Maternal nutrition and bone health in the offspring.

Osteoporosis is a major public health issue as well as a considerable socioeconomic burden owing to its association with fragility fractures. Bone mass (a composite of bone size and mineral density) increases through life, from conception to a peak in early adulthood. The magnitude of this peak bone mass is a major determinant of osteoporosis risk in later life. Over the last couple of decades, evidence has accrued that factors in utero and in early life may have persisting influences on later health and disease. Thus, low birthweight is associated with reduced bone density at peak and in older age, and poor infant growth predicts increased risk of hip fracture in later life. Maternal lifestyle, physical activity, body build and, in particular, vitamin D status, appear to be important determinants of intrauterine bone mineral accrual, with a persisting negative influence of maternal vitamin D insufficiency demonstrated at 9 years of age in the offspring. This review examines the impact of maternal nutrition on bone development in offspring and on the later risk of osteoporosis, and suggests that these observations may pave the way for novel population-based public health strategies to reduce the burden of osteoporotic fracture in future generation