The role of B-vitamin intake, B-vitamin-rich dietary patterns, the B-vitamin deficiency index in bone mineral density among school-aged children.

Abstract

To examine associations of B-vitamin intake, B-vitamin-rich dietary patterns, and the B-Vitamin Deficiency Index (BVDI) with bone mineral density (BMD) in children. This cross-sectional study included 1026 Chinese children aged 9-12 years. Dietary intake was assessed using a semi-quantitative food-frequency questionnaire. B-vitamin-rich dietary patterns were derived using reduced-rank regression, and cumulative B-vitamin inadequacy was assessed using BVDI based on Chinese Dietary Reference Intakes. Forearm BMD was measured by dual-energy X-ray absorptiometry. Multivariable logistic regression and restricted cubic splines were used. Higher quartiles of vitamin B₂, B₉, and B₁₂ (Q4 vs Q1: OR = 0.43, 95% CI: 0.25-0.74, OR = 0.50, 95% CI: 0.30-0.85, OR = 0.46, 95% CI: 0.27-0.81, respectively) were associated with lower odds of low BMD. The B-vitamin-rich dietary pattern showed an inverse but borderline association with low BMD (OR = 0.61, 95% CI: 0.36-1.02; P = 0.060). Participants in the highest BVDI quartile had 72% higher odds of low BMD than those in the lowest BVDI quartile (OR = 1.72, 95% CI:1.02-2.92). Higher intakes of vitamins B₂, B₉, and B₁₂ were associated with lower odds of low BMD, whereas higher BVDI was associated with higher odds of low BMD. These observational findings suggest that B-vitamin nutritional status may be related to pediatric bone health indicators. Reduced-rank regression identified a B-vitamin-rich dietary pattern characterized by higher intakes of beans, dairy products, meats, grains, eggs, vegetables, and aquatic products; greater adherence to this pattern showed an inverse but borderline association with low bone mineral density (BMD). Higher intakes of vitamins B₂, B₉, and B₁₂ were associated with lower odds of low BMD. The B-Vitamin Deficiency Index (BVDI), reflecting cumulative inadequacy across eight B vitamins, was associated with higher odds of low BMD. These observational findings suggest that B-vitamin nutritional status may be related to skeletal health indicators in childhood.