Bone Abstracts

Background: Nutrition is a cornerstone of child health. Appropriate nutrient intake contributes to bone health, relevant to conditions of bone fragility. Nutrient intake in chronic conditions can be adversely affected by altered dietary behaviours such as mealtime behaviour and food choice. Dietary behaviour and nutrient intake have not been explored in children with Osteogenesis Imperfecta (OI), the commonest cause of children’s bone fragility.

Aim: To pilot assessment of patterns of dietary behaviours and macro- and micronutrient intakes in children with OI.

Methods: Parents of 40 children with OI aged 4–13 years at an OI specialist centre were invited to complete a web-based 4-day food-diary (Intake-24 software), then a web-based questionnaire encompassing 4 tools: Child Eating Behaviour Questionnaire (CEBQ) and Parental Feeding Styles Questionnaire (PFQ1) (scored 1–5: 1=never – 5=always), Child Food Preference Questionnaire (CFPQ) (scored 1=strong dislike – 5=strong like), and Choosy Eating Questionnaire (CEQ) Intake analysed against Reference Nutrient Intake (RNI) of UK National Dietary Guidance for Children.

Results: Eleven children participated: 5F:6M; Mild-Moderate OI (n=7), Severe OI (n=4); on bisphosphonate/denosumab (n=7); aged 4–6y (n=3), 7-10y (n=5), 11–13y(n=3). Intake24 macronutrient analysis showed 100% had above-RNI sugar, with 81% (n=9) >4 times RNI. 91% (n=10) had carbohydrate intake more than RNI, fat intake was above RNI in 72% (n=8). Micronutrient analysis showed 100% had Vitamin D intake markedly below RNI, whereas calcium intake was at or above RNI in 72% (n=8). Nine parents completed questionnaires. FEQ showed 66%(6/9) children displayed choosy eating, occurring predominantly in older children (4/6 >7yo). 44% (4/9) offer separate meals, reporting frequent disagreements about food. CFPQ findings included strong preference for sugary-snacks (mean 4.3), dislike of vegetables (mean 2.8). CEBQ scores indicated Food-Fussiness and Emotional Under-Eating in 55% (5/9) 33% (3/9) had Slowness in Eating. PFQ1 showed 100% praise trying new foods, 54% control their child’s eating.

Conclusion: Choosy-eating behaviours reported (66%), exceeds background population (8% prevalence in >5yo), with preference for sugary-snacks and reduced preference for vegetables. Impacts were dietary inadequacies across several macro-and micronutrients. Identifying unfavourable dietary behaviours facilitates targeted advice to minimise nutritional compromise in children with OI; important as optimal vitamin D and calcium intake assists bone health.

Disclosure: The authors declared no competing interests.