Este estudo transversal teve por objetivo avaliar e relacionar entre si densidade mineral óssea (DMO), composição corporal e doença periodontal em 22 pacientes do gênero masculino, de 22 a 48 anos, portadores de obesidade, com IMC40kg/m2, candidatos à cirurgia bariátrica, atendidos no Hospital Amaral Carvalho (HAC) pelo Sistema Único de Saúde (SUS). Foram realizadas as avaliações antropométrica, do DXA e da condição periodontal. As variáveis qualitativas e quantitativas foram analisadas por meio da correlação linear pelo índice de correlação de Pearson, considerando o intervalo de confiança de 95% e nível de significância de 5% (p<0,05). O peso médio foi de 148kg (122-198); IMC médio de 48,8 (40,5-62,5); CMO, em média, de 3,31kg (2,7-4,1); DMO de corpo total média de 1,3 g/cm2 (1,1-1,5); e Z-score médio de 1,2 (0,0-2,9). A média de gordura corporal total foi de 43,3% (37,4-52,1), e a porcentagem de massa livre de gordura total foi de 56,6 (47,9-82,3). O IMG (Índice de massa gorda) médio foi de 20,6 (14,4-27,0), relação A/G de 1,2 (1.0-1,6) e o peso de tronco médio, 85,8kg (68,3-116,2). Dos pacientes, 29% apresentaram doença periodontal severa. Na casuística, ocorreu uma diferença a menor de 4,5kg (1,0 a 7,8) no peso de DXA comparado ao peso antropométrico, o que corresponde a uma diferença média de 3,06% (0,05-5,27). Na análise de correlação da avaliação odontológica vs resultado DXA, obteve-se apenas correlação significativa entre o índice de sangramento gengival e o IMG (p=0,031, R= -0,525). Pode-se concluir que o índice de massa corporal esteve inversamente relacionado ao sangramento gengival. Estudos futuros deverão ser conduzidos para esclarecer melhor estes achados. / The present cross-sectional study was aimed at evaluating and establishing the relation between bone mineral density (BMD), body composition and periodontal disease in 22 male patients, aged 22-48 years, with obesity (BMI of 40kg / m2), eligible for bariatric surgery, at Hospital Amaral Carvalho Hospital (HAC) by the Brazilian Unified Health System (SUS). Patients underwent anthropometric evaluations, whole-body DXA and periodontal assessment. Qualitative and quantitative variables were analyzed by means of linear correlation analyzes using the Pearsons correlation coefficient with 95% confidence interval and significance level of 5% (p <0.05). The data analyzes were performed with the aid of the SPSS v.22 program. Mean patients weight was 148kg (122-198); mean BMI, 48.8 (40.5-62.5); mean BMC, 3.31kg (2.7-4.1); mean whole-body BMD, 1.3 g / cm2 (1.1-1.5); and mean Z-score, 1.2 (0.0-2.9). Mean total body fat was 43.3% (37.4-52.1), and the percentage of total lean mass was 56.6 (47.9-82.3). Mean FMI (fat mass index) was 20.6 (14.4- 27.0); A/G ratio 1.2 (1.0-1.6) and mean trunk weight, 85.8 kg (68.3-116, 2). In the present study, 29% of the patients presented with severe periodontal disease. In the sample, there was a shortfall of 4.5 kg (1.0 to 7.8) in the DXA weight compared to anthropometric weight, which corresponds to an average difference of 3.06% (0.05- 5.27). In the correlation analysis between Dentistry assessment and DXA score, only a significant correlation was found between gingival bleeding index and FMI (p = 0.031, R = -0.525). It could be concluded that the body mass index was inversely related to de gingival bleeding. Future studies are needed to better clarify these findings.

Early adulthood is a period of peak bone mass formation, which is one of the basics in prevention of osteoporosis onset in older age. Milk and dairy products intake as a source of well-absorbed calcium is still very substantial at this age, as it was in the previous period of adolescence. However, it is also often a time of finding a person's own diet and a time of eliminating certain food groups from the diet, which is often due to succumbuing to widespread myths. Thus, milk is one of the most controversial foods for the public. The aim of the questionnaire research, which was part of the thesis, was to find out, how many young adults believe and succumb to these myths. Questions were asked about eating habits and respondents' views on the health benefits of milk. The survey shows that a significant percentage of them are misinformed by such myths and exclude milk from their diet, often for no reason. Although campaigns to promote milk consumption are still ongoing and have undoubtedly had a positive effect on public perception of the benefits of milk, it is certain that this activity needs to be continued and myths (not only) about milk still need to be debunked. keywords: milk, dairy products, early adulthood, myths, peak bone mass, calcium

No description available.

