Diet Quality in Relation to Fat, Lean, and Bone Mass in Children: A Population-based Study (P18-105-19)

Nutrition in early life is considered a crucial modifiable determinant of growth and development. Still, whether overall diet quality in childhood is related to body composition and bone health remains unclear. We aimed to examine associations of overall diet quality with detailed measures of fat, lean, and bone mass in childhood. We included 3991 children from a large population-based prospective cohort in the Netherlands. Dietary intake was assessed using a food-frequency questionnaire at their age of 8 years, and a diet quality score (0–10) was calculated, measuring adherence to age-specific dietary guidelines. Height, weight, and detailed body composition of the children were measured at their age of 10 years. Body composition was assessed using dual-energy X-ray absorptiometry. We calculated sex- and age-specific SD-scores for body mass index (BMI), fat mass index (FMI), fat-free mass index (FFMI), bone mineral density (BMD), bone mineral content (BMC), and area-adjusted BMC (aBMC). Mean diet quality score of the children was 4.5 (±1.2) out of 10, and 12.4% of the children had overweight. After adjustment for socioeconomic and lifestyle factors, we observed that a higher diet quality was associated with a higher height, weight, and BMI in childhood. This positive association of diet quality with BMI was fully driven by a higher FFMI (0.07 SDS per 1 point higher diet quality, 95%CI: 0.05,0.10), and not FMI. For bone health, we observed associations of higher diet quality with higher BMD (0.05 SDS, 95%CI: 0.03,0.08) and BMC (0.06 SDS, 95%CI: 0.03,0.09), but not with aBMC. These associations were independent of diet quality in infancy and not driven by specific food components included in the diet quality score. In this healthy population of children in Europe, we observed a high prevalence of overweight, whereas overall diet quality of the children was suboptimal. Our findings emphasize that an adequate diet in childhood is of high importance, not only for body composition, but also for bone health already at this young age. Dietary intake according to dietary guidelines in childhood may have a beneficial effect on growth and bone development, and may decrease the risk of obesity and osteoporosis later in life. This specific project did not receive any funding.