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Calcif Tissue Int. 2017 Sep 2. doi: 10.1007/s00223-017-0318-8. [Epub ahead of print]

Bone Health is Maintained, While Fat Mass is Reduced in Pre-pubertal Children with Obesity Participating in a 1-Year Family-Centered Lifestyle Intervention.

Author information

1
School of Human Nutrition, Macdonald Campus, McGill University, 21,111 Lakeshore Rd, Sainte-Anne-de-Bellevue, QC, H9X 3V9, Canada.
2
Department of Kinesiology and Physical Education, Wilfrid Laurier University, 75 University Avenue West, Waterloo, ON, N2L 3C5, Canada.
3
Children's Hospital, University of Manitoba, FW302-685 William Ave, Winnipeg, MB, R3E 0Z2, Canada.
4
School of Human Nutrition, Macdonald Campus, McGill University, 21,111 Lakeshore Rd, Sainte-Anne-de-Bellevue, QC, H9X 3V9, Canada. hope.weiler@mcgill.ca.

Abstract

Diet and physical activity (PA) influence bone health in children. This study tested whether increasing milk and milk products and weight-bearing types of PA favorably changed bone outcomes assessed by dual-energy X-ray absorptiometry (DXA) and bone biomarkers in children with obesity participating in a 1-year family-centered lifestyle intervention. Children were randomized to one of three groups: Control (Ctrl; no intervention), Standard treatment (StnTx: two servings milk and milk products/day; meet PA guidelines plus weight-bearing PA three times/week), or Modified treatment (ModTx: four servings milk and milk products/day; meet PA guidelines plus daily weight-bearing PA). Baseline and 12-month measurements included DXA scans for whole body (WB), lumbar spine (LS), lumbar lateral spine (LLS), and ultra-distal (UD) ulna + radius for bone mineral content (BMC), areal bone mineral density (aBMD) and BMD z-scores. Fat mass index (FMI), fat-free mass index (FFMI), and biomarkers of bone metabolism were assessed. Seventy-eight children 6-8 years old were recruited (mean body mass index for-age z-score: 3.3 ± 1.2). Compared to baseline, all groups increased BMC of WB, LS, and LLS (p < 0.001), whereas only StnTx increased UD ulna + radius BMC at 12 months (p < 0.05). At 12 months, WB-BMD z-scores were significantly lower in Ctrl (p < 0.05), whereas WB and LLS aBMD increased in StnTx and ModTx (p < 0.001) but not in Ctrl. All groups increased FFMI (p < 0.001), while only Ctrl increased FMI (p < 0.001). Bone biomarkers did not change over time. Participating in a family-centered lifestyle intervention based on Canadian diet and PA guidelines maintained bone health in obese children.

KEYWORDS:

Body composition; Childhood obesity; DXA; Lifestyle intervention; Musculoskeletal

PMID:
28866763
DOI:
10.1007/s00223-017-0318-8
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