Osteoporosis International

, Volume 16, Issue 9, pp 1057–1064 | Cite as

Improvement of nutrition stimulates bone mineral gain in Japanese school children and adolescents

Original Article


Calcium supplementation could accelerate bone mineral accrual, but the effect of other dietary factors in children is unclear. The aim of this study was to determine associations of changes in diet with bone accrual in Japanese children. All female (n=262) and male (n=286) school children aged 10–15 years living in a small town were recruited. We measured bone status at the os calcis using quantitative ultrasound (QUS) and assessed diet and other lifestyle factors using questionnaires annually for 5 years. The greatest increase in QUS values was observed between ages 11–13 years in boys and girls and peak bone status was attained typically by age 14–15 years (~2 years since menarche) in girls and 1–2 years later in boys. Initial bone status adjusted by height and weight in 10-year-old or 11-year-old children was associated positively with intake of small fish and dairy products, and negatively with age of menarche in girls, and negatively with preference for meat in boys. Annual increase in QUS bone status in girls age 10 years or 11 years was associated positively with increased intake of fish, fruit, vegetables, soybeans, and intake of milk products and negatively with preference for meat. Annual increase in QUS bone status in boys was associated positively with increased height and weight, increased intake of small fish and vegetables, intake of dairy products, and awareness of bone measurement. Thus, a dietary change incorporating an increased intake of fish, fruit, vegetables, and soy products could lead to higher bone QUS values in children.


Calcium intake Children and adolescents Fish intake Fruit and vegetables Peak bone mass Quantitative ultrasound 


