Developmental Origins of Osteoporosis: The Role of Maternal Nutrition

  • C. Cooper
  • N. Harvey
  • Z. Cole
  • M. Hanson
  • E. Dennison
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 646)

Osteoporosis is a major cause of morbidity and mortality through its association with age-related fractures. Although most effort in fracture prevention has been directed at retarding the rate of age-related bone loss, and reducing the frequency and severity of trauma among elderly people, evidence is growing that peak bone mass is an important contributor to bone strength during later life. The normal patterns of skeletal growth have been well characterised in cross-sectional and longitudinal studies. It has been confirmed that boys have higher bone mineral content, but not volumetric bone density, than girls. Furthermore, there is a dissociation between the peak velocities for height gain and bone mineral accrual in both genders. Puberty is the period during which volumetric density appears to increase in both axial and appendicular sites. Many factors influence the accumulation of bone mineral during childhood and adolescence, including heredity, gender, diet, physical activity, endocrine status, and sporadic risk factors such as cigarette smoking. In addition to these modifiable factors during childhood, evidence has also accrued that fracture risk might be programmed during intrauterine life. Epidemiological studies have demonstrated a relationship between birthweight, weight in infancy, and adult bone mass. This appears to be mediated through modulation of the set-point for basal activity of pituitary-dependent endocrine systems such as the hypothalamic-pituitary-adrenal (HPA) and growth hormone/insulin-like growth factor-1 (GH/IGF-1) axes. Maternal smoking, diet (particularly vitamin D deficiency) and physical activity also appear to modulate bone mineral acquisition during intrauterine life; furthermore, both low birth size and poor childhood growth, are directly linked to the later risk of hip fracture. The optimisation of maternal nutrition and intrauterine growth should also be included within preventive strategies against osteoporotic fracture, albeit for future generations.

