Bone Health and Body Composition in Pediatric Populations
Summary
Bone health in children and adolescents is shaped by the dynamic interplay between skeletal growth, hormonal factors, nutrition and mechanical loading. During early life, bone modelling establishes peak bone mass, which is a major determinant of lifelong skeletal integrity. Body composition—specifically the balance between lean mass and adiposity—modulates mechanical stimuli on bone as well as endocrine and inflammatory pathways. Adequate calcium and vitamin D intake, regular weight-bearing exercise and optimal hormonal milieu (including growth hormone, oestrogen and testosterone) support accrual of bone mineral density. Conversely, excess adiposity can lead to low-grade inflammation, altered bone marrow stromal cell differentiation and imbalanced secretion of adipokines, which may compromise bone quality despite increased mechanical loading. Differences in fat distribution, hormonal status and physical activity across childhood and adolescence contribute to variations in fracture risk, structural geometry and volumetric bone density, with long-term implications for osteoporosis and fracture prevention in adulthood.
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Bone Health and Body Composition in Pediatric Populations publication trend
The graph below shows the total number of articles in bone health and body composition in pediatric populations across all publications each year (not limited to Nature Index journals).
Technical terms
Bone mineral density (BMD): The amount of mineral (mainly calcium and phosphorus) per unit area of bone, reflecting bone strength and fracture risk.
Bone mineral content (BMC): The total mineral mass within a defined bone region, indicative of bone mass and growth status.
Lean mass index (LMI): A normalised measure of muscle and organ mass relative to height, used to assess the contribution of non-fat tissue to skeletal loading.
Fat mass index (FMI): The proportion of body weight attributable to adipose tissue relative to height, employed to gauge adiposity while accounting for body size.
Dual-energy X-ray absorptiometry (DXA): A non-invasive imaging technique that quantifies BMD and body composition by measuring X-ray attenuation at two energy levels.
Peak bone mass: The maximum bone mineral content and density achieved, typically in early adulthood, which determines future skeletal resilience.
References
- Insufficient Bone Mineralization to Sustain Mechanical Load of Weight in Obese Boys: A Cross-Sectional Study. The Journal of Clinical Endocrinology & Metabolism (2024).
- Decreased bone mass in adolescents with bone fragility fracture but not in young children: a case–control study. Frontiers in Endocrinology (2023).
- Preschool Obesity Is Associated With an Increased Risk of Childhood Fracture: A Longitudinal Cohort Study of 466,997 Children and Up to 11 Years of Follow‐up in Catalonia, Spain. Journal of Bone and Mineral Research (2020).
- Mechanisms Involved in Childhood Obesity-Related Bone Fragility. Frontiers in Endocrinology (2019).
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