Sabe-se que a ativação do Sistema Nervoso Simpático (SNS) induz osteopenia via adrenoceptores b2 (b2-AR). Para investigar se o hormônio tireoideano (HT) interage com o SNS para regular a massa óssea, estudamos o efeito do HT em associação com isoproterenol ou propranolol (agonista e antagonista b-adrenérgicos) e avaliamos o efeito do HT em camundongos com elevado tônus simpático, devido à dupla inativação gênica do a2A-AR e a2C-AR (a2A/a2C-AR-/-), autorreceptores que inibem a liberação de noradrenalina. Vimos que esses animais apresentam um fenótipo de alta massa óssea, apesar do elevado tônus simpático e de intacta sinalização b2-adrenérgica, sugerindo que o a2A-AR e/ou a2C-AR, além do b2-AR, possam mediar ações do SNS no osso. O propranolol limitou e o isoproterenol acentuou os efeitos deletérios do HT no esqueleto, já os animais a2A/a2C-AR-/- apresentaram resistência à osteopenia induzida pela tireotoxicose, o que sugere que há interação entre SNS e o HT para regular a massa óssea, e que esta depende tanto do b2-AR como do a2A- e/ou a2C-AR. / It is known that the sympathetic nervous system (SNS) activation induces ostepenia, via b2-adrenoceptors (b2AR). To investigate if thyroid hormone (TH) interacts with the SNS to regulate bone mass, we studied the effect of TH in association with isoproterenol or propranolol (b-adrenergic agonist and antagonist) and evaluated the effect of TH in mice with a chronic elevated sympathetic tone, due to double disruption of a2A-AR and a2C-AR (a2a/a2c-AR-/-), autoreceptors that inhibit noradrenalin release. We showed that KO mice present a high bone mass phenotype in spite of an elevated sympathetic tone and of intact b2-adrenergic signaling, which suggests that a2A- and/or a2C-AR, besides b2-AR, may also mediate the SNS actions in the bone. Propranolol limited and isoproterenol accentuated the deleterious effects of TH in the skeleton, while a2A/a2C-AR-/- mice presented resistance to the T3-induced osteopenia, which suggest that there is an interaction between the SNS and TH to regulate bone mass, and that it is dependent on b2-AR and a2A-AR and/or a2C-AR signaling.

Das Ziel dieser Studie war die Evaluierung zweier radiologischer Methoden zur Belastbarkeitsvorhersage des Regenerates bei einem Verfahren zur Kallusdistration. Im Rahmen einer tierexperimentellen Großtierstudie (Tiermodell Yucatan-Schweine) wurden die DLR und die DFR als Röntgenverfahren zur Dokumentation des zeitlichen Verlaufs der Regeneratkonsolidierung verwendet. Nach Tötung der Tiere erfolgte der Vergleich zwischen den radiologischen Daten und den biomechanisch gemessenen Werten der untersuchten Tibiae (Festigkeit, Steifigkeit). Das Knochengewicht wurde mittels einer Eichkurve in Aluminiumäquivalent EAT umgerechnet. Anhand der EAT-Werte der einzelnen Versuchstage konnte ein Zuwachs an Knochenfestigkeit festgestellt werden. Die Festigkeit des Knochenregenerates wurde nach der Tötung der Tiere biomechanisch bestimmt und daraufhin mit den EAT-Werten des letzten Versuchtages korreliert. Die digitalisierte Filmradiographie zeigte eine Korrelation des EAT-Wertes am letzten Versuchstag mit der torsionalen Steifigkeitsmessung von r=0,71 und mit dem maximalen Drehmoment von r=0,69. Die DLR konnte demgegenüber eine Korrelation des EAT-Wertes der Distraktionszone mit der torsionalen Steifigkeit von r=0,89 ebenso wie mit dem maximalen Drehmoment von r=0,8 nachweisen. Demzufolge ist eine zuverlässige Verlaufsbeurteilung des Knochenregenerates mit der hier eingeführten Dichtemessung möglich. Beide Verfahren sind geeignet, quantitative Aussagen über die Belastbarkeit des Kallusgewebes bei der Distraktionsosteogenese im Tiermodell zu machen. Die Meßungenauigkeit der Methode war vernachlässigbar, die Meßergebnisse waren unabhängig vom Untersucher. Trotz der hohen Genauigkeit dieser