Are early growth and nutrition related to bone health in adolescence? The Copenhagen Cohort Study of infant nutrition and growth.

BACKGROUND

It is generally accepted that peak bone mass affects later fracture risk in the elderly. The extent to which early nutrition and growth can program later bone health has been examined in only a few studies. In the Copenhagen Cohort Study we showed that breastfed infants had significantly higher serum (s)-osteocalcin concentration than did formula-fed infants.

OBJECTIVE

We investigated whether early nutrition and early growth are associated with later bone mass in adolescence.

DESIGN

Participants were examined at birth; at ages 2, 6, and 9 mo (n = 143); and at age 17 y (n = 109) with anthropometric and s-osteocalcin measures and whole-body dual-energy X-ray absorptiometry (DXA) scanning (age 17 y only). Total body (T) and lumbar spine (LS) DXA values were used.

RESULTS

The duration of exclusive breastfeeding was positively correlated with the sex-adjusted LS bone mineral content (BMC), LS bone area (BA), and LS bone mineral density (BMD) (all P < 0.03) and with size-adjusted LS-BMC (P = 0.075) at 17 y of age. s-Osteocalcin at 6 mo was positively correlated with sex-adjusted LS-BMC and LS-BMD (both P < 0.04) and with size-adjusted LS-BMC (P = 0.047) at 17 y of age. Weight and length at 9 mo and increase in weight and length during the first 9 mo of life were positively correlated with sex-adjusted T-BMC and T-BA at age 17 y (all P < 0.04).

CONCLUSIONS

Early body size and growth in infancy are related to bone mass in late adolescence. Furthermore, the duration of exclusive breastfeeding and the markers of bone turnover at 6 mo seem to be positively related to LS bone mass at age 17 y.