Fat mass is positively associated with bone mass acquisition in children with small or normal lean mass: A three-year follow-up study

Abstract The independent impact of fat mass (FM) on bone health is difficult to assess, as FM is correlated with lean soft tissue mass (LSTM). In a previous cross-sectional study, FM was suggested to help promote high bone mass acquisition in adolescents with small LSTM. The present prospective cohort study investigated the effects of FM on bone in pubertal children after stratification by height-normalized index of LSTM (LSTMI). The source population was all 5th grade children enrolled in either one of the two public elementary schools in Hamamatsu, Japan. Of these, 545 children who participated in both baseline (at age 11) and follow-up (at age 14) surveys were included in the present analysis. Body composition and whole body areal bone mineral density (aBMD) were measured using dual-energy X-ray absorptiometry. From baseline to follow-up, significant (P