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Are milk and alternatives and fruit and vegetable intakes during adolescence associated with cortical and trabecular bone structure, density, and strength in adulthood?

Abstract

Summary

We investigated the impact of food group intake during adolescence on bone structure and strength during adulthood. In females, we found a beneficial effect of adolescent milk and alternatives and fruit and vegetable intake on adult radius shaft and distal tibia bone structure, respectively. No association was observed in males.

Introduction

The purpose of this study was to investigate whether adolescents with high intake of milk and alternatives (M&A) or fruit and vegetables (F&V) had better adult bone structure and strength compared to those with low intake levels.

Methods

We analyzed data from 47 males and 69 females enrolled in the Pediatric Bone Mineral Accrual Study (PBMAS 1991–2011), who had one peripheral quantitative computed tomography scan at age 29 ± 2 years. We measured radius and tibia shaft total area (ToA), cortical area (CoA), cortical content (CoC), cortical density, bone strength (SSIp), and muscle area, as well as distal radius and tibia ToA, total density, trabecular area, trabecular content, trabecular density, and bone strength (BSIc). Sequential 24-h recalls were used to assess M&A and F&V intake; participants were grouped for their mean intake during adolescence (low = bottom quartile, moderate = middle quartiles, high = top quartile) and were compared using multivariate analysis of covariance while adjusting for adult height, muscle area, physical activity, energy and calcium intake and adolescent energy intake, and physical activity.

Results

Females with high M&A intake compared to low M&A intake group (mean 3.8 vs. 1.3 servings/day, respectively) had greater adult ToA (14 %, p < 0.05), CoA (15 %, p < 0.01), and CoC (16 %, p < 0.01) at radius shaft. Females with moderate F&V intake compared to low F&V intake group (mean 3.7 vs. 2.1 servings/day, respectively) had greater adult ToA (8.5 %, p < 0.05) at distal tibia.

Conclusion

Higher intake of M&A or F&V during adolescence had a long-term beneficial effect on bone structure in females, an association not observed in males.

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Abbreviations

ANOVA:

Analysis of variance

BSIc:

Bone strength index in compression

CoA:

Cortical area

CoC:

Cortical content

CoD:

Cortical density

DXA:

Dual-energy X-ray absorptiometry

F&V:

Fruit and vegetables

M&A:

Milk and alternatives

MANCOVA:

Multivariate analysis of covariance

PA:

Physical activity

PAQ:

Physical activity questionnaire

PBMAS:

Pediatric Bone Mineral Accrual Study

PHV:

Peak height velocity

pQCT:

Peripheral quantitative computed tomography

SE:

Standard errors

SSIp:

Bone strength in torsion

ToA:

Total area

ToD:

Total density

TrA:

Trabecular area

TrC:

Trabecular content

TrD:

Trabecular density

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Acknowledgments

All authors contributed to the final manuscript. The project was funded by the Canadian Institutes of Health Research (CIHR, MOP 98002; MOP57671). Dairy Farmers of Canada (DFC-417283) provided funding for the PhD student support. The authors (Movassagh, Kontulainen, Baxter-Jones, Whiting, Szafron, Papadimitropoulos, Vatanparast) have no conflict of interest to disclose.

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Correspondence to H. Vatanparast.

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Ethical approval

Ethics approval was obtained from the University of Saskatchewan and Royal Hospital advisory boards on ethics in human experimentation [21], and all procedures were in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants (or their parents) included in the study.

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Z. Movassagh, E., Kontulainen, S., Baxter-Jones, A.D.G. et al. Are milk and alternatives and fruit and vegetable intakes during adolescence associated with cortical and trabecular bone structure, density, and strength in adulthood?. Osteoporos Int 28, 609–619 (2017). https://doi.org/10.1007/s00198-016-3775-4

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Keywords

  • Adolescence
  • Bone strength
  • Cortical bone
  • Fruit and vegetables
  • Milk and alternatives
  • Trabecular bone