Abstract
Summary
We evaluated the adult bone structural traits in relation to childhood overweight in 832 men and women. Childhood overweight was associated with larger cross-sections at long bones in both sexes. Excess weight in childhood may also lead to higher trabecular density in females and somewhat lower cortical density in men.
Introduction
Excess body weight in childhood may impose more loading on growing skeleton and thus lead to more robust structure in adulthood.
Methods
This prospective cohort study evaluated the adult bone structural traits in relation to childhood overweight in a subgroup of 456 women and 376 men from the population-based cohort of Cardiovascular Risks in Young Finns Study. Between-group differences were evaluated with analysis of covariance.
Results
According to established body mass index (BMI) criterion at the age of 12 years, 31 women and 34 men were classified overweight in childhood. At the mean age (SD) of 36.1 (2.7) years, total cross-sectional (ToA) and cortical area (CoA) at the distal and shaft sites and cortical (shaft CoD) and trabecular (distal TrD) bone density of the nonweight-bearing radius and weight-bearing tibia were evaluated with pQCT. Despite being taller in adolescence, the adult body height of overweight children was similar. In both sexes, childhood overweight was consistently associated with 5–10% larger ToA at all bone sites measured in adulthood. CoA did not show such a consistent pattern. Women, who were overweight in childhood, had ~5% denser TrD with no difference in CoD. In contrast, TrD in men who were overweight in childhood was not different but their CoD was ~1% lower.
Conclusions
Childhood overweight was consistently associated with larger long bone cross-sections in both sexes. Excess weight in childhood may also lead to higher trabecular density in women and somewhat lower cortical density in men. Specific mechanisms underlying these associations are not known.
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References
Manzoni P, Brambilla P, Pietrobelli A et al (1996) Influence of body composition on bone mineral content in children and adolescents. Am J Clin Nutr 64:603–607
Leonard MB, Shults J, Wilson BA, Tershakovec AM, Zemel BS (2004) Obesity during childhood and adolescence augments bone mass and bone dimensions. Am J Clin Nutr 80:514–523
Stettler N, Berkowtiz RI, Cronquist JL et al (2008) Observational study of bone accretion during successful weight loss in obese adolescents. Obesity (Silver Spring) 16:96–101
Goulding A, Taylor RW, Jones IE et al (2000) Overweight and obese children have low bone mass and area for their weight. Int J Obes Relat Metab Disord 24:627–632
Petit MA, Beck TJ, Lin HM et al (2004) Femoral bone structural geometry adapts to mechanical loading and is influenced by sex steroids: the Penn State Young Women’s Health Study. Bone 35:750–759
Klein KO, Larmore KA, de Lancey E et al (1998) Effect of obesity on estradiol level, and its relationship to leptin, bone maturation, and bone mineral density in children. J Clin Endocrinol Metab 83:3469–3475
Pollock NK, Laing EM, Baile CA et al (2007) Is adiposity advantageous for bone strength? A peripheral quantitative computed tomography study in late adolescent females. Am J Clin Nutr 86:1530–1538
Goulding A, Jones IE, Taylor RW, Williams SM, Manning PJ (2001) Bone mineral density and body composition in boys with distal forearm fractures: a dual-energy x-ray absorptiometry study. J Pediatr 139:509–515
Goulding A, Jones IE, Taylor RW, Manning PJ, Williams SM (2000) More broken bones: a 4-year double cohort study of young girls with and without distal forearm fractures. J Bone Miner Res 15:2011–2018
Skaggs DL, Loro ML, Pitukcheewanont P, Tolo V, Gilsanz V (2001) Increased body weight and decreased radial cross-sectional dimensions in girls with forearm fractures. J Bone Miner Res 16:1337–1342
Bolotin HH, Sievanen H, Grashuis JL (2003) Patient-specific DXA bone mineral density inaccuracies: quantitative effects of nonuniform extraosseous fat distributions. J Bone Miner Res 18:1020–1027
