Bone Health, Body Composition, and Vitamin D Status of Black Preadolescent Children in South Africa

White, Zelda; White, Samantha; Dalvie, Tasneem; Kruger, Marlena C.; Zyl, Amanda Van; Becker, Piet J.

doi:10.3390/nu11061243

Cited by 16 publications

(19 citation statements)

References 53 publications

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“…Furthermore, the girls also had lower levels of physical activity as compared to boys, re ecting less outdoor activities and exposure to the sun. However, neither our study nor a similar study among preadolescent children in South Africa with low levels of serum vitamin D showed any association between bone parameters and levels of 25(OH)D (31).…”

Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 88%

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Factors Associated With Bone Health Status of Malaysian Pre-adolescent Children in the PREBONE-kids Study

Chang

Arasu

Wong

et al. 2020

Preprint

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Background: Modifiable lifestyle factors and body composition can affect the attainment of peak bone mass during childhood. This study performed a cross-sectional analysis of the determinants of bone health among pre-adolescent Malaysian children with habitually low calcium intakes and vitamin D status in Kuala Lumpur (PREBONE-Kids Study). Methods: Body composition, bone mineral density (BMD), and bone mineral content (BMC) at the lumbar spine (LS) and total body (TB) were assessed using dual-energy X-ray absorptiometry (DXA). Calcium intake was assessed using 1-week diet history, MET (metabolic equivalent of task) score using cPAQ questionnaire, and serum 25(OH) vitamin D using LC-MS/MS. Results: The mean calcium intake was 348.8 ± 180.1 mg/day and mean serum 25-OH vitamin D level was 43.9 ± 14.5nmol/L. In boys, lean mass (LM) was significantly associated with LSBMC (β = 0.539, p<0.001), LSBMD (β=0.607, p<0.001), TBBMC (β=0.675, p<0.001) and TBBMD (β= 0.481, p<0.01). Height was significantly associated with LSBMC (β =0.346, p<0.001) and TBBMC (β =0.282, p<0.001) while fat mass (FM) (β=0.261, p=0.034) and MET score (β =0.163, p=0.026) were significant predictors of TBBMD. Among girls, LM was significantly associated with LSBMC (β = 0.620, p<0.001), LSBMD (β=0.700, p<0.001), TBBMC (β=0.542, p<0.001) and TBBMD (β= 0.747, p<0.001). Calcium intake was a significant predictor of LSBMC (β=0.102, p=0.034), TBBMC (β=0.122, p<0.001) and TBBMD (β=0.196, p=0.002) in girls. Lean mass (LM) was weakly correlated with MET scores (r = 0.205, p = 0.001) but not protein (r = 0.055, p = 0.393) or energy intake (r = 0.101, p = 0.117). MET score (β = 0.207, p = 0.043) was a significant predictor of LM in boys but no factor was found to predict LM in girls. Conclusion: LM is the major determinant of BMC and BMD among pre-adolescent Malaysian children and physical activity is a significant predictor of LM in boys. Encouraging physical activity, calcium intake and optimum diets that build lean body mass should be the focus for developing public health guidance to ensure optimal bone health status during rapid growth.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 88%

Factors Associated With Bone Health Status of Malaysian Pre-adolescent Children in the PREBONE-kids Study

Chang

Arasu

Wong

et al. 2020

Preprint

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“…Two published studies from India and Iran amongst adolescents (mean age ranged from 13.2-15.4 years old) reported a positive association between lean mass and bone parameters as measured by DXA [31,32]. The effect of the association between LM with BMC and BMD (standardised β = 0.5to 0.8) were similar to the studies reported in Caucasian children of a similar age group [33][34][35]. Furthermore, our finding is aligned with the systematic review by Sioen et al [8]which reported that LM was a stronger determinant of bone parameters as measured by DXA than FM and BF %.…”

