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Abstract
Higher bone mineral density (BMD) at a young age, calcium intake, and exercise are important for prevention of osteoporosis later in life. We examined familial effects of BMD between mothers and children and adolescents aged 8-19 in Cheonan, Korea and the relationships between BMD and lifestyle parameters, including: food and nutrient intake and exercise. For daughters and sons, significant differences in BMD were observed at the three bone sites (total femur, femur neck, and lumbar spine) according to age, gender, body mass index, exercise, and milk consumption, compared to the reference value for each classification category. Mean differences in children's BMD were observed according to maternal BMD. Energy and calcium intake were lower in both children and mothers in comparison to the estimated daily energy requirement; however, their protein intake was much greater than the daily recommended intake. After adjusting for age and gender and for mother's age, body mass index, and total calorie intake, results of the food frequency test showed an association of a higher intake of meat, meat products, milk and milk products with greater BMD of total femur, femur neck, and lumbar spine of children. In addition, exercise was positively associated with higher BMD. Regression analysis showed a positive association of BMD with age, male gender, exercise, and mother's BMD. In conclusion, after adjustment for environmental parameters, maternal BMD had a positive influence on BMD in daughters and sons. This finding suggests that parents need to check their BMD in order to determine whether their children are at increased risk of low BMD.
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Table 1.
Bone mineral density (BMD) of total femur, femur neck and lumbar spine of children according to general characteristics
| Classification variables | n | Bone mineral density (g/cm 2) | ||
|---|---|---|---|---|
| Total femur | Femur neck | Lumbar spine | ||
| Total | 199 | 0.853 (0.836-0.870) | 0.831 (0.813-0.848) | 0.873 (0.852-0.893) |
| Gender | ||||
| Boy | 104 | 0.875 (0.851-0.899) | 0.855 (0.830-0.879) | 0.844 (0.817-0.871) |
| Girl | 95 | 0.829 (0.806-0.851)∗∗ | 0.804 (0.782-0.827)∗∗ | 0.903 (0.872-0.935)∗∗ |
| Age group | ||||
| 10-11 | 66 (35) 1) | 0.769 (0.752-0.786) | 0.748 (0.732-0.765) | 0.758 (0.739-0.777) |
| 12-13 | 59 (32)1) | 0.835 (0.810-0.860) | 0.813 (0.787-0.840) | 0.832 (0.805-0.859) |
| 14-15 | 48 (20) 1) | 0.918 (0.892-0.945) | 0.887 (0.862-0.912) | 0.978 (0.942-1.013) |
| 15- | 26 (17)1) | 0.988 (0.937-1.038)∗∗∗ | 0.974 (0.920-1.027)∗∗∗ | 1.061 (1.026-1.097)∗∗∗ |
| Body mass index | ||||
| Underweight | 87 | 0.850 (0.829-0.870) | 0.829 (0.808-0.851) | 0.873 (0.851-0.895) |
| Normal weight | 89 | 0.886 (0.867-0.905)∗∗ | 0.859 (0.839-0.878)∗ | 0.932 (0.912-0.952)∗∗∗ |
| Overweight | 23 | 0.919 (0.881-0.957)∗∗ | 0.911 (0.873-0.950)∗∗∗ | 0.943 (0.903-0.982)∗∗ |
| Mother’s BMD | ||||
| Low | 70 2) | 0.851 (0.829-0.872) | 0.830 (0.808-0.852) | 0.879 (0.858-0.900) |
| Middle | 66 2) | 0.875 (0.853-0.897) | 0.853 (0.830-0.876) | 0.899 (0.875-0.923) |
| High | 63 2) | 0.904 (0.881-0.927)∗∗∗ | 0.881 (0.858-0.904)∗∗∗ | 0.958 (0.935-0.982)∗∗∗ |
| Fracture | ||||
| Yes | 47 | 0.869 (0.828-0.910) | 0.846 (0.805-0.886) | 0.869 (0.824-0.914) |
| No | 150 | 0.848 (0.830-0.866) | 0.826 (0.807-0.844) | 0.875 (0.852-0.899) |
Table 2.
