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. and Daly, Robin M. 2009, 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, American journal of clinical nutrition, vol. 90, no. 4, pp. 1104-1111.

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Title 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
Author(s) Ducher, Gaele
Bass, Shona L.
Naughton, Geraldine A.
Eser, Prisca
Telford, Richard D.
Daly, Robin M.
Journal name American journal of clinical nutrition
Volume number 90
Issue number 4
Start page 1104
End page 1111
Total pages 8
Publisher American Society for Clinical Nutrition
Place of publication New York, N.Y.
Publication date 2009-10
ISSN 0002-9165
1938-3207
Summary 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.
Language eng
Field of Research 110699 Human Movement and Sports Science not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2009, American Society for Nutrition
Persistent URL http://hdl.handle.net/10536/DRO/DU:30035185

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