Keywords

Epidemiology osteoporosis fetal origins bone mineral 

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References

  1. Antoniades L, MacGregor AJ, Andrew T, et al. (2003). Association of birthweight with osteoporosis and osteoarthritis in adult twins. Rheumatology 42: 791–796.PubMedCrossRefGoogle Scholar
  2. Barker DJP (1995). Fetal origins of coronary heart disease. BMJ 311: 171–174.PubMedGoogle Scholar
  3. Bateson P (2001). Fetal experience and good adult disease. Int J Epidemiol 30: 928–934.PubMedCrossRefGoogle Scholar
  4. Consensus Development Conference (1991). Prophylaxis and treatment of osteoporosis. Osteoporosis Int 1: 114–117.CrossRefGoogle Scholar
  5. Cooney CA, Dave AA, Wolff GL (2002). Maternal methyl supplements in mice affect epigenetic variation and DNA methylation of offspring. J Nutr 132(Suppl 8): 2393S–2400S.PubMedGoogle Scholar
  6. Cooper C (2003). Epidemiology of osteoporosis. In: Favus MJ (ed.), Primer on the metabolic bone diseases and disorders of mineral metabolism. 5th edition. Washington, DC: American Society for Bone and Mineral Research, pp. 307–313.Google Scholar
  7. Cooper C, Cawley MID, Bhalla A, et al. (1995). Childhood growth, physical activity and peak bone mass in women. J Bone Min Res 10: 940–947.CrossRefGoogle Scholar
  8. Cooper C, Fall C, Egger P, et al. (1997). Growth in infancy and bone mass in later life. Ann Rheum Dis 56: 17–21.PubMedCrossRefGoogle Scholar
  9. Cooper C, Eriksson JG, Forsén T, et al. (2001). Maternal height, childhood growth and risk of hip fracture in later life: a longitudinal study. Osteoporosis Int 12: 623–629.CrossRefGoogle Scholar
  10. Dennison E, Hindmarsh P, Fall C, et al. (1999). Profiles of endogenous circulating cortisol and bone mineral density in healthy elderly men. J Clin Endocrinol Metab 84: 3058–3063.PubMedCrossRefGoogle Scholar
  11. Dennison EM, Arden NK, Keen RW, et al. (2001). Birthweight, vitamin D receptor genotype and the programming of osteoporosis. Paediatr Peri Epidemiol 15: 211–219.CrossRefGoogle Scholar
  12. Dennison EM, Syddall HE, Rodriguez S, et al. (2004). Polymorphism in the growth hormone gene, weight in infancy, and adult bone mass. J Clin Endocrinol Metab 89: 4898–4903.PubMedCrossRefGoogle Scholar
  13. Dennison EM, Syddall HE, Sayer AA, et al. (2005). Birth weight and weight at 1 year are independent determinants of bone mass in the seventh decade: the Hertfordshire cohort study. Pediatr Res 57(4): 582–586.CrossRefGoogle Scholar
  14. Fall C, Hindmarsh P, Dennison E, et al. (1998). Programming of growth hormone secretion and bone mineral density in elderly men; an hypothesis. J Clin Endocrinol Metab 83: 135–139.PubMedCrossRefGoogle Scholar
  15. Gluckman PD, Hanson MA (2004). Living with the past: evolution, development and patterns of disease. Science 305: 1733–1736.PubMedCrossRefGoogle Scholar
  16. Godfrey K, Walker-Bone K, Robinson S, et al. (2001). Neonatal bone mass: influence of parental birthweight, maternal smoking, body composition, and activity during pregnancy. J Bone Min Res 16: 1694–1703.CrossRefGoogle Scholar
  17. Javaid MK, Crozier SR, Harvey NC, Gale CR, Dennison EM, Boucher BJ, Arden NK, Godfrey KM, Cooer C, Princess Anne Hospital Study Group. (2006, Jan 7). Maternal vitamin D status during pregnancy and childhood bone mass at age 9 years: a longitudinal study. Lancet 367(9504): 36–43. Erratum in: Lancet 2006, May 6; 367(9521): 1486.PubMedCrossRefGoogle Scholar
  18. Keen R, Egger P, Fall C, et al. (1997). Polymorphisms of the vitamin D receptor, infant growth and adult bone mass. Calcif Tiss Int 60: 233–235.CrossRefGoogle Scholar
  19. Lucas A (1991). Programming by early nutrition in man. In: Bock GR, Whelan J (eds.), The childhood environment and adult disease. New York: Wiley, pp. 38–55.CrossRefGoogle Scholar
  20. Phillips DIW, Barker DJP, Fall CHD, et al. (1998). Elevated plasma cortisol concentrations: a link between low birthweight and the insulin resistance syndrome? J Clin Endocrinol Metab 83: 757–760.PubMedCrossRefGoogle Scholar
  21. Ralston SH (1998). Do genetic markers aid in risk assessment? Osteoporosis Int 8: S37–S42.Google Scholar
  22. Weaver IC, Cervoni N, Champagne FA, et al. (2004). Epigenetic programming by maternal behaviour. Nat Neurosci 7: 847–854.PubMedCrossRefGoogle Scholar
  23. West-Eberhard MJ (2003). Developmental plasticity and evolution. 1st edition. New York: Oxford University Press.Google Scholar
  24. Widdowson EM, McCance RA (1974). The determinants of growth and form. Proceedings of the Royal Society of London 185: 1–17.PubMedCrossRefGoogle Scholar
  25. Zamora SA, Rizzoli R, Belli DC, et al. (1999). Vitamin D supplementation during infancy is associated with higher bone mineral mass in prepubertal girls. J Clin Endocrinol Metab 84: 4541–4544.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media B.V 2009

Authors and Affiliations

  • C. Cooper
    • 1
  • N. Harvey
    • 1
  • Z. Cole
    • 1
  • M. Hanson
    • 1
  • E. Dennison
    • 1
  1. 1.MRC Epidemiology Resource Centre and Centre for Developmental Origins of Health and Adult DiseaseUniversity of Southampton, Southampton General HospitalSouthampton

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