  1. 1.
    Kanis JA, Melton LJ 3rd, Christiansen C, Johnston CC, Khaltaev N (1994) The diagnosis of osteoporosis. J Bone Miner Res 9:1137–1141PubMedGoogle Scholar
  2. 2.
    Matkovic V (1992) Calcium and peak bone mass. J Intern Med 231:151–160Google Scholar
  3. 3.
    Weaver CM, Peacock M, Johnston CC Jr (1999) Adolescent nutrition in the prevention of postmenopausal osteoporosis. J Clin Endocrinol Metab 84:1839–1843CrossRefGoogle Scholar
  4. 4.
    Slemenda CW, Hui SL, Longcope C, Wellman H, Johnston CC Jr (1990) Predictors of bone mass in perimenopausal women. A prospective study of clinical date using photon absorptiometry. Ann Intern Med 112:96–101Google Scholar
  5. 5.
    Pocock NA, Eisman JA, Hopper JL, Yeates MG, Sambrook PN, Eberl S (1987) Genetic determinants of bone mass in adults: a twin study. J Clin Invest 80:706–710PubMedGoogle Scholar
  6. 6.
    Johnston CC Jr, Miller JZ, Slemenda CW, Reister TK, Hui S, Christian JC, Peacock M (1992) Calcium supplementation and increases in bone mineral density in children. N Engl J Med 327:82–87PubMedGoogle Scholar
  7. 7.
    Lloyd T, Andon MB, Rollings N, Martel JK, Landis JR, Demers LM, et al (1993) Calcium supplementation and bone mineral density in adolescent girls. JAMA 270:841–844CrossRefPubMedGoogle Scholar
  8. 8.
    Bonjour JP, Carrié AL, Ferrari S, Clavien H, Slosman D, Theintz G, Rizzoli R (1997) Calcium-enriched foods and bone mass growth in prepubertal girls: a randomized, double-blind, placebo-controlled trial. J Clin Invest 99:1287–1294PubMedGoogle Scholar
  9. 9.
    Heaney RP (2000) Calcium, dairy products and osteoporosis. J Am Coll Nutr 19:83S–99SPubMedGoogle Scholar
  10. 10.
    Food and Nutrition Board, Institute of Medicine (1997) Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. National Academy, Washington D.C.Google Scholar
  11. 11.
    The study circle for health and nutrition information (2002) The national nutrition survey in Japan, 2000: Ministry of Health, Labour and Welfare, Japan. Daiichishuppan, JapanGoogle Scholar
  12. 12.
    Schwartz AV, Kelsey JL, Maggi S, Tuttleman M, Ho SH, Jonsson PV, et al (1999) International variation in the incidence of hip fracture: cross-sectional project on osteoporosis for the WHO program for Research on Aging. Osteoporosis Int 9:242–253CrossRefGoogle Scholar
  13. 13.
    Chan GM, Hoffman K, McMurry M (1995) Effects of dairy products on bone and body composition in pubertal girls. J Pediatr 126:551–556PubMedGoogle Scholar
  14. 14.
    Cadogan J, Eastell R, Jones N, Barker ME (1997) Milk intake and bone mineral acquisition in adolescent girls: randomized, controlled intervention trial. BMJ 315:1255–1260PubMedGoogle Scholar
  15. 15.
    Renner E, Hermes M, Stracke H (1998) Bone mineral density of adolescents as affected by calcium intake through milk and milk products. Int Dairy J 8:759–764CrossRefGoogle Scholar
  16. 16.
    Resources Council, Science and Technology Agency, Japan (2000) Standard Tables of Food Composition in Japan, 5th revised edn. JapanGoogle Scholar
  17. 17.
    Bauer DC, Gluer CC, Cauley JA, Vogt TM, Ensrud KE, Genant HK, Black DM (1997) Broadband ultrasound attenuation predicts fractures strongly and independently of densitometry in order women. Arch Intern Med 157:629–634CrossRefPubMedGoogle Scholar
  18. 18.
    Hans D, Dargent-Molina P, Schotto AM, Sebert JL, Cormier C, Kotzki PO, et al (1996) Ultrasonographic heel measurements to predict hip fracture in elderly women: the EPIDOS prospective study. Lancet 348:511–514CrossRefPubMedGoogle Scholar
  19. 19.
    Faulkner KG, McClung MR, Coleman LJ, Kingston-Sandahl E (1994) Quantitative ultrasound of the heel: correlation with densitometric measurements at different skeletal sites. Osteoporosis Int 4:42–47Google Scholar
  20. 20.
    Bailey DA, Martin AD, McKay HA, Whiting S, Mirwald R (2000) Calcium accretion in girls and boys during puberty: a longitudinal analysis. J Bone Miner Res 15:2245–2250PubMedGoogle Scholar
  21. 21.
    Theintz G, Buchs B, Rizzoli R, Slosman D, Clavien H, Sizonenko PC, Bonjour JP (1992) Longitudinal monitoring of bone mass accumulation in healthy adolescents: evidence for a marked reduction after 16 years of age at the levels of lumbar spine and femoral neck in female subjects. J Clin Endocrinol Metab 75:1060–1065Google Scholar
  22. 22.
    Hirota T, Nara M, Ohguri M, Manago E, Hirota K (1992) Effect of diet and lifestyle on bone mass in Asian young women. Am J Clin Nutr 55:1168–1173Google Scholar
  23. 23.
    Kalkwarf HJ, Khoury JC, Lanphear BP (2003) Milk intake during childhood and adolescence, adult bone density, and osteoporotic fractures in US women. Am J Clin Nutr 77:257–265PubMedGoogle Scholar
  24. 24.
    Teegarden D, Lyle RM, Proulx WR, Johnston CC, Waver CM (1999) Previous milk consumption is associated with greater bone density in young women. Am J Clin Nutr 69:1014–1017PubMedGoogle Scholar
  25. 25.
    Hirota T, Hara M, Kitoh Y, Shirokawa N, Matsuda M, Hosokawa K, Hirota K (1998) Change of lifestyle caused by health education improves ultrasound density of os calcis in osteopenic adolescents. Bone 23:S290Google Scholar
  26. 26.
    Kruger MC, Coetzer H, de Winter R, Gericke G, van Papendorp DH (1998) Calcium, gamma-linolenic acid eicosapentaenoic acid supplementation in senile osteoporosis. Aging (Milano) 10:385–394Google Scholar
  27. 27.
    Debra B, Kettler MS, DC (2001) Can manipulation of the ratios of essential fatty acids slow the rapid rate of postmenopausal bone loss? Alt Med Rev 6:61–77Google Scholar
  28. 28.
    Albertazzi P, Coupland K (2002) Polyunsaturated fatty acids. Is there a role in postmenopausal osteoporosis prevention? Maturitas 42:13–22CrossRefGoogle Scholar
  29. 29.
    Hirota T, Kusu T, Yamanishi S, Hirota K (2000) Traditional living style on Tatami mat significantly increased bone mass in adolescent girls: 5-year follow-up study in a small village. J Bone Miner Res 15:S540Google Scholar
  30. 30.
    Tucker KL, Hannan MT, Chen H, Cupples A, Wilson PWF, Kiel DP (1999) Potassium, magnesium, and fruit and vegetable intakes are associated with greater bone mineral density in elderly men and women. Am J Clin Nutr 69:727–736PubMedGoogle Scholar
  31. 31.
    Hall SL, Greendale GA (1998) The relation of dietary vitamin C intake to bone mineral density: results from the PEPI study. Calcif Tissue Int 63:183–189CrossRefGoogle Scholar
  32. 32.
    Tucker KL, Hannan MT, Kiel DP (2001) The acid-base hypothesis: diet and bone in the Framingham Osteoporosis Study. Eur J Nutr 40:231–237PubMedGoogle Scholar
  33. 33.
    New SA, MacDonald HM, Campbell MK, Martin JC, Garton MJ, Robins SP, Reid DM (2004) Lower estimates of net endogenous noncarbonic acid production are positively associated with indexes of bone health in premenopausal and perimenopausal women. Am J Clin Nutr 79:131–138PubMedGoogle Scholar
  34. 34.
    Frost ML, Blake GM, Fogelman I (2001) Quantitative ultrasound and bone mineral density are equally strongly associated with risk factors for osteoporosis. J Bone Miner Res 16:406–416PubMedGoogle Scholar
  35. 35.
    Nicholson PHF, Muller R, Cheng XG, Ruegsegger P, Van Der Perre G, Dequeker J, Boonen S (2001) Quantitative ultrasound and trabecular architecture in the human calcaneus. J Bone Miner Res 16:1886–1892Google Scholar
  36. 36.
    Howard GM, Nguyen TV, Harris M, Kelly PJ, Eisman JA (1998) Genetic and environmental contributions to the association between quantitative ultrasound and bone mineral density measurements: a twin study. J Bone Miner Res 13:1318–1327PubMedGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2005

Authors and Affiliations

  1. 1.Research LaboratoryTsuji Academy of NutritionOsaka-cityJapan
  2. 2.Department of Obstetrics and GynecologyNissay HospitalOsaka-cityJapan

Personalised recommendations