Journal of Adolescent Health
Volume 45, Issue 1 , Pages 33-39, July 2009

Disordered-Eating Attitudes in Relation to Bone Mineral Density and Markers of Bone Turnover in Overweight Adolescents

  • Natasha A. Schvey, B.A.

      Affiliations

    • Unit 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
    • Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Washington, DC
    • ,
  • Marian Tanofsky-Kraff, Ph.D.

      Affiliations

    • Unit 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
    • Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Washington, DC
    • Corresponding Author InformationAddress correspondence to: Marian Tanofsky-Kraff, Ph.D., MPS, USUHS, 4301 Jones Bridge Road, Bethesda, MD 20814-4712.
    • ,
  • Lisa B. Yanoff, M.D.

      Affiliations

    • Unit 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
    • ,
  • Jenna M. Checchi, B.S.

      Affiliations

    • Unit 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
    • Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive Kidney Diseases, NIH, DHHS, Rockville, Maryland
    • ,
  • Lauren B. Shomaker, Ph.D.

      Affiliations

    • Unit 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
    • Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Washington, DC
    • ,
  • Sheila Brady, M.S.N., CRNP

      Affiliations

    • Unit 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
    • ,
  • David M. Savastano, Ph.D.

      Affiliations

    • Unit 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
    • ,
  • Lisa M. Ranzenhofer, B.S.

      Affiliations

    • Unit 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
    • Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Washington, DC
    • Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive Kidney Diseases, NIH, DHHS, Rockville, Maryland
    • ,
  • Susan Z. Yanovski, M.D.

      Affiliations

    • Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive Kidney Diseases, NIH, DHHS, Rockville, Maryland
    • ,
  • James C. Reynolds, M.D.

      Affiliations

    • Nuclear Medicine Department, Hatfield Clinical Research Center, NIH, DHHS, Rockville, Maryland
    • ,
  • Jack A. Yanovski, M.D., Ph.D.

      Affiliations

    • Unit 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

Received 10 April 2008; accepted 29 December 2008. published online 27 April 2009.

See Editorial p. 3

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.

Keywords: Adolescents, Bone turnover, Bone mineral density, Disordered-eating attitudes, Overweight, Cortisol

 

PII: S1054-139X(09)00054-8

doi:10.1016/j.jadohealth.2008.12.020

Journal of Adolescent Health
Volume 45, Issue 1 , Pages 33-39, July 2009

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