Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Carbohydrates, insulin resistance and diabetes mellitus

Milk-cereal and whole-grain dietary patterns protect against low bone mineral density among male adolescents and young adults

European Journal of Clinical Nutrition volume 71, pages 1101–1107 (2017)Cite this article

Subjects

Abstract

Background/Objectives:

Evidence supporting the possible effect of dietary factors on adult bone health has emerged in recent decades. The purpose of this study was to ascertain the influence of different dietary patterns on bone mineral density (BMD) among Korean male youth.

Subjects/Methods:

Data were extracted from the Korean National Health and Nutrition Examination Survey (KNHANES) during 2008–2011. The subjects included 1351 male aged 10–25 years. We defined ‘low BMD group’ as subjects with a BMD Z-score of −2.0 or less. Dietary patterns were derived from 20 food groups via factor analysis.

Results:

Three dietary patterns—meat and vegetable, white rice and kimchi, milk-cereal and whole grain—were derived. The ‘milk-cereal and whole-grain’ dietary pattern score showed positive association with energy, protein, fat, calcium, phosphorus, potassium, riboflavin and vitamin C intakes. Participants in the top tertile of the milk-cereal and whole-grain pattern were less likely to have low BMD, compared with subjects in the bottom tertile (odds ratio=0.36, 95% confidence interval=0.16–0.81, P=0.018).

Conclusions:

Our findings suggest that the milk-cereal and whole-grain dietary pattern may have a benign influence on bone health in the Korean male youth.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A . Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res 2007; 22: 465–475.

    Article  Google Scholar 

  2. Li SJ, Paik HY, Joung H . Dietary patterns are associated with sexual maturation in Korean children. Br J Nutr 2006; 95: 817–823.

    Article  CAS  Google Scholar 

  3. Cooper C, Melton LJ 3rd . Epidemiology of osteoporosis. Trends Endocrinol Metab 1992; 3: 224–229.

    Article  CAS  Google Scholar 

  4. Johnston CC, Slemenda CW . Peak bone mass, bone loss and risk of fracture. Osteoporos Int 1994; 4: 43–45.

    Article  Google Scholar 

  5. McGuigan FEA, Murray L, Gallagher A, Davey-Smith G, Neville CE, Van't Hof R et al. Genetic and environmental determinants of peak bone mass in young men and women. J Bone Miner Res 2002; 17: 1273–1279.

    Article  CAS  Google Scholar 

  6. Pettifor JM, Prentice A . The role of vitamin D in paediatric bone health. Best Pract Res Clin Endocrinol Metab 2011; 25: 573–584.

    Article  CAS  Google Scholar 

  7. Hu FB . Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 2002; 13: 3–9.

    Article  CAS  Google Scholar 

  8. Kant AK . Dietary patterns and health outcomes. J Am Diet Assoc 2004; 104: 615–635.

    Article  Google Scholar 

  9. Tucker KL . Dietary patterns, approaches, and multicultural perspective. Appl Physiol Nutr Metab 2010; 35: 211–218.

    Article  Google Scholar 

  10. Kontogianni MD, Melistas L, Yannakoulia M, Malagaris L, Panagiotakos DB, Yiannakouris N . Association between dietary patterns and indices of bone mass in a sample of Mediterranean women. Nutrition 2009; 25: 165–171.

    Article  Google Scholar 

  11. Langsetmo L, Poliquin S, Hanley DA, Prior JC, Barr S, Anastassiades T et al. Dietary patterns in Canadian men and women ages 25 and older: relationship to demographics, body mass index, and bone mineral density. BMC Musculoskelet Disord 2010; 11: 20.

    Article  Google Scholar 

  12. Okubo H, Sasaki S, Horiguchi H, Oguma E, Miyamoto K, Hosoi Y et al. Dietary patterns associated with bone mineral density in premenopausal Japanese farmwomen. Am J Clin Nutr 2006; 83: 1185–1192.

    Article  CAS  Google Scholar 

  13. Shin S, Joung H . A dairy and fruit dietary pattern is associated with a reduced likelihood of osteoporosis in Korean postmenopausal women. Br J Nutr 2013; 110: 1926–1933.

