title: Infant dietary patterns and bone mass in childhood: the Generation R Study.
abstract: Early life nutrition affects peak bone mass attainment. In this prospective cohort study, children with high adherence to a "dairy and whole grains" pattern in infancy had higher bone mineral density at the age of 6 years. Although the observed effects are small, our study provides insight into mechanisms linking early nutrition to bone acquisition in childhood.
  
  
  BACKGROUND
  Nutrition in early life may affect peak bone mass attainment. Previous studies on childhood nutrition and skeletal health mainly focused on individual nutrients, which does not consider the cumulative effects of nutrients. We investigated the associations between dietary patterns in infancy and childhood bone health.
  
  
  METHODS
  This study included 2850 children participating in a population-based prospective cohort study. Dietary information was obtained from a food frequency questionnaire at the age of 13 months. Using principal component analysis, three major dietary patterns were extracted, explaining in total 30% of the variation in dietary intake. At the age of 6 years, a total body dual-energy X-ray absorptiometry (DXA) scan was performed, and bone mineral density (BMD), bone mineral content (BMC), area-adjusted BMC (aBMC), and bone area (BA) were analyzed.
  
  
  RESULTS
  Higher adherence score to a "dairy and whole grains" pattern was positively associated with BMD and aBMC, but not with BMC and BA. Accordingly, children in the highest quartile of the "dairy and whole grains" pattern had higher BMD (difference 3.98 mg/cm(2), 95% confidence interval (CI) 0.36 to 7.61) and aBMC (difference 4.96 g, 95% CI 1.27 to 8.64) than children in the lowest quartile. Stratification for vitamin D supplementation showed that the positive associations between the "dairy and whole grains" pattern and bone outcomes were only observed in children who did not receive vitamin D supplementation. A "potatoes, rice, and vegetables" and a "refined grains and confectionery" pattern were not consistently associated with bone outcomes.
  
  
  CONCLUSIONS
  An infant dietary pattern characterized by high intakes of dairy and cheese, whole grains, and eggs is positively associated with bone development in childhood. Further research is needed to investigate the consequences for bone health in later life.
authors: Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands, e.vandenhooven@erasmusmc.nl.
authors: E H
authors: EH
authors: van den Hooven
authors: D H M
authors: DH
authors: Heppe
authors: J C
authors: JC
authors: Kiefte-de Jong
authors: C
authors: C
authors: Medina-Gomez
authors: H A
authors: HA
authors: Moll
authors: A
authors: A
authors: Hofman
authors: V W V
authors: VW
authors: Jaddoe
authors: F
authors: F
authors: Rivadeneira
authors: O H
authors: OH
authors: Franco
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000328:Adult; D015519:Bone Density / Q000502:physiology*; D001846:Bone Development / Q000502:physiology; D003611:Dairy Products / Q000706:statistics & numerical data; D004032:Diet / Q000706:statistics & numerical data; D004034:Diet Surveys; D019587:Dietary Supplements; D005247:Feeding Behavior / Q000502:physiology*; D005260:Female; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena / Q000502:physiology*; D008297:Male; D011446:Prospective Studies; D014807:Vitamin D / Q000008:administration & dosage; D000067348:Whole Grains
chemical_list: D014807:Vitamin D