Methode im Tiermodell kann noch keine Aussage über die Anwendung der Verfahrens beim Menschen gemacht werden. Daher werden weitere Studien notwendig sein, um hierüber Klarheit zu schaffen. / The aim of the study was an evaluation of two radiologic methods to predict the strength of bone regeneration in distraction osteogenesis. In this animal study the digitized radiography and the digital luminescence radiography were used for the documentation of bone regeneration. After the death of the animals a comparision between radiologic data and biomechanical data of the tibia was performed. The bone mass was determined by a calibration curve in equivalent aluminium thickness (EAT). On the basis of the EAT data of each examination day an increase of the bone strength could be determined. The bone strength was assessed after the sacrification by biomechanical testing and correlated with the radiologic data of the last examination day. The digitized radiography showed a correlation with the torsional stiffness of r=0,71 and with the maximal torsional moment of r=0,69. The digital luminescence radiography showed a correlation with the torsional stiffness of r=0,89 and with the maximal torsional moment of r=0,8. Therefore a reliable bone mass measurement is available by this method. Both radiographic procedures are suitable to predict the strength of bone regeneration in distraction osteogenesis in this experimental animal study. The inaccuracy of the method was negligible and independent to the investigator. But for all that high accuracy of the method a statement concerning the applicability of this method in humans in not possible. Therefore further investigation are neccessary.

Sabe-se que a ativação do Sistema Nervoso Simpático (SNS) induz osteopenia via adrenoceptores b2 (b2-AR). Para investigar se o hormônio tireoideano (HT) interage com o SNS para regular a massa óssea, estudamos o efeito do HT em associação com isoproterenol ou propranolol (agonista e antagonista b-adrenérgicos) e avaliamos o efeito do HT em camundongos com elevado tônus simpático, devido à dupla inativação gênica do a2A-AR e a2C-AR (a2A/a2C-AR-/-), autorreceptores que inibem a liberação de noradrenalina. Vimos que esses animais apresentam um fenótipo de alta massa óssea, apesar do elevado tônus simpático e de intacta sinalização b2-adrenérgica, sugerindo que o a2A-AR e/ou a2C-AR, além do b2-AR, possam mediar ações do SNS no osso. O propranolol limitou e o isoproterenol acentuou os efeitos deletérios do HT no esqueleto, já os animais a2A/a2C-AR-/- apresentaram resistência à osteopenia induzida pela tireotoxicose, o que sugere que há interação entre SNS e o HT para regular a massa óssea, e que esta depende tanto do b2-AR como do a2A- e/ou a2C-AR. / It is known that the sympathetic nervous system (SNS) activation induces ostepenia, via b2-adrenoceptors (b2AR). To investigate if thyroid hormone (TH) interacts with the SNS to regulate bone mass, we studied the effect of TH in association with isoproterenol or propranolol (b-adrenergic agonist and antagonist) and evaluated the effect of TH in mice with a chronic elevated sympathetic tone, due to double disruption of a2A-AR and a2C-AR (a2a/a2c-AR-/-), autoreceptors that inhibit noradrenalin release. We showed that KO mice present a high bone mass phenotype in spite of an elevated sympathetic tone and of intact b2-adrenergic signaling, which suggests that a2A- and/or a2C-AR, besides b2-AR, may also mediate the SNS actions in the bone. Propranolol limited and isoproterenol accentuated the deleterious effects of TH in the skeleton, while a2A/a2C-AR-/- mice presented resistance to the T3-induced osteopenia, which suggest that there is an interaction between the SNS and TH to regulate bone mass, and that it is dependent on b2-AR and a2A-AR and/or a2C-AR signaling.