    Article  CAS  Google Scholar 

  14. Tucker KL, Chen HL, Hannan MT, Cupples LA, Wilson PWF, Felson D et al. Bone mineral density and dietary patterns in older adults: the Framingham Osteoporosis Study. Am J Clin Nutr 2002; 76: 245–252.

    Article  CAS  Google Scholar 

  15. Hardcastle AC, Aucott L, Fraser WD, Reid DM, Macdonald HM . Dietary patterns, bone resorption and bone mineral density in early post-menopausal Scottish women. Eur J Clin Nutr 2011; 65: 378–385.

    Article  CAS  Google Scholar 

  16. Shin S, Hong K, Kang SW, Joung H . A milk and cereal dietary pattern is associated with a reduced likelihood of having a low bone mineral density of the lumbar spine in Korean adolescents. Nutr Res 2013; 33: 59–66.

    Article  CAS  Google Scholar 

  17. Whittle CR, Woodside JV, Cardwell CR, McCourt HJ, Young IS, Murray LJ et al. Dietary patterns and bone mineral status in young adults: the Northern Ireland Young Hearts Project. Br J Nutr 2012; 108: 1494–1504.

    Article  CAS  Google Scholar 

  18. Wosje KS, Khoury PR, Claytor RP, Copeland KA, Hornung RW, Daniels SR et al. Dietary patterns associated with fat and bone mass in young children. Am J Clin Nutr 2010; 92: 294–303.

    Article  CAS  Google Scholar 

  19. Song Y, Park MJ, Paik HY, Joung H . Secular trends in dietary patterns and obesity-related risk factors in Korean adolescents aged 10-19 years. Int J Obes (Lond) 2010; 34: 48–56.

    Article  CAS  Google Scholar 

  20. Lee HA, Park H . Correlations between poor micronutrition in family members and potential risk factors for poor diet in children and adolescents using Korean National Health and Nutrition Examination Survey Data. Nutrients 2015; 7: 6346–6361.

    Article  CAS  Google Scholar 

  21. Hernandez E, Kim M, Kim WG, Yoon J . Nutritional aspects of night eating and its association with weight status among Korean adolescents. Nutr Res Pract 2016; 10: 448–455.

    Article  Google Scholar 

  22. Butler LM, Wu AH, Wang RW, Koh WP, Yuan JM, Yu MC . A vegetable-fruit-soy dietary pattern protects against breast cancer among postmenopausal Singapore Chinese women. Am J Clin Nutr 2010; 91: 1013–1019.

    Article  CAS  Google Scholar 

  23. National Rural Nutrition Institute Food Composition Tables. National Rural Nutrition Institute: Seoul, 2012.

  24. Moon JS, Lee SY, Nam CM, Choi JM, Choe BK, Seo JW et al. 2007 Korean National Growth Charts: review of developmental process and an outlook. Korean J Pediatr 2008; 51: 1–25.

    Article  Google Scholar 

  25. World Health Organization The Asia-Pacific Perspective: Redefining Obesity and Its Treatment. The International Obesity Task Force, Health Communications Australia Pty Ltd: Brisbane, Australia, 2000.

  26. Henry YM, Fatayerji D, Eastell R . Attainment of peak bone mass at the lumbar spine, femoral neck and radius in men and women: relative contributions of bone size and volumetric bone mineral density. Osteoporos Int 2004; 15: 263–273.

    Article  Google Scholar 

  27. Lewiecki EM, Gordon CM, Baim S, Leonard MB, Bishop NJ, Bianchi ML et al. International Society for Clinical Densitometry 2007 Adult and Pediatric Official Positions. Bone 2008; 43: 1115–1121.

    Article  Google Scholar 

  28. Mu M, Wang SF, Sheng J, Zhao Y, Wang GX, Liu KY et al. Dietary patterns are associated with body mass index and bone mineral density in Chinese freshmen. J Am Coll Nutr 2014; 33: 120–128.

