title: Disordered-eating attitudes in relation to bone mineral density and markers of bone turnover in overweight adolescents.
abstract: OBJECTIVE
  To examine the relationships between cognitive eating restraint and both bone mineral density (BMD) and markers of bone turnover in overweight adolescents.
  
  
  METHODS
  One hundred thirty-seven overweight (BMI 39.1 +/- 6.8 kg/m(2)) African American and Caucasian adolescent (age = 14.4 +/- 1.4 years) girls (66.4%) and boys were administered the Eating Disorder Examination (EDE) interview and Eating Inventory (EI) questionnaire and underwent dual energy X-ray absorptiometry (DXA) to measure total lumbar spine BMD. Markers of bone formation (serum bone specific alkaline phosphatase and osteocalcin), bone resorption (24-hour urine N-telopeptides), and stress (urine free cortisol) were measured.
  
  
  RESULTS
  After accounting for the contribution of demographics, height, weight, serum 25-hydroxyvitamin D, and depressive symptoms, adolescents' weight concern, as assessed by interview, was a significant contributor to the model of urine free cortisol (beta = .30, p < .05). Shape concern, as also assessed by interview, was significantly associated with lumbar spine bone mineral density (beta = -.15, p < .05). Dietary restraint was not a significant predictor in any of these models.
  
  
  CONCLUSIONS
  These findings suggest that among severely overweight adolescents, dissatisfaction with shape and weight may be salient stressors. Future research is required to illuminate the relationship between bone health and disordered-eating attitudes in overweight adolescents.
authors.affiliation: Unit on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Rockville, Maryland, USA.
authors.forename: Natasha A
authors.initials: NA
authors.lastname: Schvey
authors.forename: Marian
authors.initials: M
authors.lastname: Tanofsky-Kraff
authors.forename: Lisa B
authors.initials: LB
authors.lastname: Yanoff
authors.forename: Jenna M
authors.initials: JM
authors.lastname: Checchi
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Shomaker
authors.forename: Sheila
authors.initials: S
authors.lastname: Brady
authors.forename: David M
authors.initials: DM
authors.lastname: Savastano
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Ranzenhofer
authors.forename: Susan Z
authors.initials: SZ
authors.lastname: Yanovski
authors.forename: James C
authors.initials: JC
authors.lastname: Reynolds
authors.forename: Jack A
authors.initials: JA
authors.lastname: Yanovski
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D001294:Attitude to Health; D015415:Biomarkers; D015519:Bone Density; D001842:Bone and Bones / Q000378:metabolism*; D002648:Child; D024042:Collagen Type I / Q000652:urine; D001068:Feeding and Eating Disorders / Q000523:psychology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000652:urine; D007407:Interviews as Topic; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D050177:Overweight / Q000503:physiopathology*; D010455:Peptides / Q000652:urine; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers; D024042:Collagen Type I; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D006854:Hydrocortisone