Made available in DSpace on 2016-06-02T19:22:01Z (GMT). No. of bitstreams: 1 TeseESCQ.pdf: 16215443 bytes, checksum: 498b5d348520a9ccfd63ba1b85af9b1c (MD5) Previous issue date: 2007-07-15 / Financiadora de Estudos e Projetos / Osteoporosis is attributed to an imbalance between bone formation and resorption, followed by bone mass loss and microarchitectural deterioration, leading to increased bone fragility and fracture risk. Nitric oxide (NO) is a signaling molecule with important regulatory effects on bone cell function. Nitric oxide donor nitroglycerin has been reported to alleviate ovariectomy-induced and corticosteroid-induced bone loss. The aim of the present study was to investigate the effect of NO on cancellous and cortical bone of orchiectomized rats. A total of 98 male Wistar rats (four months old) were randomly divided in the following groups - Experiment I: intact treated with saline (stomacal gavage - gv), orchiectomized treated with saline (gv), and orchiectomized treated with NO donor isosorbide dinitrate - ISDN (gv); Experiment II: intact treated with saline (subcutaneous injection - sc), orchiectomized treated with saline (sc), and orchiectomized treated with NO synthase inhibitor NG-nitro-L-arginine-methylester - L-NAME (sc); Experiment III: intact treated with saline (intraperitoneous injection - ip), orchiectomized treated with saline (ip), and orchiectomized treated with NO precursor L-arginine (ip); Basal group: one group was killed at the beginning of the study (four months old) and served as a baseline group. The animals were killed after 8 weeks of treatment. At death, both femurs and lumbar vertebrae (L5-6) were obtained from each rat, and changes in both cancellous and cortical bone mass and biomechanical competence were assessed. The treatment with NO donor isosorbide dinitrate protected the cortical bone mass of adult rats from the deleterious effects of castration. The protective effect of ISDN treatment on the cancellous bone mass was not as significant as the one observed on the cortical bone. The L-NAME treatment did not increase the deleterious effects induced by orchiectomy in both cancellous and cortical bone mass. No effect was observed with the L-arginine treatment, in the dose used in this study. In conclusion, this study suggest that NO donor isosorbide dinitrate can be used in the future as an alternative pharmacological strategy for the prevention of androgen deficiency osteoporosis, in men with proven hypogonadism and in eugonadal men. / A osteoporose é atribuída a um desequilíbrio entre a reabsorção e a formação óssea, seguido por perda de massa óssea e deterioração da microarquitetura óssea, levando ao aumento da fragilidade óssea e do risco de fraturas. O óxido nítrico (NO) é uma molécula sinalizadora com efeito regulatório importante sobre a função celular óssea. A nitroglicerina, um doador de NO, tem sido mostrada como uma substância eficiente para atenuar perdas ósseas induzidas por ovariectomia e por corticosteróide. O objetivo do presente estudo foi investigar o efeito do NO sobre o osso trabecular e o osso cortical de ratos orquiectomizados. Um total de noventa e oito ratos Wistar com quatro meses de idade foram aleatoriamente divididos nos seguintes grupos: Experimento 1 = intactos tratados com salina (gavagem estomacal - gv), orquiectomizados tratados com salina (gv), orquiectomizados tratados com o doador de NO dinitrato de isossorbida ISDN (gv); Experimento 2 = intactos tratados com salina (subcutânea - sc), orquiectomizados tratados com salina (sc), orquiectomizados tratados com o inibidor da síntese de NO NG-nitro-L-arginina-metil ester - L-NAME (sc); Experimento 3 = intactos tratados com salina (intraperitonial -ip), orquiectomizados tratados com salina (ip), orquiectomizados tratados com o precursor de NO L-Arginina - L-ARG (ip); Basal, um grupo foi sacrificado no início do estudo (quatro meses de idade) para servir como linha de base. Os animais foram sacrificados por decapitação após oito semanas de tratamento. Os fêmures e as vértebras lombares (L5 e L6) foram retiradas de cada animal para verificação das mudanças que ocorreram na massa óssea e competência biomecânica do osso trabecular e cortical de cada grupo experimental. O tratamento com o doador de NO, ISDN, preveniu os efeitos deletérios da orquiectomia sobre o osso cortical e atenuou estes efeitos sobre o osso trabecular. O tratamento com L-NAME não intensificou o efeito osteopênico da castração e ainda amenizou tal efeito tanto no osso cortical quanto no osso trabecular. A suplementação com L-arginina realizada durante o período de oito semanas, na dose utilizada, não produziu efeitos significativos. Em conclusão, este estudo sugere que o doador de NO dinitrato de isossorbida pode ser usado no futuro como uma estratégia farmacológica alternativa para a prevenção de osteoporose causada por deficiência androgênica, que acomete homens portadores de hipogonadismo ou são submetidos a orquiectomia.

