The inverse relationship between fatness and bone mineral content is mediated by the adolescent appendicular skeletal muscle mass index: The Cogni-Action Project

Carlos Cristi-Montero; Humberto Peña-Jorquera; Leslie Landaeta-Díaz; Julio B Mello; Felipe Araya-Quintanilla; Caroline Brand; Cézane Reuter; Carlos Jorquera; Gerson Ferrari

doi:10.3389/fnut.2022.1040116

The inverse relationship between fatness and bone mineral content is mediated by the adolescent appendicular skeletal muscle mass index: The Cogni-Action Project

Front Nutr. 2022 Nov 15:9:1040116. doi: 10.3389/fnut.2022.1040116. eCollection 2022.

Authors

Affiliations

¹ IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile.
² Facultad de Salud y Ciencias Sociales, Universidad de las Américas, Santiago, Chile.
³ Physical Education School, Faculdade SOGIPA, Porto Alegre, Brazil.
⁴ eFiDac Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile.
⁵ Escuela de Kinesiología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Santiago, Chile.
⁶ Graduate Program in Health Promotion, Universidade de Santa Cruz do Sul-UNISC, Santa Cruz do Sul, Brazil.
⁷ Escuela de Nutrición y Dietética, Facultad de Ciencias, Universidad Mayor, Santiago, Chile.
⁸ Escuela de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile (USACH), Santiago, Chile.

Abstract

Background: Excess adipose tissue negatively influences bone health during childhood, affecting future bone fragility diseases such as osteoporosis. However, little is known about how adolescent appendicular skeletal muscle mass index (ASMI) may mediate the relation between fatness and bone mineral content (BMC).

Methods: The sample comprised 1,296 adolescents (50% girls) aged 10-14. A principal component analysis was performed to obtain a factor made up of four fatness indicators (a) neck circumference, (b) kilograms of fat, (c) visceral fat area, and (d) waist-to-height ratio. BMC, kilograms of fat, visceral fat area, and appendicular skeletal muscle mass were obtained by a multi-frequency bioelectrical impedance analyzer. ASMI was calculated as the appendicular skeletal muscle mass divided by height squared (kg/m²). A mediation analysis was performed adjusting by age, sex, maturation, socioeconomic status, physical activity, and adolescents' body weight. We also explore differences by sex and nutritional status.

Results: The fatness factor explained 71.5% of the proportion variance. Fatness was inversely associated with the ASMI and BMC, while the ASMI was positively related to BMC. Overall, the inverse relationship between fatness and BMC was partially mediated by the adolescents' ASMI (29.7%, indirect effect: B= -0.048, 95%CI -0.077 to -0.022), being higher in girls than in boys (32.9 vs. 29.2%). Besides, the mediation effect was higher in adolescents with normal body weight than with overweight-obese (37.6 vs 23.9%, respectively).

Conclusions: This finding highlighted the relevance of promoting healthy habits to reduce fatness and improve muscle mass in adolescents. Moreover, this highlights the central role of ASMI mediating the inverse association between fatness and BMC in female and male adolescents. Public health strategies should promote bone health in childhood, reducing the incidence of early osteopenia and osteoporosis.

Keywords: bone health; children; obesity; physical activity; skeletal muscle mass index.