The Effects of Dairy Product Supplementation on Bone Health Indices in Children Aged 3 to 18 Years: A Meta-Analysis of Randomized Controlled Trials

Bone mass accrual in children

PURPOSE OF REVIEW

Bone accrual during childhood and adolescence is critical for the attainment of peak bone mass and is a major contributing factor towards osteoporosis in later life. Bone mass accrual is influenced by nonmodifiable factors, such as genetics, sex, race, ethnicity, and puberty, as well as modifiable factors, such as physical activity and diet. Recent progress in bone imaging has allowed clinicians and researchers to better measure the morphology, density, and strength of the growing skeleton, thereby encompassing key characteristics of peak bone strength. In this review, the patterning of bone accrual and contributors to these changes will be described, as well as new techniques assessing bone mass and strength in pediatric research and clinical settings.

RECENT FINDINGS

This review discusses factors influencing peak bone mass attainment and techniques used to assess the human skeleton.

SUMMARY

The rate of bone accrual and the magnitude of peak bone mass attainment occurs in specific patterns varying by sex, race, ethnicity, longitudinal growth, and body composition. Physical activity, diet, and nutritional status impact these processes. There is a need for longitudinal studies utilizing novel imaging modalities to unveil factors involved in the attainment and maintenance of peak bone strength.

The Relationship between Bone Health Parameters, Vitamin D and Iron Status, and Dietary Calcium Intake in Young Males

Vitamin D, calcium, and iron are micronutrients crucial for bone health. However, their effect has been studied primarily in the cortical bone, with vitamin D status being assessed mainly from the total 25(OH)D serum fraction. The study aimed to investigate the impact of vitamin D (total and free fraction) and iron status (i.e., serum ferritin or soluble transferrin receptor) and calcium intake (ADOS-Ca questionnaire) on lumbar cortical and trabecular bone. In a cohort of 113 male subjects (76 athletes, 37 non-athletes) aged 15-19, the lumbar spine status (Z-score, bone mineral apparent density (BMAD), and trabecular bone score (TBS)) was determined using dual-energy X-ray absorptiometry (DXA). Relationships between the examined micronutrients and bone health parameters were observed only in athletes. Free 25(OH)D was significantly (p < 0.001) correlated with Z-score and BMAD, while total 25(OH)D (p < 0.001) and iron status (ferritin, Fe stores; p < 0.01) correlated solely with BMAD. Free 25(OH)D and ferritin concentrations were the best determinants of bone status (R2 = 0.330; p < 0.001) and explained 25% and 7% of the BMAD variance, respectively. No relationships were found between the micronutrients and TBS. The results confirmed the positive influence of vitamin D and iron on cortical, but not trabecular, bone status solely in physically active subjects. In athletes, free 25(OH)D seems to be a superior indicator of bone health to a total 25(OH)D fraction.

Association between lung function and bone mineral density in children and adolescents: Insights from the NHANES

Bone development and lung function are integral to child and adolescent health. Both influence an individual's overall well-being and potentially affect long-term health. Utilizing a comprehensive dataset from the National Health and Nutrition Examination Survey, this study aims to elucidate the relationship between lung function and bone mineral density (BMD) in a representative sample of children and adolescents. The analysis covered 3410 participants aged 8 to 19 years. We employed weighted multivariate linear regression and restricted cubic spline curve visualizations to explore the intricate association between lung function metrics, particularly first-second expiratory volume 1 second/forced vital capacity ratio, and lumbar BMD. Our data indicated a positive association between lung function and lumbar BMD in children and adolescents. Specifically, higher lung function metrics were linked with increased lumbar BMD. This association was more pronounced in younger participants or those with a lower body mass index. A significant positive relationship exists between lung function and BMD in the pediatric population. Recognizing this association is crucial for holistic health strategies for children and adolescents. This study underscores the need for integrated health monitoring during formative years, which can influence health trajectories as these individuals transition to adulthood.

Bone health: biology and nutrition

PURPOSE OF REVIEW

Recent findings in the influence of dietary patterns, dairy products, beverages and microbiota composition and function on bone health are reviewed and discussed.

RECENT FINDINGS

Evidence is accumulating on the increased risk of fracture in individuals following a vegan diet. Meta-analysis of randomized controlled trials indicates a favourable, though of low amplitude, effect of dairy products on bone mass accrual during childhood and adolescence. Though mostly based on results from observational studies, it seems that dairy product consumption, particularly fermented dairy products, is associated with a lower risk of hip fracture. Regular green tea drinkers may have a lower fracture risk than tea abstainers. Magnesium intake is beneficial for bone health. Prune supplements prevents bone loss in untreated postmenopausal women. This seems to be associated with modification of gut microbiota.

SUMMARY

This information should help the medical practitioners facing questions from their patients on how to protect bone health through nutrition.