Bolotin HH, Sievanen H, Grashuis JL, Kuiper JW, Jarvinen TL (2001) Inaccuracies inherent in patient-specific dual-energy X-ray absorptiometry bone mineral density measurements: comprehensive phantom-based evaluation. J Bone Miner Res 16:417–426
Gilsanz V, Kovanlikaya A, Costin G et al (1997) Differential effect of gender on the sizes of the bones in the axial and appendicular skeletons. J Clin Endocrinol Metab 82:1603–1607
Ducher G, Bass SL, Naughton GA et al (2009) Overweight children have a greater proportion of fat mass relative to muscle mass in the upper limbs than in the lower limbs: implications for bone strength at the distal forearm. Am J Clin Nutr 90:1104–1111
Beck TJ, Petit MA, Wu G et al (2009) Does obesity really make the femur stronger? BMD, geometry, and fracture incidence in the women’s health initiative-observational study. J Bone Miner Res 24:1369–1379
Laitinen J, Kiukaanniemi K, Heikkinen J et al (2005) Body size from birth to adulthood and bone mineral content and density at 31 years of age: results from the northern Finland 1966 birth cohort study. Osteoporos Int 16:1417–1424
Uusi-Rasi K, Kannus P, Pasanen M, Sievanen H (2010) Is childhood obesity associated with bone density and strength in adulthood? J Osteoporos. doi:10.4061/2010/904806
Kannus P, Haapasalo H, Sankelo M et al (1995) Effect of starting age of physical activity on bone mass in the dominant arm of tennis and squash players. Ann Intern Med 123:27–31
Raitakari OT, Juonala M, Ronnemaa T et al (2008) Cohort profile: the cardiovascular risk in Young Finns Study. Int J Epidemiol 37:1220–1226
Laaksonen MM, Sievanen H, Tolonen S et al (2010) Determinants of bone strength and fracture incidence in adult Finns: Cardiovascular Risk in Young Finns Study/the GENDI pQCT study. Arch Osteoporos 5:119–130
Cole TJ, Bellizzi MC, Flegal KM, Dietz WH (2000) Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 320:1240–1243
Slaughter MH, Lohman TG, Boileau RA et al (1988) Skinfold equations for estimation of body fatness in children and youth. Hum Biol 60:709–723
Laaksonen MM, Mikkila V, Rasanen L et al (2009) Genetic lactase non-persistence, consumption of milk products and intakes of milk nutrients in Finns from childhood to young adulthood. Br J Nutr 102:8–17
Telama R, Yang X, Viikari J et al (2005) Physical activity from childhood to adulthood: a 21-year tracking study. Am J Prev Med 28:267–273
Sievanen H, Koskue V, Rauhio A et al (1998) Peripheral quantitative computed tomography in human long bones: evaluation of in vitro and in vivo precision. J Bone Miner Res 13:871–882
Kontulainen S, Sievanen H, Kannus P, Pasanen M, Vuori I (2002) Effect of long-term impact-loading on mass, size, and estimated strength of humerus and radius of female racquet-sports players: a peripheral quantitative computed tomography study between young and old starters and controls. J Bone Miner Res 17:2281–2289
Riggs BL, Melton Iii LJ 3rd, Robb RA et al (2004) Population-based study of age and sex differences in bone volumetric density, size, geometry, and structure at different skeletal sites. J Bone Miner Res 19:1945–1954
Schoenau E, Neu CM, Rauch F, Manz F (2002) Gender-specific pubertal changes in volumetric cortical bone mineral density at the proximal radius. Bone 31:110–113
De Simone M, Farello G, Palumbo M et al (1995) Growth charts, growth velocity and bone development in childhood obesity. Int J Obes 19:851–857
Chevalley T, Bonjour JP, Ferrari S, Rizzoli R (2009) The influence of pubertal timing on bone mass acquisition: a predetermined trajectory detectable five years before menarche. J Clin Endocrinol Metab 94:3424–3431
Chevalley T, Bonjour JP, Ferrari S, Rizzoli R (2008) Influence of age at menarche on forearm bone microstructure in healthy young women. J Clin Endocrinol Metab 93:2594–2601
Kindblom JM, Lorentzon M, Norjavaara E et al (2006) Pubertal timing is an independent predictor of central adiposity in young adult males: the Gothenburg osteoporosis and obesity determinants study. Diabetes 55:3047–3052
