Table 9.
Infant nutrition and bone health in children and adolescents
| Source | Study description | Population description | Number of subjects | End points | Results | ||
|---|---|---|---|---|---|---|---|
| Koo et al. 2003 [211] | 6-month randomized, double-blind, parallel study assessing changes in bone mineral accretion by DXA in healthy infants fed a milk-based formula with or without palm olein | Sex: 57 males, 71 females Age: Infants >2 weeks at baseline Race:72 African American, 48 Caucasian, 8 Hispanic/Asian/other Location: USA and Canada |
128 | Total body BMC (%) | Group mean increase | ||
| Breast-fed | Control formula (milk-based formula) | Treatment (milk-based formula with palm olein) | |||||
| 3 months | 62.1 | 76.2* | |||||
| 6 months | 134.3 | 149.6* | |||||
| Observational studies | |||||||
| Butte et al. 2000 [216] | Prospective cohort study of breast-fed and formula-fed infants over 24 months | Sex: 33 males, 43 females Age: >2 weeks at baseline Race: 55 Caucasian, 7 African American, 11 Hispanic, 3 Asian Location: USA |
76 | Total body BMC (g) | Breast-fed (<12 months) | Breast-fed (>12 months) | Formula-fed |
| 12 months | Data not reported | Lowera | Highera,** | ||||
| 24 months | 310 (P = 0.05) | 289 (P = 0.05) | Data not reported | ||||
| Jones et al. 2000 [217] | Prospective cohort study to determine whether breastfeeding in early life is associated with bone mass in prepubertal children | Sex: 215 males, 115 females Age: 8 years at follow-up Race: predominantly Caucasian Location: Tasmania |
330 | Breast-fed | Bottle fed | ||
| Total body BMD at 8 years (g/cm2) | 0.642 ± 0.082 | 0.627 ± 0.073* | |||||
| Femoral neck BMD at 8 years (g/cm2) | 0.608 ± 0.072 | 0.590 ± 0.068 | |||||
| Lumbar spine BMD at 8 years, g/cm2 | 0.781 ± 0.047 | 0.766 ± 0.047** | |||||
| Ma and Jones 2003 [219] | Population-based case-controlled study to examine the association between bone mass and upper limb fractures in children | Sex: 206 males, 124 females Age: 8 years at follow-up Race: predominantly Caucasian Location: Tasmania |
324 | Breast-fed | |||
| Multivariate OR (95 % CI) | 0.43 (0.19–0.94)a | ||||||
| Young et al. 2005 [221] | BMD was assessed in healthy 4-year-old children after confirming the type of infant feeding by history. All children had exclusively consumed human milk, infant formula without palm olein oil, or an infant formula with palm olein oil. | Sex: 58 % male Mean age: 4.5 years Race: 85 % Caucasian Location: USA |
178 | Human milk | Formula without palm olein oil | Formula with palm olein oil | |
| Total body BMC at 4 years (g) | 566 ± 12 | 583 ± 10c | 570 ± 7 | ||||
| Harvey et al. 2009 [213] | Prospective cohort study examining associations between duration of breastfeeding and compliance with infant dietary guidelines and later bone size and density at age 4 years | Sex: 158 males, 149 females Age: 6 months at baseline Race: not reported Location: UK |
599 | Breast milk (<1 month) | Breast milk (2–6 months) | ||
| No differencea | No differencea | ||||||
| Molgaard et al. 2011 [212] | Random sample of infants from the Copenhagen Cohort Study of Infant Growth and Nutrition were investigated to determine if early nutrition and early growth are associated with later bone mass in adolescence. | Sex: 44 males, 65 females Age: birth to 12 weeks. Examination at 17 years Race: Danish origin; otherwise not reported Location: Denmark Years: 1987–2005 |
109 | Lumbar spine BMC | The duration of exclusive breastfeeding was positively correlated with the sex-adjusted lumbar spine BMCa,**. | ||
| Pirila et al. 2011 [214] | Prospective study of infants divided into three equal-sized groups according to the total duration of breastfeeding (short = 3 months, intermediate = >3 to <7 months, and prolonged = >7 months) followed-up after 32 years | Sex: 76 males, 82 females Age: 2 weeks to 12 months in original cohort; 31.7–34.0 years at follow-up Race: not reported Location: Finland Year(s): 2007–2009 |
158 | Total body BMC | In males, short breastfeeding was associated with higher bone area, BMC, and BMD compared to longer breastfeeding. Males in the short breastfeeding group had on average 4.7 % higher total body BMD than males in the prolonged breastfeeding groupa,**. | ||
| Fewtrell et al. 2013 [220] | To compare total body and lumbar spine bone in children aged 10 years that as infants participated in a randomized trial and either were breast-fed or randomly received a control formula or an sn-2 palmitate-enriched formula using a double-blind permuted block allocation. The study was completed at 12 weeks and follow-up measurements were taken at 10 years. | Sex: 52 % male, 48 % female Age: birth to 12 weeks; follow-up at 10 years Race: not reported Location: Cambridge, UK |
91 | Breast-fed | Formula with standard fat blend | Formula with high sn-2 fat blend | |
| Lumbar spine BMC (g) | 23.12 ± 4.46 | 22.54 ± 4.52 | 24.38 ± 5.15 | ||||
| Total body BMC (g) | 1062 ± 213 | 1049 ± 264 | 1097 ± 231 | ||||
| Jones et al. 2013 [218] | Birth cohort study to determine if early life factors (e.g., breastfeeding) were associated with bone mass and fractures in 16-year-old adolescents | Sex: 265 males, 150 females Age: 16 years at follow-up Race: predominantly Caucasian Location: Tasmania |
415 | OR (95 % CI) | Any fracture | Upper limb fracture | Lower limb fracture |
| Intention to breastfeed | 0.71 (0.55–0.94)c | 0.80 (0.55–1.66) | 0.63 (0.36–1.13) | ||||
| Breastfeeding at 1 month | 0.65 (0.48–0.87)c | 0.84 (0.54–1.73) | 0.49 (0.26–0.93)c | ||||
| Breastfeeding at 3 months | 0.80 (0.60–1.09) | 0.87 (0.58–1.31) | 0.82 (0.45–1.48) | ||||
| Maternal recall of breastfeeding | 0.69 (0.54–0.89)c | 0.73 (0.51–1.39) | 0.75 (0.42–1.34) | ||||
| Kalkwarf et al. 2013 [215] | A cross-sectional study to describe age, sex, race, growth, and human milk feeding effects on bone | Sex: 158 males, 149 females Age: 1–36 months Race: 225 Caucasian, 63 African American, 15 mixed Caucasian and African American, and 4 Asian Location: USA |
307 | Human milk | No human milk | ||
| Overall BMD Z-score | −0.05 | 0.21** | |||||
95 % CI confidence interval, BMC bone mineral content, BMD bone mineral density, DXA dual-energy x-ray absorptiometry, OR odds ratio, RCT randomized controlled trial
aValues were reported in a figure and via text
*P < 0.01; **P < 0.05