title: Identification of a dietary pattern prospectively associated with bone mass in Australian young adults.
abstract: BACKGROUND
  Relatively little is known about the relations between dietary patterns and bone health in adolescence, which is a period of substantial bone mass accrual.
  
  
  OBJECTIVE
  We derived dietary patterns that were hypothesized to be related to bone health on the basis of their protein, calcium, and potassium contents and investigated their prospective associations with bone mineral density (BMD), bone area, and bone mineral content (BMC) in a cohort of young adults.
  
  
  METHODS
  The study included 1024 young adults born to mothers who were participating in the Western Australian Pregnancy Cohort (Raine) Study. Dietary information was obtained from food-frequency questionnaires at 14 and 17 y of age. Dietary patterns were characterized according to protein, calcium, and potassium intakes with the use of reduced-rank regression. BMD, bone area, and BMC were estimated with the use of a total body dual-energy X-ray absorptiometry scan at 20 y of age.
  
  
  RESULTS
  We identified 2 major dietary patterns. The first pattern was positively correlated with intakes of protein, calcium, and potassium and had high factor loadings for low-fat dairy products, whole grains, and vegetables. The second pattern was positively correlated with protein intake but negatively correlated with intakes of calcium and potassium and had high factor loadings for meat, poultry, fish, and eggs. After adjustment for anthropometric, sociodemographic, and lifestyle factors, a higher z score for the first pattern at 14 y of age was positively associated with BMD and BMC at 20 y of age [differences: 8.6 mg/cm(2) (95% CI: 3.0, 14.1 mg/cm(2)) and 21.9 g (95% CI: 6.5, 37.3 g), respectively, per SD increase in z score]. The z score for this same pattern at 17 y of age was not associated with bone outcomes at 20 y of age. The second pattern at 14 or 17 y of age was not associated with BMD, BMC, or bone area.
  
  
  CONCLUSIONS
  A dietary pattern characterized by high intakes of protein, calcium, and potassium in midadolescence was associated with higher BMD and BMC at 20 y of age. Our results indicate that high consumption of low-fat dairy products, whole grains, and vegetables in adolescence are associated with beneficial effects on bone development.
authors.affiliation: Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands;
authors.forename: Edith H
authors.initials: EH
authors.lastname: van den Hooven
authors.affiliation: School of Population Health and Telethon Kids Institute, University of Western Australia, Perth, Australia;
authors.forename: Gina L
authors.initials: GL
authors.lastname: Ambrosini
authors.affiliation: Telethon Kids Institute, University of Western Australia, Perth, Australia;
authors.forename: Rae-Chi
authors.initials: RC
authors.lastname: Huang
authors.affiliation: School of Population Health and.
authors.forename: Jenny
authors.initials: J
authors.lastname: Mountain
authors.affiliation: School of Physiotherapy, Curtin University, Perth, Australia;
authors.forename: Leon
authors.initials: L
authors.lastname: Straker
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Perth, Australia; and Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia.
authors.forename: John P
authors.initials: JP
authors.lastname: Walsh
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Perth, Australia; and Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia.
authors.forename: Kun
authors.initials: K
authors.lastname: Zhu
authors.affiliation: Telethon Kids Institute, University of Western Australia, Perth, Australia; wendy.oddy@telethonkids.org.au.
authors.forename: Wendy H
authors.initials: WH
authors.lastname: Oddy
mesh_terms: D000293:Adolescent; D041923:Adolescent Development; D017195:Adolescent Nutritional Physiological Phenomena; D000328:Adult; D015519:Bone Density; D001846:Bone Development; D001851:Bone Diseases, Metabolic / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D002136:Calcium, Dietary / Q000008:administration & dosage / Q000627:therapeutic use; D015331:Cohort Studies; D004032:Diet / Q000009:adverse effects; D004044:Dietary Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D018673:Nutrition Policy; D010349:Patient Compliance; D017419:Potassium, Dietary / Q000008:administration & dosage / Q000627:therapeutic use; D011446:Prospective Studies; D014904:Western Australia / Q000453:epidemiology; D055815:Young Adult
chemical_list: D002136:Calcium, Dietary; D004044:Dietary Proteins; D017419:Potassium, Dietary
keywords: Raine Study; body composition; dietary patterns; peak bone mass; young adults