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    The relationship between dairy intake, body composition, physical activity, and bone health among pre-pubertal children : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Human Nutrition at Massey University, Palmerston North, New Zealand
    (Massey University, 2015) Awan, Tahibia Manzoor
    Objective: To examine the effects of dairy intake, body composition parameters, and physical activity on the bone mineral status of pre-pubertal children. Study design: This was a cross-sectional study of 45 healthy pre-pubertal children aged 5-10 years. Total headless bone mineral content (tBMC), total headless bone mineral density (tBMD), lumbar spine bone mineral content (LS-BMC), and lumbar spine bone mineral density (LS-BMD) were measured with dual energy x-ray absorptiometry (DEXA). Dietary calcium intake was assessed using a food frequency questionnaire (FFQ) and a 3-day estimated food record. Anthropometric data was collected and a previous day physical activity recall (PDPAR) was used to measure the physical activity as metabolic equivalents of task (METs) and energy expenditure (EE). The FFQ was also validated against the 3-day estimated food record. Results: The average daily serves of dairy consumed by children were above the recommended levels. Similarly the FFQ analysis also showed mean calcium intake of the sample to be higher than the recommended dietary intake (RDI) level. Boys had significantly higher lean body mass (LBM) than girls (p <0.02). Girls on the other hand had significantly higher percent body fat (%BF) compared to boys (p<0.0005). Multiple linear regression analyses for the population sample showed no significant association was present between calcium or dairy intake and any bone parameters. Furthermore, calcium/dairy intake was also not significantly related to body composition, physical activity, and anthropometric variables. tBMC and tBMD did show a positive significant relationship with LBM and TFM but an inverse significant association with %BF. Average EE showed a significantly positive relationship with tBMD only. Whereas, METs were a negative significant predictor of only %BF. Validation of the FFQ showed that it overestimated daily calcium intake. Conclusions: Calcium or dairy intakes were not significantly associated with bone health status. LBM, TFM, and %BF are important significant predictors of children’s bone health. And finally, physical activity has beneficial effects upon the bone health and body fat.
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    The effect of a high calcium dairy based supplement on parameters of bone health in pre-pubertal New Zealand children : a thesis presented in partial fulfilment of the requirements for the degree of Masters of Science in Nutritional Science at Massey University
    (Massey University, 2002) Merrilees, Megan Joan
    With an ageing population and an increased awareness of the rising health costs of fractures caused by osteoporosis (1); the focus of osteoporosis research is changing from treatment to prevention. More recent studies have looked at the effect of calcium supplementation during childhood and adolescence as a method of increasing the peak bone mass (2-10). It is postulated this will lead to a decrease in fractures in later life. This study investigated the effect of a calcium enriched milk drink on bone density, bone mineral content and bone size in both male and female 8-10 year old New Zealand (NZ) pre-pubertal children. One hundred and fifty four NZ pre-pubertal boys and girls were randomized to receive a high calcium dairy (Ca 2+ =1200mg) drink or a control (Ca 2+ =400mg) drink for 18 months. They were assessed at baseline and then every 6 months for the first 18 months, during the supplementation period; they were then followed up 12 months later. Bone mineral density, and bone mineral content was assessed at the total body, hip and spine. Indicators of bone size were measured at the spine. Anthropometric data was collected and Tanner stages of pubertal development, dietary calcium intake, compliance and medical questionnaires were administered. The calcium food frequency questionnaire was validated against a 3 day weighed food record at baseline. There was no significant difference between the 2 groups for bone mineral density or bone mineral content observed either before or after the intervention. Trends were seen in bone mineral density in the total hip (p=0.081) and the trochanter (p=0.088). There was no difference in vertebral height or width at any stage of the study, indicating no additional influence on bone size. There were no significant differences between height, weight, lean mass or fat mass. Both groups had high habitual calcium intakes at baseline and this continued throughout the study, resulting in calcium intakes above the estimated calcium threshold for both groups. In this 2 1/2 year study (18 months supplementation, 1 year follow-up) there was no difference in bone mineral density in children aged 8-12 years. This is most likely due to a high habitual dietary calcium intake, that even with minimal addition of calcium to the diet a threshold level was reached where no further benefit was seen.