The influence of dairy consumption, sedentary behaviour and physical activity on bone mass in Flemish children: a cross-sectional study.

BACKGROUND: This cross-sectional study aimed to look for an association in young children between whole body bone mineral content (BMC) and areal bone mineral density (aBMD) and dairy consumption as well as sedentary behaviour (SB) and physical activity (PA). Moreover, we investigated whether there was an interaction effect between dairy consumption and SB or PA on BMC and aBMD. METHODS: Healthy children (6-12 years) were recruited from primary schools. Body composition and whole body bone mass were measured with dual-energy X-ray absorptiometry (DXA), dairy consumption was assessed with a food frequency questionnaire (FFQ) and PA and SB with an accelerometer. In total, 272 children underwent a DXA scan. Complete FFQ data were available for 264 children and 210 children had matching data from accelerometry recordings. Regression analyses were used to study the associations between (1) BMC and aBMD and (2) dairy consumption, SB and PA, adjusting for age, gender, pubertal stage, height and body composition. RESULTS: Dairy consumption was positively associated with whole body BMC and aBMD (absolute value as well as z-score), after correction for relevant confounders. SB was negatively associated with aBMD z-score and light PA was positively associated with both BMC and aBMD z-score. No gender differences were found. Moreover, an interaction effect between vigorous PA (VPA) and dairy consumption on aBMD (z-score) and BMC z-score was found, indicating that children with both high VPA and high dairy consumption had higher values for BMC and aBMD of the whole body minus the head. CONCLUSION: Already at young age, PA and dairy consumption positively influence whole body bone mass assessed by DXA. Moreover, this study indicates clearly that SB is negatively associated with whole body bone density. Promoting regular PA and sufficient dairy consumption in young children and limiting SB can be expected to positively influence their bone mass accumulation, which can help in the prevention of osteoporosis later in life.

Bridging the gap: metabolic and endocrine care of patients during transition.

OBJECTIVE: Seamless transition of endocrine patients from the paediatric to adult setting is still suboptimal, especially in patients with complex disorders, i.e., small for gestational age, Turner or Prader-Willi syndromes; Childhood Cancer Survivors, and those with childhood-onset growth hormone deficiency. METHODS: An expert panel meeting comprised of European paediatric and adult endocrinologists was convened to explore the current gaps in managing the healthcare of patients with endocrine diseases during transition from paediatric to adult care settings. RESULTS: While a consensus was reached that a team approach is best, discussions revealed that a 'one size fits all' model for transition is largely unsuccessful in these patients. They need more tailored care during adolescence to prevent complications like failure to achieve target adult height, reduced bone mineral density, morbid obesity, metabolic perturbations (obesity and body composition), inappropriate/inadequate puberty, compromised fertility, diminished quality of life and failure to adapt to the demands of adult life. Sometimes it is difficult for young people to detach emotionally from their paediatric endocrinologist and/or the abrupt change from an environment of parental responsibility to one of autonomy. Discussions about impending transition and healthcare autonomy should begin in early adolescence and continue throughout young adulthood to ensure seamless continuum of care and optimal treatment outcomes. CONCLUSIONS: Even amongst a group of healthcare professionals with a great interest in improving transition services for patients with endocrine diseases, there is still much work to be done to improve the quality of healthcare for transition patients.

Osteopathy may decrease obstructive apnea in infants: a pilot study.

BACKGROUND: Obstructive apnea is a sleep disorder characterized by pauses in breathing during sleep: breathing is interrupted by a physical block to airflow despite effort. The purpose of this study was to test if osteopathy could influence the incidence of obstructive apnea during sleep in infants. METHODS: Thirty-four healthy infants (age: 1.5-4.0 months) were recruited and randomized in two groups; six infants dropped out. The osteopathy treatment group (n = 15 infants) received 2 osteopathic treatments in a period of 2 weeks and a control group (n = 13 infants) received 2 non-specific treatments in the same period of time. The main outcome measure was the change in the number of obstructive apneas measured during an 8-hour polysomnographic recording before and after the two treatment sessions. RESULTS: The results of the second polysomnographic recordings showed a significant decrease in the number of obstructive apneas in the osteopathy group (p = 0.01, Wilcoxon test), in comparison to the control group showing only a trend suggesting a gradual physiologic decrease of obstructive apneas. However, the difference in the decline of obstructive apneas between the groups after treatment was not significant (p = 0.43). CONCLUSION: Osteopathy may have a positive influence on the incidence of obstructive apneas during sleep in infants with a previous history of obstructive apneas as measured by polysomnography. Additional research in this area appears warranted.