Daily nutrient intake of children and their mother
| Nutrients | Mean (95% confidence Interval) | ||
|---|---|---|---|
| Boy (n = 104) | Girl (n = 95) | Mother (n = 121) | |
| Energy (kcal) | 1,673 (1,576-1,770)∗∗ | 1,440 (1,346-1,535) | 1,460 (1,370-1,550) |
| Energy (% DRI) | 74.0 (69.1-78.6) | 77.0 (71.8-81.7) | 72.1 (72.1-81.5) |
| Protein (g) | 65.2 (59.6-70.9)∗∗ | 53.5 (49.1-57.8) | 57.7 (53.5-61.9) |
| Protein (% DRI) | 180 (156.3-201.1) | 151 (138.4-163.5) | 128 (118.8-137.2) |
| Lipid (g) | 52.0 (47.1-56.9) | 47.0 (42.3-51.7) | 41.7 (37.6-45.9) |
| Carbohydrates (g) | 239.5 (225.6-253.3)∗∗ | 204.8 (191.7-218.0) | 212.4 (199.4-225.5) |
| Fiber (g) | 13.5 (12.5-14.5)∗ | 11.7 (10.8-12.6) | 17.1 (15.8-18.4) |
| Calcium (mg) | 457.5 (403.0-511.9) | 406.1 (354.6-457.5) | 413.1 (372.6-453.6) |
| Calcium (% DRI) | 62.0 (54.8-69.2) | 58.2 (50.7-65.6) | 63.4 (57.2-69.6) |
| Phosphorus (mg) | 879.3 (810.2-948.3)∗∗ | 748.9 (686.0-811.8) | 808.0 (751.6-864.4) |
| Iron (mg) | 11.8 (10.1-13.6) | 10.1 (8.5-11.7) | 11.1 (10.3-12.0) |
| Iron (% DRI) | 118.1 (97.8-138.5) | 102.5 (87.1-117.9) | 82.0 (74.6-89.0) |
| Sodium (mg) | 2,975 (2,774-3,176)∗∗ | 2,515 (2,302-2,728) | 3,313 (3,018-3,608) |
| Potassium (mg) | 2,026 (1,851-2,200)∗∗ | 1,707 (1,570-1,845) | 2,179 (2,016-2,341) |
| Zinc (mg) | 7.6 (7.0-8.2)∗∗ | 6.4 (5.9-6.9) | 6.8 (6.3-7.3) |
Table 3.
Bone mineral density of total femur, femur neck and lumbar spine of children according to the frequencies of food intake after covariate adjustment 1)
| Tertiles of each food group | n | Bone mineral density (g/cm 2) | ||
|---|---|---|---|---|
| Total femur | Femur neck | Lumbar spine | ||
| Rice | ||||
| 1 | 78 | 0.877 (0.856-0.898) | 0.853 (0.832-0.875) | 0.903 (0.880-0.925) |
| 2 | 55 | 0.880 (0.856-0.905) | 0.862 (0.837-0.887) | 0.917 (0.890-0.943) |
| 3 | 66 | 0.872 (0.848-0.895) | 0.848 (0.824-0.872) | 0.913 (0.888-0.938) |
| Meat | ||||
| 1 | 52 | 0.865 (0.840-0.890) | 0.840 (0.814-0.866) | 0.895 (0.868-0.922) |
| 2 | 76 | 0.863 (0.842-0.884) | 0.845 (0.824-0.866) | 0.900 (0.878-0.922) |
| 3 | 71 | 0.899∗ (0.877-0.921) | 0.876∗ (0.853-0.898) | 0.932∗ (0.909-0.955) |
| Vegetables | ||||
| 1 | 47 | 0.848 (0.815-0.881) | 0.826 (0.792-0.860) | 0.883 (0.839-0.927) |
| 2 | 65 | 0.852 (0.824-0.880) | 0.832 (0.804-0.860) | 0.874 (0.839-0.908) |
| 3 | 87 | 0.856 (0.829-0.883) | 0.832 (0.805-0.859) | 0.866 (0.833-0.899) |
| Fast foods | ||||
