Evidence that birth weight is related to bone mass in later life suggests that the intrauterine environment programs the trajectory of subsequent bone development. To explore this hypothesis, we examined whether maternal diet in pregnancy, as assessed by the maternal food frequency questionnaire (FFQ) completed at 32 weeks gestation, is related to bone mass of the child, as measured by total body DXA carried out at age 9 years in the Avon Longitudinal Study of Parents and Children (ALSPAC). Diet records were linked to DXA scan results for the total body and spine sub-region and pooled between pre- and early pubertal boys and girls ( n =4,451). Regression analysis was carried out between DXA values and dietary factors following adjustment for social and other confounding factors. Maternal magnesium intake was related to total body BMC (β=4.9, 7.4–23.1; g) and BMD (β=4.9, 2.5–7.3; g/cm2 ×103) (standardized regression coefficient with 95% confidence limits; P <0.001). An equivalent relationship was no longer observed after adjusting for the height of the child, to which magnesium intake was also related (β=0.48, 0.20–0.77; cm; P =0.001). Maternal intake of potassium was related to spinal BMC (β=1.8, 0.8–2.9; g) and BMD (β=10.5, 4.9–16.0; g/cm2 ×103) ( P =0.001), which was no longer observed after adjusting for the weight of the child, to which potassium intake was also related (β=0.52, 0.16–0.88, P =0.005; kg). A significant association was also observed between maternal dietary folate intake and spinal BMC adjusted for bone area using a linear regression model (β=0.55, 0.16–0.94; g; P =0.006), which persisted after adjusting for height and weight. Our observation that constituents of maternal diet are related to DXA measures at age 9 is consistent with the hypothesis that the trajectory of bone development in childhood is programmed by early life factors.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
Cooper C, Cawley MID, Bhalla A, et al (1995) Childhood growth, physical activity and peak bone mass in women. J Bone Miner Res 10:940–947
Cooper C, Fall C, Egger P, et al (1997) Growth in infancy and bone mass in later life. Ann Rheum Dis 56:17–21
Gale CE, Martyn CN, Kellingray S, et al (2001) Intrauterine programming of adult body composition. J Clin Enocrinol Metab 86:267–272
Jones G, Dwyer T (2000) Birth weight, birth length, and bone density in prepubertal children: evidence for an association that may be mediated by genetic factors. Calcif Tissue Int 67:304–308
Yarbrough DE, Barrett-Connor E, Morton DJ (2000) Birth weight as a predictor of adult bone mass in postmenopausal women: the Rancho Bernardo Study. Osteoporos Int 11:626–630
Cooper C, Eriksson JG, Fosen T, et al (2001) Maternal height, childhood growth and risk of hip fracture in later life: a longitudinal study. Osteoporos Int 12:623–629
Javaid MK, Cooper C (2002) Prenatal and childhood influences on osteoporosis. Best Pract Res Clin Endocrinol Metab 16:349–367
Barker DJP (1995) Fetal origins of adult disease. Proc R Soc Lond B Biol Sci 262:37–43
Jones G, Riley MD, Dwyer T (2000) Maternal diet during pregnancy is associated with bone mineral density in children: a longitudinal study. Eur J Nutr 54:749–756
Javaid MK, Shore SR, Taylor P, et al (2003) Maternal vitamin D status during late pregnancy and accrual of childhood bone mineral. J Bone Min Res 18 [Suppl 1]:S13
Hernadez CJ, Beaupre GS, Cater DR (2003) A theoretical analysis of the relative influences of peak BMD, age-related bone loss and menopause on the development of osteoporosis. Osteoporos Int 14:843–847
Golding J, Pembrey M, Jones R (2001) ALSPAC—The Avon Longitudinal Study of Parents and Children 1. Study methodology. Paediatr Perinat Epidemiol 15:74–87
Tobias JH, Cook DG, Chambers TJ, et al (1994) A comparison of bone mineral density between Caucasian, Asian and Afro-Caribbean women. Clin Sci (Colch) 87:587–591
Rogers IS, Emmett PM (1998) Diet during pregnancy in a population of pregnant women in South West England. Eur J Clin Nutr 52:246–250
Bachrach LK, Hastie T, Wang M-C, et al (1999) Bone mineral acquisition in healthy Asian, Hispanic, black, and Caucasian youth: a longitudinal study. J Clin Endocrinol Metab 84:4702–4712
Godfrey K, Walker-Bone K, Robinson S, et al (2001) Neonatal bone mass: influence of parental birth weight, maternal smoking, body composition, and activity during pregnancy. J Bone Miner Res 16:1694–1703
Tobias JH, Cooper C (2004) PTH/PTHrP activity and the programming of skeletal development in utero. J Bone Miner Res 19:177–182
McLarnon SJ, Riccardi D (2002) Physiological and pharmacological agonists of the extracellular calcium sensing receptor. Eur J Pharmacol 447:271–278
Kovacs CS, Kronenberg HM (1997) Maternal-fetal calcium and bone metabolism during pregnancy, puerperium, and lactation. Endocr Rev 18:832–872
Lanske B, Karaplis AC, Lee K, et al (1996) PTH/PTHrP receptor in early development and Indian hedgehog-regulated bone growth. Science 273:663-666
Thomas T, Burguera B (2002) Is leptin the link between fat and bone mass? J Bone Min Res 17:1563–1569
McLean RR, Karasik D, Selhub J, et al (2004) Association of a common polymorphism in the methylenetetrahydrofolate reductase (MTHFR) gene with bone phenotypes depends on plasma folate status. J Bone Miner Res 19:410–418.
Cagnacci A, Baldassari F, Rivolta G, et al (2003) Relation of homocysteine, folate, and vitamin B12 to bone mineral density of postmenopausal women. Bone 33:956–959
Villa ML, Marcus R, Ramirez Delay R, et al (1995) Factors contributing to skeletal health of postmenopausal Mexican-American women. J Bone Miner Res 10:1233–1242
Golbahar J, Hamidi A, Aminzadeh MA, et al (2004) Association of plasma folate, plasma total homocysteine, but not methylenetetrahydrofolate reductase C667T polymorphism, with bone mineral density in postmenopausal Iranian women: a cross-sectional study. Bone 35:760–765
This project was funded by a project grant from the Wellcome Trust. We are extremely grateful to all the mothers and children who took part and to the midwives for their cooperation and help in recruitment. The whole ALSPAC Study Team comprises interviewers, computer technicians, laboratory technicians, clerical workers, research scientists, volunteers and managers who continue to make the study possible. This study could not have been undertaken without the financial support of the Medical Research Council, the Wellcome Trust, UK government departments, medical charities and others. The ALSPAC study is part of the WHO-initiated European Longitudinal Study of Pregnancy and Childhood.
This article was written by the authors and the ALSPAC study team.
About this article
Cite this article
Tobias, J.H., Steer, C.D., Emmett, P.M. et al. Bone mass in childhood is related to maternal diet in pregnancy. Osteoporos Int 16, 1731–1741 (2005). https://doi.org/10.1007/s00198-005-1912-6