) Bone Mineral Apparent Density (BMAD) Z-scores.ResultsThe 97 CWH were older (mean age 12.7 vs. 10.0 years) and therefore taller (mean height 142cm vs. 134cm) than those 77 uninfected. However, stunting (height-for-age Z-score≤-2) was more prevalent in CWH (35% vs. 5%, p<0.001). Amongst CWH, 15% had low LS-BMAD (Z-score ≤-2) and 13% had low TBLH-BMCLBM, vs. 1% and 3% respectively in those uninfected (both p≤0.02). After age, sex, height and puberty adjustment, LS-BMAD was 0.33 SDs (95%CI −0.01, 0.67; p=0.06) lower in CWH, with no differences in TBLH-BMCLBM, lean mass or grip strength by HIV status. However, there was a strong relationship between age at ART initiation and both LS-BMAD Z-score (r=-0.33, p=0.001) and TBLH-BMCLBM Z-score (r=-0.23, p=0.027); for each year ART initiation was delayed a 0.13 SD reduction in LS-BMAD was seen.ConclusionSize-adjusted low bone density is common in CWH. Delay in initiating ART adversely affects bone density. Findings support immediate ART initiation at HIV diagnosis.


2012 ◽  
Vol 37 (4) ◽  
pp. 706-714 ◽  
Author(s):  
Laura E. Chouinard ◽  
Janis Randall Simpson ◽  
Andrea C. Buchholz

Osteoporosis is a major public health concern in Canada and worldwide. Although much is known about bone health in older adults, little is known about bone health in young, healthy Canadian men and women. The objectives of this research were to describe bone mineral density (BMD) of young, healthy adults living in southern Ontario, Canada, and to identify predictors of BMD in this population. Two-hundred and fifty-eight Caucasian men and women aged 18–33 years completed health and physical activity questionnaires along with a calcium and vitamin D specific food frequency questionnaire. Height and mass were measured. BMD of the total hip, femoral neck, spine, and total body was measured using dual energy X-ray absorptiometry. Among men, body mass, weight-bearing physical activity, and calcium intake were significant predictors of BMD. Among women, body mass, calcium intake, and family history of osteoporosis significantly predicted log BMD. The predictors of BMD in young Canadian men and women identified in this study may inform the development of longitudinal studies designed to examine the influence of lifestyle factors on BMD in young adults.


Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2111
Author(s):  
María-José de Castro ◽  
Paula Sánchez-Pintos ◽  
Nisreem Abdelaziz-Salem ◽  
Rosaura Leis ◽  
María L. Couce

Children with inborn errors of intermediary metabolism (IEiM) must follow special diets that restrict their intake of essential nutrients and may compromise normal growth and development. We evaluated body composition, bone mineral density, physical activity, and food intake in IEiM patients undergoing dietary treatment. IEiM patients (n = 99) aged 5–19 years and healthy age- and sex-matched controls (n = 98) were recruited and underwent dual-energy X-ray absorptiometry to evaluate anthropometric characteristics and body composition. Data on food intake and physical activity were also collected using validated questionnaires. The height z-score was significantly lower in IEiM patients than controls (−0.28 vs. 0.15; p = 0.008), particularly in those with carbohydrate and amino acid metabolism disorders. Significant differences in adiposity were observed between patients and controls for the waist circumference z-score (−0.08 vs. −0.58; p = 0.005), but not the body mass index z-score (0.56 vs. 0.42; p = 0.279). IEiM patients had a significantly lower total bone mineral density (BMD) than controls (0.89 vs. 1.6; p = 0.001) and a higher risk of osteopenia (z-score < −2, 33.3% vs. 20.4%) and osteoporosis (z-score < −2.5, 7.1% vs. 0%), but none presented fractures. There was a significant positive correlation between natural protein intake and BMD. Our results indicate that patients with IEiM undergoing dietary treatment, especially those with amino acid and carbohydrate metabolism disorders, present alterations in body composition, including a reduced height, a tendency towards overweight and obesity, and a reduced BMD.


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