DIETARY PATTERNS FROM CHILDHOOD TO EARLY ADULTHOOD AND THEIR ASSOCIATIONS WITH BONE HEALTH

Abstract

The amount of bone accrued during adolescence is an important determinant of later osteoporosis risk. I examined the role of adolescent dietary patterns (DPs) and food group intakes on the adult bone acquisition, and assessed the stability of DPs over time using the data from Saskatchewan Pediatric Bone Mineral Accrual Study (1991-2011). Principal component analysis was used to derive adolescent DPs including “Vegetarian- style”, “Western-like”, “High-fat, high-protein”, “Mixed” and “Snack” DPs. Associations between adolescent DPs and adolescent (age 12.7±2 years, n=125) or adult (age 28.2±3 years, n=115) bone mineral content (BMC) and areal bone mineral density (aBMD) were analyzed while adjusting for covariates. Mean adolescent total body aBMD and young adult total body BMC and aBMD and femoral neck BMC and aBMD were 5, 8.5, 6, 10.6 and 9% higher (P<0.05), respectively, in third quartile of “Vegetarian-style” DP compared to first quartile. Associations between adolescents’ intake of milk and alternatives (M&A) or fruit and vegetables (F&V) and adult bone structure and strength at tibia and radius were also investigated. Females with high M&A intake compared to low M&A intake group (mean 4 vs. 1.5 servings/d, respectively) had 14, 15 and 16% greater (P<0.05) adult ToA, CoA and CoC at radius shaft, respectively. Females with moderate F&V intake compared to low F&V intake group (mean 4 vs. 2 servings/d, respectively) had greater adult ToA (8.5%, P<0.05) at distal tibia. The stability of DPs from childhood to adulthood were assessed by generalized estimating equations using the energy-adjusted applied DP scores. I found a moderate tracking for the “Vegetarian-style” (ß=0.44, P<0.001) and “High-fat, high-protein” (ß=0.39, P<0.001) DPs in females and “Vegetarian-style” DP (ß=0.30, P<0.001) in males; and a poor-to-fair tracking for remaining DPs, in both sexes. The “Western-like” DP was not stable in females. Adherence to “Vegetarian-style” DP increased and adherence to “High-fat, high-protein” DP decreased by age. Higher adherence to “Vegetarian style” DP (in both sex) and higher intake of M&A or F&V (only in females) during adolescence was positively associated with bone health. Healthy dietary habits established during childhood and adolescence could moderately continue into adulthood.