    Article  CAS  Google Scholar 

  29. Noh HY, Song YJ, Lee JE, Joung H, Park MK, Li SJ et al. Dietary patterns are associated with physical growth among school girls aged 9-11 years. Nutr Res Pract 2011; 5: 569–577.

    Article  CAS  Google Scholar 

  30. Mesías M, Seiquer I, Navarro MP . Calcium nutrition in adolescence. Crit Rev Food Sci Nutr 2011; 51: 195–209.

    Article  Google Scholar 

  31. Nicklas TA . Calcium intake trends and health consequences from childhood through adulthood. J Am Coll Nutr 2003; 22: 340–356.

    Article  CAS  Google Scholar 

  32. Im JG, Kim SH, Lee GY, Joung H, Park MJ . Inadequate calcium intake is highly prevalent in Korean children and adolescents: the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2010. Public Health Nutr 2014; 17: 2489–2495.

    Article  Google Scholar 

  33. Herrmann M, Widmann T, Colaianni G, Colucci S, Zallone A, Herrmann W . Increased osteoclast activity in the presence of increased homocysteine concentrations. Clin Chem 2005; 51: 2348–2353.

    Article  CAS  Google Scholar 

  34. Dai Z, Koh WP . B-vitamins and bone health—a review of the current evidence. Nutrients 2015; 7: 3322–3346.

    Article  CAS  Google Scholar 

  35. Abrahamsen B, Madsen JS, Tofteng CL, Stilgren L, Bladbjerg EM, Kristensen SR et al. Are effects of MTHFR (C677T) genotype on BMD confined to women with low folate and riboflavin intake? Analysis of food records from the Danish osteoporosis prevention study. Bone 2005; 36: 577–583.

    Article  CAS  Google Scholar 

  36. Macdonald HM, McGuigan FE, Fraser WD, New SA, Ralston SH, Reid DM . Methylenetetrahydrofolate reductase polymorphism interacts with riboflavin intake to influence bone mineral density. Bone 2004; 35: 957–964.

    Article  CAS  Google Scholar 

  37. Yazdanpanah N, Uitterlinden AG, Zillikens MC, Jhamai M, Rivadeneira F, Hofman A et al. Low dietary riboflavin but not folate predicts increased fracture risk in postmenopausal women homozygous for the MTHFR 677T allele. J Bone Miner Res 2008; 23: 86–94.

    Article  CAS  Google Scholar 

  38. Ilich JZ, Kerstetter JE . Nutrition in bone health revisited: a story beyond calcium. J Am Coll Nutr 2000; 19: 715–737.

    Article  CAS  Google Scholar 

  39. Vicente-Rodriguez G, Ezquerra J, Mesana MI, Fernandez-Alvira JM, Rey-Lopez JP, Casajus JA et al. Independent and combined effect of nutrition and exercise on bone mass development. J Bone Miner Metab 2008; 26: 416–424.

    Article  Google Scholar 

  40. Nelson DA . Peak bone mass. Osteoporosis Int 2000; 11: S47–S48.

    Article  Google Scholar 

  41. Golden NH, Abrams SA, Nutr C . Optimizing bone health in children and adolescents. Pediatrics 2014; 134: E1229–E1243.

    Article  Google Scholar 

Download references

Acknowledgements

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2014R1A6A3A03056928) and was supported by the 2013 Merck Serono research grant. Ministry of Education, Science and Technology and Merck Serono had no role in the design, analysis or writing of this article.

Author information

Authors and Affiliations

  1. Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea

    S Shin

  2. Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea

    S Shin

  3. Graduate School of Public Health, Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea

    S Shin & H Joung

  4. Department of Pediatrics, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea

    S-H Kim & M J Park

Authors
  1. S Shin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S-H Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H Joung
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M J Park
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to H Joung or M J Park.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shin, S., Kim, SH., Joung, H. et al. Milk-cereal and whole-grain dietary patterns protect against low bone mineral density among male adolescents and young adults. Eur J Clin Nutr 71, 1101–1107 (2017). https://doi.org/10.1038/ejcn.2017.81

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2017.81

This article is cited by

Search

Advanced search

Quick links