The Impact of Dietary and Lifestyle Factors on Bone Health in Children during the First 5 Years of Life: A Large Cross‐Sectional Multicenter Bone Study in Jiangsu Province

ABSTRACT Background : To explore the bone mineral density (BMD) in children in Jiangsu Province, China, during the first 5 years of life, and to observe the relationship between BMD and lifestyle factors. Methods : This study was conducted at 12 Children's Health Care Centers (2014–2015), measuring BMD via Sunlight Omnisense 7000P. Speed of sound (SOS) values and Z‐scores were recorded. Results : A total of 5289 children were investigated with an SOS value of 3366.84 m/s and a low BMD prevalence of 14.7%. Significantly higher rates of low BMD were observed in children with the following characteristics: sleep duration >14 h/day, outdoor activity <1 h/day, breastfeeding ≥8 times/day, complementary feeding before 4 months, vitamin D intake ≥400 IU/day, calcium intake >300 mg/day, fish and shrimp intake <1 times/week, milk and dairy intake >500 mL/day, and no daily egg intake. Conclusions : For the first time, this study identified the following lifestyle risk factors independently associated with insufficient bone mass in children during the first 5 years of life in Jiangsu Province: sleep duration >14 h/d, outdoor activities <1 h/d, breastfeeding ≥8 times/day, complementary feeding before 4 months, vitamin D intake ≥400 IU/d, calcium intake >300 mg/d, daily milk and dairy products intake less than 150 mL or more than 500 mL and no daily egg intake. This research addressed knowledge gaps in early growth and bone development by analyzing variables such as daily sleep duration, daily milk and dairy products intake, and seafood consumption among 0–5‐year‐olds, providing region‐specific (Jiangsu Province) reference standards.