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

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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.

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Acknowledgements

The authors would like to thank Sherry Agellon for her work with the biomarkers. This study was supported by an operating grant from the Dairy Research Cluster Initiative (Dairy Farmers of Canada, Agriculture and Agri-Food Canada, and the Canadian Dairy Commission). TC is supported by Frederick Banting and Charles Best Canada Graduate Doctoral Award (Canadian Institutes of Health Research). HW is supported by funding from the Canada Research Chairs Program and the Canada Foundation for Innovation.

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Authors and Affiliations

  1. School of Human Nutrition, Macdonald Campus, McGill University, 21,111 Lakeshore Rd, Sainte-Anne-de-Bellevue, QC, H9X 3V9, Canada

    Tamara R. Cohen, Catherine A. Vanstone & Hope A. Weiler

  2. Department of Kinesiology and Physical Education, Wilfrid Laurier University, 75 University Avenue West, Waterloo, ON, N2L 3C5, Canada

    Tom J. Hazell

  3. Children’s Hospital, University of Manitoba, FW302-685 William Ave, Winnipeg, MB, R3E 0Z2, Canada

    Celia Rodd

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  1. Tamara R. Cohen
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  2. Tom J. Hazell
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  3. Catherine A. Vanstone
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  4. Celia Rodd
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  5. Hope A. Weiler
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Correspondence to Hope A. Weiler.

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Conflicts of interest

Tamara R. Cohen, Tom J. Hazell, Catherine A. Vanstone, Celia Rodd, Hope A. Weiler declares that they have no conflict of interest.

Human and Animal Rights and Informed Consent

Ethics approvals were obtained from the McGill University Faculty of Medicine Institutional Review Board, Lester B. Pearson School Board and the English Montreal School Board (Trial Registration: ClinicalTrials.gov: NCT01290016). All procedures performed in this study that involved human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Cohen, T.R., Hazell, T.J., Vanstone, C.A. et al. Bone Health is Maintained, While Fat Mass is Reduced in Pre-pubertal Children with Obesity Participating in a 1-Year Family-Centered Lifestyle Intervention. Calcif Tissue Int 101, 612–622 (2017). https://doi.org/10.1007/s00223-017-0318-8

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