| 1 | 47 | 0.874 (0.847-0.902) | 0.853 (0.825-0.881) | 0.917 (0.887-0.946) |
| 2 | 138 | 0.872 (0.856-0.888) | 0.849 (0.833-0.866) | 0.907 (0.890-0.924) |
| 3 | 14 | 0.921 (0.873-0.970) | 0.903 (0.854-0.953) | 0.921 (0.869-0.973) |
| Cola | ||||
| 1 | 150 | 0.872 (0.856-0.888) | 0.852 (0.835-0.869) | 0.908 (0.891-0.925) |
| 2 | 32 | 0.875 (0.843-0.907) | 0.851 (0.818-0.884) | 0.897 (0.863-0.931) |
| 3 | 17 | 0.912 (0.867-0.957) | 0.882 (0.837-0.928) | 0.949 (0.901-0.997) |
| Crackers | ||||
| 1 | 68 | 0.875 (0.853-0.897) | 0.853 (0.830-0.876) | 0.909 (0.885-0.932) |
| 2 | 57 | 0.876 (0.851-0.900) | 0.853 (0.828-0.878) | 0.911 (0.885-0.937) |
| 3 | 74 | 0.878 (0.855-0.900) | 0.856 (0.834-0.879) | 0.911 (0.887-0.934) |
| Ramyun | ||||
| 1 | 26 | 0.877 (0.840-0.914) | 0.856 (0.819-0.893) | 0.886 (0.848-0.925) |
| 2 | 139 | 0.874 (0.857-0.891) | 0.853 (0.836-0.870) | 0.917 (0.900-0.935) |
| 3 | 34 | 0.883 (0.852-0.915) | 0.857 (0.825-0.889) | 0.900 (0.867-0.933) |
| Seaweeds | ||||
| 1 | 18 | 0.871 (0.828-0.914) | 0.853 (0.809-0.897) | 0.892 (0.846-0.938) |
| 2 | 86 | 0.875 (0.854-0.896) | 0.854 (0.833-0.875) | 0.910 (0.888-0.932) |
| 3 | 95 | 0.879 (0.859-0.898) | 0.855 (0.835-0.874) | 0.913 (0.893-0.934) |
| Fried foods | ||||
| 1 | 57 | 0.874 (0.849-0.898) | 0.853 (0.828-0.879) | 0.908 (0.881-0.934) |
| 2 | 106 | 0.874 (0.856-0.893) | 0.854 (0.835-0.873) | 0.904 (0.884-0.924) |
| 3 | 36 | 0.885 (0.854-0.915) | 0.857 (0.826-0.887) | 0.928 (0.896-0.960) |
| Fruits | ||||
| 1 | 58 | 0.857 (0.834-0.882) | 0.829 (0.805-0.853) | 0.899 (0.873-0.924) |
| 2 | 82 | 0.881 (0.861-0.901) | 0.864 (0.843-0.884) | 0.911 (0.890-0.933) |
| 3 | 59 | 0.889 (0.864-0.914) | 0.867∗ (0.842-0.892) | 0.920 (0.894-0.946) |
| Milk | ||||
| 1 | 47 | 0.857 (0.831-0.884) | 0.836 (0.809-0.863) | 0.892 (0.864-0.920) |
| 2 | 71 | 0.873 (0.850-0.895) | 0.849 (0.826-0.872) | 0.901 (0.878-0.925) |
| 3 | 81 | 0.891∗ (0.871-0.912) | 0.871∗ (0.850-0.892) | 0.929∗ (0.907-0.951) |
| Exercise | ||||
| 1 | 44 | 0.856 (0.828-0.883) | 0.832 (0.804-0.860) | 0.902 (0.873-0.931) |
| 2 | 76 | 0.876 (0.855-0.897) | 0.856 (0.834-0.877) | 0.895 (0.873-0.917) |
| 3 | 79 | 0.892∗ (0.869-0.916) | 0.870∗ (0.846-0.893) | 0.933∗ (0.909-0.958) |
Table 4.
Regression coefficient of bone mineral densities (BMD) of three area of children according to classification variables including mother’s BMD
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