Skip to main content
Log in

Bone status of young adults with periodic avoidance of dairy products since childhood

  • Original Article
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Proper nutrition throughout childhood and adolescence is crucial for normal bone development. We investigated whether adherence to Christian Orthodox Church fasting is characterized by periodic avoidance of animal foods (including dairy products), since childhood affects stature or bone health in young adults. This cross-sectional study included 200 healthy men and women, aged 18–35, of whom 100 had been following religious fasting for a median of 14 years, starting at the age of 10, and 100 were non-fasters. Measurements included body height; bone mineral density and bone mineral content at the lumbar spine, right hip, left hip, right femoral neck, and left femoral neck; prevalence of bone fracture; serum biochemical parameters; food and nutrient intake; and physical activity and smoking habits. Fasters did not differ from non-fasters in anthropometric measures (including height), bone mineral density and content, or prevalence of low bone mineral density at any of the five sites measured; number of bone fractures; or serum calcium or 25-hydroxyvitamin D concentrations (P > 0.05). Fasters had lower daily calcium and protein intakes, as well as lower dairy consumption than non-fasters. Groups did not differ in physical activity, and fasters smoked less than non-fasters.

Conclusion: Despite lower calcium intake and lower dairy product consumption, individuals adhering to religious fasting since childhood did not differ in height, bone mineral density and content, or prevalence of fractures from controls. Therefore, periodic abstention from dairy and, generally, animal products since childhood does not seem to compromise bone health in young adults.

What is Known:

Bone health is an important determinant of overall health and longevity.

Proper nutrition throughout childhood and adolescence is crucial for normal bone development.

Adequate intake of dairy products is considered important due to their high calcium content.

What is New:

Young adults with limited calcium intake and dairy product consumption, due to adherence to the fasting rules of the Christian Orthodox Church since childhood, do not differ in height or indices of bone health from non-fasting controls.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

BMC:

Bone mineral content

BMD:

Bone mineral density

COC:

Christian Orthodox Church

References

  1. Golden NH, Abrams SA, Committee on Nutrition (2014) Optimizing bone health in children and adolescents. Pediatrics 134(4):e1229–e1243. https://doi.org/10.1542/peds.2014-2173

    Article  PubMed  Google Scholar 

  2. Rønne M, Heidemann M, Schou A, Laursen JO, Bojesen AB, Lylloff L, Husby S, Wedderkopp N, Mølgaard C (2018) Tracking of bone mass from childhood to puberty: a 7-year follow-up. The CHAMPS study DK. Osteoporos Int 29(8):1843–1852. https://doi.org/10.1007/s00198-018-4556-z

    Article  PubMed  Google Scholar 

  3. Wren TAL, Kalkwarf HJ, Zemel BS et al (2014) Longitudinal tracking of dual-energy X-ray absorptiometry bone measures over 6 years in children and adolescents: persistence of low bone mass to maturity. J Pediatr 164(6):1280–1285.e2. https://doi.org/10.1016/j.jpeds.2013.12.040

    Article  PubMed  PubMed Central  Google Scholar 

  4. Yang Y, Wu F, Winzenberg T, Jones G (2018) Tracking of areal bone mineral density from age eight to young adulthood and factors associated with deviation from tracking: a 17-year prospective cohort study. J Bone Miner Res 33(5):832–839. https://doi.org/10.1002/jbmr.3361

    Article  CAS  PubMed  Google Scholar 

  5. Weaver CM, Gordon CM, Janz KF, Kalkwarf HJ, Lappe JM, Lewis R, O'Karma M, Wallace TC, Zemel BS (2016) The National Osteoporosis Foundation’s position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations. Osteoporos Int 27(4):1281–1386. https://doi.org/10.1007/s00198-015-3440-3

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Rodopaios NE, Mougios V, Konstantinidou A, Iosifidis S, Koulouri AA, Vasara E, Papadopoulou SK, Skepastianos P, Dermitzakis E, Hassapidou M, Kafatos AG (2019) Effect of periodic abstinence from dairy products for approximately half of the year on bone health in adults following the Christian Orthodox Church fasting rules for decades. Arch Osteoporos 14(1):68–68. https://doi.org/10.1007/s11657-019-0625-y

    Article  PubMed  Google Scholar 

  7. Sarri KO, Linardakis MK, Bervanaki FN, Tzanakis NE, Kafatos AG (2004) Greek Orthodox fasting rituals: a hidden characteristic of the Mediterranean diet of Crete. Br J Nutr 92:277–284. https://doi.org/10.1079/BJN20041197

    Article  CAS  PubMed  Google Scholar 

  8. Lewiecki EM, Gordon CM, Baim S, Leonard MB, Bishop NJ, Bianchi ML, Kalkwarf HJ, Langman CB, Plotkin H, Rauch F, Zemel BS, Binkley N, Bilezikian JP, Kendler DL, Hans DB, Silverman S (2008) International Society for Clinical Densitometry 2007 adult and pediatric official positions. Bone 43(6):1115–1121. https://doi.org/10.1016/j.bone.2008.08.106