L’ostéoporose est une maladie du squelette caractérisée par une dégradation de la qualité osseuse conduisant à une majoration du risque fracturaire. Le seul examen permettant actuellement de prédire ce risque est l’ostéodensitométrie à double rayonnement X (DXA) par la mesure de la densité minérale osseuse (DMO). Cependant, la DMO seule ne rend compte que de 40 à 70% de la variation de la résistance mécanique osseuse. Les 3 buts ce travail étaient : 1/ d’évaluer les rôles respectifs de la microarchitecture corticale et trabéculaire dans le comportement mécanique vertébral, 2/ d’évaluer le rôle propre de l’hétérogénéité de la microarchitecture trabéculaire et 3/ de décrire le comportement mécanique vertébral post-fracturaire et d’en identifier les déterminants. Nous montrons que la mesure de l’épaisseur de la corticale antérieure et de son rayon de courbure ainsi que la détermination de la variation régionale de la microarchitecture trabéculaire améliorent significativement la prédiction du risque fracturaire. Il existe une variation marquée du comportement mécanique vertébral après une fracture de grade 1 de Genant. La microarchitecture osseuse, et non la masse osseuse, explique les propriétés mécaniques vertébrales plastiques et élastiques post-fracturaires. / Osteoporosis is characterized by altered bone quality and compromised bone strength leading to increased fracture risk. Measurement of areal bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA) is the most widely used index of bone strength. However, BMD alone can only account for 40 to 70% of the variation of bone strength. This study aimed to determine: 1/ the respective role of cortical and trabecular microarchitecture to vertebral mechanical behavior, 2/ the role of trabecular microarchitecture heterogeneity and 3/ the mechanical behavior of a vertebra after simulated mild fracture and its determinants. Our data imply that measurements of cortical thickness and curvature as well as determination of trabecular microarchitecture heterogeneity enhance prediction of vertebral fragility. We found marked variation in the post-fracture load-bearing capacity following simulated mild vertebral fractures. Bone microarchitecture, but not bone mass, was associated with post-fracture mechanical behavior of vertebrae.

Les buts de cette thèse étaient de définit les déterminants du TBS chez les jeunes adultes et les femmes ménopausées, et de vérifier si le TBS était associé aux fractures ostéoporiques chez les femmes ménopausées et les femmes ménopausées obèses. L'étude 1a a été menée sur 26 jeunes femmes et montre que la consommation maximale d'oxygène et le niveau de puissance musculaire des membres inférieurs sont positivement corrélés au TBS ( valeurs de "r" comprises entre 0.37 et 0.63). L'étude 1b a été menée sur 56 jeunes femmes dont 14 en surchage pondérale ; elle suggère que le fait d'être en surcharge pondérale n'est pas associé à des valeurs de TBS plus élevées. Le seul déterminant positif du TBS dans l'étude 1b était dans la VO₂ max. L'étude 1c a été menée sur 67 jeunes hommes dont 32 en surpoids et 12 obèses ; elle suggère que l'obésité et le surpoids n'influencent pas positivement les valeurs de TBS. L'étude 1c montre que le poids et le pourcentage de masse grasse sont négativement corrélés au TBS ( r= -0.28 et r = -0.38 respectivement). L'étude 2a a été menée sur 1000 femmes ménopausées dont 164 ayant des fractures ostéoporotiques prévalentes ; elle suggère que le TBS est associé avec la présence des franctures ostéoporotiques prévalentes. L'étude 2a suggère que chez les femmes ménopausées, des corrélations positives existent entre la DMO du rachis lombaire et le TBS, et des corrélations négatives existent entre l'âge et le TBS. L'étude 2b a été menée chez 300 femmes ménopausées obèses dont 40 ayant des fractures ostéoporotiques prévalentes ; elle suggère que le TBS n'est pas associé avec la présence des fractures ostéoporotiques prévalentes dans cette population contrairement à la DMO du rachis lombaire qui était associée avec la présence de ces fractures. L'étude 2b suggère donc que le TBS n'est pas un déterminant indépendant des fractures ostéoporotiques prévalentes chez les femmes ménopausées adultes. / The aims of this thesis were to define the determinants of TBS in young adults and postmenopausal women and to verify