Disordered-Eating Attitudes in Relation to Bone Mineral Density and Markers of Bone Turnover in Overweight Adolescents
Received 10 April 2008; accepted 29 December 2008. published online 27 April 2009.
Abstract
Purpose
To examine the relationships between cognitive eating restraint and both bone mineral density (BMD) and markers of bone turnover in overweight adolescents.
Methods
One hundred thirty-seven overweight (BMI 39.1 ± 6.8 kg/m2) African American and Caucasian adolescent (age = 14.4 ± 1.4 years) girls (66.4%) and boys were administered the Eating Disorder Examination (EDE) interview and Eating Inventory (EI) questionnaire and underwent dual energy X-ray absorptiometry (DXA) to measure total lumbar spine BMD. Markers of bone formation (serum bone specific alkaline phosphatase and osteocalcin), bone resorption (24-hour urine N-telopeptides), and stress (urine free cortisol) were measured.
Results
After accounting for the contribution of demographics, height, weight, serum 25-hydroxyvitamin D, and depressive symptoms, adolescents' weight concern, as assessed by interview, was a significant contributor to the model of urine free cortisol (β = .30, p < .05). Shape concern, as also assessed by interview, was significantly associated with lumbar spine bone mineral density (β = −.15, p < .05). Dietary restraint was not a significant predictor in any of these models.
Conclusions
These findings suggest that among severely overweight adolescents, dissatisfaction with shape and weight may be salient stressors. Future research is required to illuminate the relationship between bone health and disordered-eating attitudes in overweight adolescents.
aUnit on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (NIH), DHHS, Rockville, Maryland
bMedical and Clinical Psychology, Uniformed Services University of the Health Sciences, Washington, DC
cDivision of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive Kidney Diseases, NIH, DHHS, Rockville, Maryland
dNuclear Medicine Department, Hatfield Clinical Research Center, NIH, DHHS, Rockville, Maryland
Address correspondence to: Marian Tanofsky-Kraff, Ph.D., MPS, USUHS, 4301 Jones Bridge Road, Bethesda, MD 20814-4712.
ABSTRACT