Life-course determinants of bone mass in young adults from a transitional rural community in India: The Andhra Pradesh Children and Parents Study (APCAPS)

Matsuzaki, Mika, Kuper, Hannah, Kulkarni, Bharati, Radhakrishna, K.V., Viljakainen, Heli, Taylor, Amy, Sullivan, Ruth, Bowen, Liza, Tobias, Jon, Ploubidis, George, Wells, Jonathon, Prabhakaran, Dorairaj, Smith, George Davey, Ebrahim, Shah, Ben-Shlomo, Yoav, & Kinra, Sanjay (2014) Life-course determinants of bone mass in young adults from a transitional rural community in India: The Andhra Pradesh Children and Parents Study (APCAPS). The American Journal of Clinical Nutrition, 99(6), pp. 1450-1459.

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Background: Undernutrition and physical inactivity are both associated with lower bone mass.

Objective: This study aimed to investigate the combined effects of early-life undernutrition and urbanized lifestyles in later life on bone mass accrual in young adults from a rural community in India that is undergoing rapid socioeconomic development.

Design: This was a prospective cohort study of participants of the Hyderabad Nutrition Trial (1987–1990), which offered balanced protein-calorie supplementation to pregnant women and preschool children younger than 6 y in the intervention villages. The 2009–2010 follow-up study collected data on current anthropometric measures, bone mineral density (BMD) measured by dual-energy X-ray absorptiometry, blood samples, diet, physical activity, and living standards of the trial participants (n = 1446, aged 18–23 y).

Results: Participants were generally lean and had low BMD [mean hip BMD: 0.83 (women), 0.95 (men) g/cm2; lumbar spine: 0.86 (women), 0.93 (men) g/cm2]. In models adjusted for current risk factors, no strong evidence of a positive association was found between BMD and early-life supplementation. On the other hand, current lean mass and weight-bearing physical activity were positively associated with BMD. No strong evidence of an association was found between BMD and current serum 25-hydroxyvitamin D or dietary intake of calcium, protein, or calories.

Conclusions: Current lean mass and weight-bearing physical activity were more important determinants of bone mass than was early-life undernutrition in this population. In transitional rural communities from low-income countries, promotion of physical activity may help to mitigate any potential adverse effects of early nutritional disadvantage.

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ID Code: 88734
Item Type: Journal Article
Refereed: Yes
DOI: 10.3945/ajcn.113.068791
ISSN: 0002-9165
Divisions: Current > Research Centres > Centre for Health Research
Current > QUT Faculties and Divisions > Faculty of Health
Copyright Owner: Copyright 2014 American Society for Nutrition
Copyright Statement: This is an open access article distributed under the CC-BY license (
Deposited On: 30 Oct 2015 00:28
Last Modified: 30 Oct 2015 00:28

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