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Associations Between Body Composition and Bone Health in Children and Adolescents: A Systematic Review

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Abstract

More clarification on the associations between children’s and adolescents’ lean and fat mass (LM and FM) on the one hand and their bone health on the other hand is needed, given the rising prevalence of overweight and obesity in this population. This systematic literature review aimed to describe the current evidence on these associations. Data sources were Medline/PubMed, EMBASE, CINAHL and The Cochrane Library (up to November 2014). Search items included LM, FM, children and adolescents (0–18 years), bone health measured with dual-energy X-ray absorptiometry and peripheral quantitative computed tomography (pQCT) and search items concerning study design: observational and longitudinal studies. The study populations were healthy children and adolescents including obese children. Children with other diseases and clinical series of study subjects were excluded. Based on the studies included in this review (n = 19), there is a consensus that the contribution of LM to the variance of the different bone parameters is larger than the contribution of FM and that an increase in LM is associated with an increase in bone parameters. Most of the studies indicated that the increase in bone parameters seen in overweight and obese children and adolescents is due to an increase in LM and not to greater FM. The results on the association between body fat and bone parameters were contradictory and depended on children’s age and sex. Still more data from studies with a longitudinal study design using (high resolution) pQCT and a representative sample are needed to get further insight in the associations between body fat and bone parameters in children, specifically concerning differences in sex, skeletal site and fat depots.

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Abbreviations

aBMD:

Areal bone mineral density

BA:

Bone area

BF LM:

Bone-free lean mass

BF %:

Body fat percentage

BMC:

Bone mineral content

BSI:

Bone strength index

C:

Controls

Cort vBMD:

Cortical volumetric bone mineral density

CortA:

Cortical area

CortC:

Cortical bone mineral content

CortTh:

Cortical thickness

DXA:

Dual-energy X-ray absorptiometry

FM:

Fat mass

FN:

Femoral neck

FS:

Femoral shaft

HRpQCT:

High-resolution pQCT

HW:

Healthy weight

L2–L4:

Lumbar segment 2–4

LM:

Lean mass

Ln:

Natural logarithm

LS:

Lumbar spine

NA:

Not applicable

NS:

Not significant

OW:

Overweight

Pcir:

Periosteal circumference

pQCT:

Peripheral quantitative computed tomography

pSSI:

Polar strength strain index

QCT:

Quantitative computed tomography

RG:

Rhythmic gymnasts

SSI:

Strength strain index

TA:

Total area

T BMC:

Total bone mineral content

TH:

Total hip

T vBMD:

Total volumetric bone mineral density

TR:

Trochanter

Trab vBMD:

Trabecular volumetric bone mineral density

TrabC:

Trabecular bone mineral content

TrabTh:

Trabecular thickness

vBMD:

Volumetric bone mineral density

WB:

Whole body

WB aBMD:

Whole-body areal bone mineral density

WB BMC:

Whole-body bone mineral content

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Acknowledgments

Dr. Sioen is financially supported by the Research Foundation—Flanders (Grant No: 1.2.683.14.N.00). Dr. Jiménez-Pavón was supported by a grant from the Spanish Ministry of Science and Innovation—MINECO (Grant No: RYC-2014-16938).

Conflict of interest

Isabelle Sioen, Elisa Lust, Stefaan De Henauw, Luis A Moreno and David Jimenez-Pavon declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Public Health, Ghent University, UZ 4K3, De Pintelaan 185, 9000, Ghent, Belgium

    I. Sioen, E. Lust & S. De Henauw

  2. Research Foundation Flanders, Brussels, Belgium

    I. Sioen

  3. GENUD (Growth, Exercise, Nutrition and Development) Research Group, Facultad de Ciencias de la Salud, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Universidad de Zaragoza, Saragossa, Spain

    L. A. Moreno

  4. GALENO Research Group, Department of Physical Education, University of Cádiz, Puerto Real, Cádiz, Spain

    D. Jiménez-Pavón

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Correspondence to I. Sioen.

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Sioen, I., Lust, E., De Henauw, S. et al. Associations Between Body Composition and Bone Health in Children and Adolescents: A Systematic Review. Calcif Tissue Int 99, 557–577 (2016). https://doi.org/10.1007/s00223-016-0183-x

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