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Overweight children have a greater proportion of fat mass relative to muscle mass in the upper limbs than in the lower limbs: implications for bone strength at the distal forearm
Ducher, Gaele Bass, Shona L. Naughton, Geraldine A. Eser, Prisca Telford, Richard D. Daly, Robin M.
Ducher, Gaele
Bass, Shona L.
Naughton, Geraldine A.
Eser, Prisca
Telford, Richard D.
Daly, Robin M.
Abstract
Background: The influence of adiposity on upper-limb bone strength has rarely been studied in children, despite the high incidence of forearm fractures in this population. Objective: The objective was to compare the influence of muscle and fat tissues on bone strength between the upper and lower limbs in prepubertal children. Design: Bone mineral content, total bone cross-sectional area, cortical bone area (CoA), cortical thickness (CoTh) at the radius and tibia (4% and 66%, respectively), trabecular density (TrD), bone strength index (4% sites), cortical density (CoD), stress-strain index, and muscle and fat areas (66% sites) were measured by using peripheral quantitative computed tomography in 427 children (206 boys) aged 7–10 y. Results: Overweight children (n = 93) had greater values for bone variables (0.3–1.3 SD; P < 0.0001) than did their normal-weight peers, except for CoD 66% and CoTh 4%. The between-group differences were 21–87% greater at the tibia than at the radius. After adjustment for muscle cross-sectional area, TrD 4%, bone mineral content, CoA, and CoTh 66% at the tibia remained greater in overweight children, whereas at the distal radius total bone cross-sectional area and CoTh were smaller in overweight children (P < 0.05). Overweight children had a greater fat-muscle ratio than did normal-weight children, particularly in the forearm (92 ± 28% compared with 57 ± 17%). Fat-muscle ratio correlated negatively with all bone variables, except for TrD and CoD, after adjustment for body weight (r = −0.17 to −0.54; P < 0.0001). Conclusions: Overweight children had stronger bones than did their normal-weight peers, largely because of greater muscle size. However, the overweight children had a high proportion of fat relative to muscle in the forearm, which is associated with reduced bone strength.
Keywords
Date
2009
Type
Journal article
Journal
American Journal of Clinical Nutrition: A journal reporting the practical application of our world-wide knowledge of nutrition
Book
Volume
90
Issue
4
Page Range
1104-1111
Article Number
ACU Department
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Open Access Status
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Controlled