Section: Discussionsupporting

confidence: 74%

Factors associated with bone health status of Malaysian pre-adolescent children in the PREBONE-Kids Study

et al. 2021

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Background Modifiable lifestyle factors and body composition can affect the attainment of peak bone mass during childhood. This study performed a cross-sectional analysis of the determinants of bone health among pre-adolescent (N = 243) Malaysian children with habitually low calcium intakes and vitamin D status in Kuala Lumpur (PREBONE-Kids Study). Methods Body composition, bone mineral density (BMD), and bone mineral content (BMC) at the lumbar spine (LS) and total body (TB) were assessed using dual-energy X-ray absorptiometry (DXA). Calcium intake was assessed using 1-week diet history, MET (metabolic equivalent of task) score using cPAQ physical activity questionnaire, and serum 25(OH) vitamin D using LC-MS/MS. Results The mean calcium intake was 349 ± 180 mg/day and mean serum 25(OH)D level was 43.9 ± 14.5 nmol/L. In boys, lean mass (LM) was a significant predictor of LSBMC (β = 0.539, p < 0.001), LSBMD (β = 0.607, p < 0.001), TBBMC (β = 0.675, p < 0.001) and TBBMD (β = 0.481, p < 0.01). Height was a significant predictor of LSBMC (β = 0.346, p < 0.001) and TBBMC (β = 0.282, p < 0.001) while fat mass (FM) (β = 0.261, p = 0.034) and physical activity measured as MET scores (β = 0.163, p = 0.026) were significant predictors of TBBMD in boys. Among girls, LM was also a significant predictor of LSBMC (β = 0.620, p < 0.001), LSBMD (β = 0.700, p < 0.001), TBBMC (β = 0.542, p < 0.001) and TBBMD (β = 0.747, p < 0.001). Calcium intake was a significant predictor of LSBMC (β = 0.102, p = 0.034), TBBMC (β = 0.122, p < 0.001) and TBBMD (β = 0.196, p = 0.002) in girls. Conclusions LM was the major determinant of BMC and BMD among pre-adolescent Malaysian children alongside other modifiable lifestyle factors such as physical activity and calcium intake.

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“…Previous studies have reported a positive association between BMD and serum 25(OH)D levels in early and late pubertal children [ 37 , 38 , 39 ]. However, other studies, like ours, have not found any association between vitamin D status and BMD in pre-adolescent children [ 40 , 41 ]. Yang et al [ 42 ] examined the association of vitamin D status at different stages of growth with bone measures at 8, 16, and 25 years old, and they suggested that vitamin D status at the youngest age of 8 years old may not be as important as during adolescence in influencing BMD during young adulthood.…”

Section: Discussioncontrasting

confidence: 65%

“…Yang et al [ 42 ] examined the association of vitamin D status at different stages of growth with bone measures at 8, 16, and 25 years old, and they suggested that vitamin D status at the youngest age of 8 years old may not be as important as during adolescence in influencing BMD during young adulthood. The BMD and BMC of the children in this age-group could also be more easily determined by body weight and lean mass than by vitamin D status [ 41 , 43 ]. Hence, a prospective longitudinal study design would better verify the associations between 25(OH)D and associated changes in BMD in our population.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D Status Is Associated with Modifiable Lifestyle Factors in Pre-Adolescent Children Living in Urban Kuala Lumpur, Malaysia

et al. 2021

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Studies on vitamin D status and its determinants in growing children in countries with ample sunshine such as Malaysia have been limited. The aim of our study was to determine factors associated with serum 25(OH)D concentrations such as lifestyle, dietary intake, anthropometry, and body composition in 243 pre-adolescent Malaysian children from low-income families living in Kuala Lumpur. This cross-sectional study measured bone density and body composition using dual-energy X-ray absorptiometry (DXA), while serum 25(OH)D was measured using LC–MS/MS. Time spent outdoors, body surface area exposed to sunlight, dietary intake, and physical activity level were assessed using questionnaires. Multiple linear regression and stepwise analysis were performed to identify significant predictors for serum 25(OH)D. About 69.4% had 25(OH)D < 50 nmol/L, and 18.9% were vitamin-D-deficient with 25(OH)D < 30 nmol/L. Girls had a nine-fold higher prevalence of vitamin D deficiency than boys. Body surface area exposed to sunlight, Sun Index, and fat mass were significant predictors of 25(OH)D concentrations in this population. Modifiable lifestyle factors such as sun exposure and reducing obesity are important public health guidance to ensure optimal vitamin D status in these children.

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Bone Health, Body Composition, and Vitamin D Status of Black Preadolescent Children in South Africa

Cited by 16 publications

References 53 publications

Factors Associated With Bone Health Status of Malaysian Pre-adolescent Children in the PREBONE-kids Study

Factors Associated With Bone Health Status of Malaysian Pre-adolescent Children in the PREBONE-kids Study

Factors associated with bone health status of Malaysian pre-adolescent children in the PREBONE-Kids Study

Vitamin D Status Is Associated with Modifiable Lifestyle Factors in Pre-Adolescent Children Living in Urban Kuala Lumpur, Malaysia

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