Lorentzon M, Norjavaara E, Kindblom JM (2011) Pubertal timing predicts leg length and childhood body mass index predicts sitting height in young adult men. J Pediatr 158:452–457
Husu P, Paronen O, Suni JH, Vasankari T (2011) [Suomalaisten fyysinen aktiivisuus ja kunto 2010] Physical activity and fitness of Finns in 2010. Publications of Ministry of Education and Culture
Paturi M, Tapanainen H, Reinivuo H, Pietinen P (eds) (2008) The National FINDIET 2007 survey. Publications of National Public Health institute
Frost HM (1999) An approach to estimating bone and joint loads and muscle strength in living subjects and skeletal remains. Am J Hum Biol 11:437–455
Petit MA, Beck TJ, Shults J et al (2005) Proximal femur bone geometry is appropriately adapted to lean mass in overweight children and adolescents. Bone 36:568–576
Wetzsteon RJ, Petit MA, Macdonald HM et al (2008) Bone structure and volumetric BMD in overweight children: a longitudinal study. J Bone Miner Res 23:1946–1953
Wapniarz M, Lehmann R, Reincke M et al (1997) Determinants of radial bone density as measured by PQCT in pre- and postmenopausal women: the role of bone size. J Bone Miner Res 12:248–254
Wang MC, Bachrach LK, Van Loan M et al (2005) The relative contributions of lean tissue mass and fat mass to bone density in young women. Bone 37:474–481
Currey JD (2003) How well are bones designed to resist fracture? J Bone Miner Res 18:591–598
Clark EM, Ness AR, Tobias JH (2006) Adipose tissue stimulates bone growth in prepubertal children. J Clin Endocrinol Metab 91:2534–2541
Viljakainen HT, Pekkinen M, Saarnio E et al (2011) Dual effect of adipose tissue on bone health during growth. Bone 48:212–217
Schoenau E, Neu CM, Rauch F, Manz F (2001) The development of bone strength at the proximal radius during childhood and adolescence. J Clin Endocrinol Metab 86:613–618
Jarvinen TL, Kannus P, Sievanen H (2003) Estrogen and bone—a reproductive and locomotive perspective. J Bone Miner Res 18:1921–1931
Uusi-Rasi K, Sievanen H, Vuori I et al (1999) Long-term recreational gymnastics, estrogen use, and selected risk factors for osteoporotic fractures. J Bone Miner Res 14:1231–1238
Radak TL (2004) Caloric restriction and calcium’s effect on bone metabolism and body composition in overweight and obese premenopausal women. Nutr Rev 62:468–481
Larmore KA, O’Connor D, Sherman TI et al (2002) Leptin and estradiol as related to change in pubertal status and body weight. Med Sci Monit 8:CR206–CR210
Veldhuis JD, Roemmich JN, Richmond EJ et al (2005) Endocrine control of body composition in infancy, childhood, and puberty. Endocr Rev 26:114–146
Cheng S, Volgyi E, Tylavsky FA et al (2009) Trait-specific tracking and determinants of body composition: a 7-year follow-up study of pubertal growth in girls. BMC Med 7:5
Bailey DA, McKay HA, Mirwald RL, Crocker PR, Faulkner RA (1999) A six-year longitudinal study of the relationship of physical activity to bone mineral accrual in growing children: the University of Saskatchewan bone mineral accrual study. J Bone Miner Res 14:1672–1679
Acknowledgements
The Young Finns Study has been financially supported by the Academy of Finland (grants no. 117797, 126925, 121584, 117941), the Social Insurance Institution of Finland, the Turku University Foundation, the Finnish Cultural Foundation, the Yrjö Jahnsson Foundation, the Emil Aaltonen Foundation (TL), Competitive Research Funding of Tampere University Hospital (grant 9M048), Turku University Central Hospital Medical Fund, the Juho Vainio Foundation, and the Finnish Foundation for Cardiovascular Research and Tampere Tuberculosis Foundation.
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Uusi-Rasi, K., Laaksonen, M., Mikkilä, V. et al. Overweight in childhood and bone density and size in adulthood. Osteoporos Int 23, 1453–1461 (2012). https://doi.org/10.1007/s00198-011-1737-4
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DOI: https://doi.org/10.1007/s00198-011-1737-4