ABSTRACT
This chapter discusses the contribution of early growth to the developmental origins of osteoporosis, detailing large epidemiological studies and exploring potential underlying mechanisms. There are two principal factors that determine the risk of fracture: the mechanical strength of bone and the strength of the forces applied to it. The strength of a bone is directly related to 'bone mass', a term which describes a composite measure with contributions from bone size and volumetric bone mineral density. The use of high-resolution ultrasound measurements during pregnancy have enabled much more detailed, and, importantly, longitudinal assessment of fetal growth to be made, and to be related to later outcomes such as bone mineral and body composition. This underlines the importance of adopting preventative strategies for osteoporosis at all stages of the lifecourse including the in-utero environment. It is evident that optimising both maternal and infant nutrition are essential strategies for decreasing future osteoporosis risk.