    Article  PubMed  Google Scholar 

  9. Panagiotakos DB, Pitsavos C, Stefanidis C (2006) Dietary patterns: a Mediterranean diet score and its relation to clinical and biological markers of cardiovascular disease risk. Nutr Metab Cardiovasc Dis 16:559–568. https://doi.org/10.1016/j.numecd.2005.08.006

    Article  PubMed  Google Scholar 

  10. Xu J, Lombardi G, Jiao W, Banfi G (2016) Effects of exercise on bone status in female subjects, from young girls to postmenopausal women: an overview of systematic reviews and meta-analyses. Sports Med 46(8):1165–1182. https://doi.org/10.1007/s40279-016-0494-0

    Article  PubMed  Google Scholar 

  11. Weaver CM (2014) How sound is the science behind the dietary recommendations for dairy? Am J Clin Nutr 99(5):1217S–1222S. https://doi.org/10.3945/ajcn.113.073007

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Bian S, Hu J, Zhang K, Wang Y, Yu M, Ma J (2018) Dairy product consumption and risk of hip fracture: a systematic review and meta-analysis. BMC Public Health 18:165. https://doi.org/10.1186/s12889-018-5041-5

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Biver E, Durosier-Izart C, Merminod F, Chevalley T, van Rietbergen B, Ferrari SL, Rizzoli R (2018) Fermented dairy products consumption is associated with attenuated cortical bone loss independently of total calcium, protein, and energy intakes in healthy postmenopausal women. Osteoporos Int 29:1771–1782

    Article  CAS  PubMed  Google Scholar 

  14. Feskanich D, Meyer HE, Fung TT, A B-FH, C WW (2018) Milk and other dairy foods and risk of hip fracture in men and women. Osteoporos Int 29:385-396.

  15. Dolan E, Sale C (2019) Protein and bone health across the lifespan. Proc Nutr Soc 78:45–55. https://doi.org/10.1017/S0029665118001180

    Article  CAS  PubMed  Google Scholar 

  16. Houillier P, Froissart M, Maruani G, Blanchard A (2006) What serum calcium can tell us and what it can’t. Nephrol Dial Transplant 21(1):29–32. https://doi.org/10.1093/ndt/gfi268

    Article  CAS  PubMed  Google Scholar 

  17. Gaddini GW, Turner RT, Grant KA, Iwaniec UT (2016) Alcohol: a simple nutrient with complex actions on bone in the adult skeleton. Alcohol Clin Exp Res 40(4):657–671. https://doi.org/10.1111/acer.13000

    Article  PubMed  PubMed Central  Google Scholar 

  18. Strozyk D, Gress TM, Breitling LP (2018) Smoking and bone mineral density: comprehensive analyses of the third National Health and Nutrition Examination Survey (NHANES III). Arch Osteoporos 13(1):16. https://doi.org/10.1007/s11657-018-0426-8

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We are grateful to Metropolitan Varnavas of Neapolis and Stavroupolis, Thessaloniki; Metropolitan Georgios of Kitros, Katerini, and Platamon; Hieromonk Father Luke Kipouros of Holy Trinity Monastery, Panorama, Thessaloniki; Nun, Melani Chatzipatera, Mother Superior of Assumption of Virgin Monastery, Panorama, Thessaloniki; Professor Emeritus of the School of Theology, Aristotle University of Thessaloniki, Dimitrios Tselegidis; Archimandrite Nikodemos Skrettas-Plexidas; and Archpriest Athanasios Gikas; Professors of the School of Pastoral and Social Theology, Aristotle University of Thessaloniki, for their help in collecting the study sample.

Author information

Authors and Affiliations

Authors

Contributions

N. Rodopaios conceptualized and designed the study, collected data, analyzed data, drafted the initial manuscript, and critically reviewed and revised the manuscript.

V. Mougios analyzed data, drafted the initial manuscript, and critically reviewed and revised the manuscript.

A-A Koulouri designed the study and collected data, and critically revised the manuscript.

E. Vasara collected and analyzed data, and critically revised the manuscript.

S. Papadopoulou and Dr Skepastianos collected data, and critically revised the manuscript.

E. Dermitzakis and Hassapidou provided essential materials data, and critically revised the manuscript.

A Kafatos conceptualized and designed the study, coordinated and supervised data collection, reviewed and critically revised the manuscript.

All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Nikolaos E. Rodopaios.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Additional information

Communicated by Mario Bianchetti

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rodopaios, N.E., Mougios, V., Koulouri, AA. et al. Bone status of young adults with periodic avoidance of dairy products since childhood. Eur J Pediatr 179, 645–651 (2020). https://doi.org/10.1007/s00431-019-03542-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00431-019-03542-1

Keywords

Navigation