Low bone mineral density and bone
mineral content are associated with
low cobalamin status in adolescents |
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| Authors: | R A M Dhonukshe-Rutten M van Dusseldorp J Schneede L C P G M de Groot W A van Staveren |
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| Institution: | (1) Division of Human Nutrition, Wageningen University, 8129, 6700 EV Wageningen, The Netherlands;(2) Food and Chemical Risk Analysis, TNO Nutrition and Food Research, Zeist, The Netherlands;(3) Dept. of Clinical Chemistry, University of Umeå, Umeå, Sweden |
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| Abstract: | Summary
Background
Cobalamin
deficiency is prevalent in vegetarians
and has been associated
with increased risk of osteoporosis.
Aim of the study
To examine the association
between cobalamin status
and bone mineral density in adolescents
formerly fed a macrobiotic
diet and in their counterparts.
Methods
In this cross–sectional
study bone mineral density (BMD)
and bone mineral content (BMC)
were determined by DEXA in 73
adolescents (9–15 y) who were fed
a macrobiotic diet up to the age of
6 years followed by a lacto–(–ovo–)
vegetarian or omnivorous diet.
Data from 94 adolescents having
consumed an omnivorous diet
throughout their lives were used as
controls. Serum concentrations of
cobalamin, methylmalonic acid
(MMA) and homocysteine were
measured and calcium intake was
assessed by questionnaire. Analysis
of covariance (MANCOVA) was
performed to calculate adjusted
means for vitamin B12 and MMA
for low and normal BMC and BMD
groups.
Results
Serum cobalamin
concentrations were significantly
lower (geometric mean (GM) 246
pmol/L vs. 469 pmol/L) and MMA
concentrations were significantly
higher (GM 0.27 µmol/L vs.
0.16 µmol/L) in the formerly macrobiotic–fed adolescents compared
to their counterparts. In the total
study population, after adjusting
for height, weight, bone area, percent
lean body mass, age, puberty
and calcium intake, serum MMA
was significantly higher in subjects
with a low BMD (p = 0.0003) than
in subjects with a normal BMD. Vitamin
B12 was significantly lower in
the group with low BMD
(p = 0.0035) or BMC (p = 0.0038)
than in the group with normal
BMD or BMC. When analyses were
restricted to the group of formerly
macrobiotic–fed adolescents, MMA
concentration remained higher in
the low BMD group compared to
the normal BMD group.
Conclusion
In adolescents, signs of an
impaired cobalamin status, as
judged by elevated concentrations
of methylmalonic acid, were associated
with low BMD. This was especially
true in adolescents fed a
macrobiotic diet during the first
years of life, where cobalamin deficiency
was more prominent. |
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| Keywords: | adolescents bone
mass cobalamin deficiency macrobiotic diet vegetarian diet analysis of covariance |
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