whether TBS is associated with osteoporotic fractures in postmenopausal women and in obese postmenopausal women. Study 1a included 26 young women and showed that maximal oxygen consumption and muscular power level of the lower limbs are positively correlated to TBS (r values between 0.37 and 0.63). Study 1b included 56 young women 14 of which were overweight ; this study suggests that being overweight is not associated with higher TBS values. The only positive determinant of TBS in study 1b was VO₂ max. Study 1c included 67 young men 32 of which were overweight, and 12 were obese ; this study suggests that obesity and overweight do not positively influence TBS values. Study 1c shows that body weight and fat mass percentage are negatively correlated to TBS (r = -0.28 and r = -0.38 respectively). Study 2a included 1000 postmenopausal women 164 of which have presented a previous osteoporic fracture ; this study suggests that TBS is associated with previous osteoporotic fractures. Study 2 a suggests that in postmenopausal women, lumbar spine BMD is positively correlated to TBS while age is negatively correlated to TBS. Study 2b included 300 obese postmenopausal women 40 of which have presented a previous osteoporotic fracture ; this study suggests that TBS is not associated with previous osteoporotic fractures in this population contrary to lumbar spine BMD which is associated with previous osteoporotic fractures. Study 2b suggests therefore that TBS is not independant determinant of osteoporotic fractures in obese postmenopausal women.

L'allergie au lait de vache (ALV) représente l'allergie alimentaire la plus fréquemment rencontrée durant l'enfance. Cette allergie a longtemps été reconnue comme transitoire mais des données récentes révèlent que celle-ci est persistante chez environ 15% des enfants qui en sont touchés durant l'enfance, posant ainsi un risque à leur santé. La présente étude examine 26 enfants avec ALV et 12 enfants contrôles recrutés au CHU Sainte-Justine durant l’hiver 2011-2012. L'objectif étant de comparer la densité minérale osseuse (DMO) et les niveaux sériques de 25(OH)D d'enfants prépubères avec ALV non résolue à un groupe contrôle d'enfants avec autres allergies alimentaires, en plus d'évaluer les apports en calcium et en vitamine D ainsi que l'adhérence à la supplémentation chez cette population. La DMO lombaire (L2-L4) ne diffère pas significativement entre les groupes. Cependant, une faible densité osseuse, caractérisée par un score-Z entre -1,0 et -2,0 pour l'âge et le sexe, est détectée chez plus de 30% des enfants avec ALV et plus de 16% du groupe contrôle, sans allergie au lait. Tel qu'attendu, les apports en calcium sont significativement moins élevés chez les enfants avec ALV comparé au groupe contrôle, avec près de 90% de tous nos participants ne rencontrant pas les besoins pour l’âge en vitamine D. Plus de la moitié des enfants avec ALV présentent une concentration de 25(OH)D inférieure à 75 nmol/L. Cependant, notre étude n'a décelé aucune différence entre les niveaux sériques de 25(OH)D des enfants avec ALV comparativement au groupe contrôle. Enfin, l'adhérence à la supplémentation est jugée adéquate chez plus de 75% de notre groupe d'enfants avec ALV, soit ≧ 4 journées par semaine, un facteur aussi associé à une meilleure atteinte de leurs apports nutritionnels en calcium et en vitamine D. Enfin, ces résultats soulignent l'importance de suivre la santé osseuse d'enfants avec ALV ainsi qu'avec allergies multiples, qui présentent un risque de faible densité osseuse. L'intervention nutritionnelle devrait suivre l'adhérence à la supplémentation chez les enfants avec ALV non résolue, afin d'optimiser les apports nutritionnels insuffisants en calcium et en vitamine D / Cow's milk allergy (CMA) is the most frequent food allergy seen during childhood. Though usually recognized as transient, recent data suggest that the evolution of CMA has changed over time, having become more persistent and therefore, more capable of jeopardizing child growth and development. The following study included 26 children with proven CMA and 12 controls, recruited at Sainte-Justine hospital, during the winter of 2011-2012. The aim of this study was to compare bone density and vitamin D status (25(OH)D) in prepubertal children with CMA to a control group of children without milk allergy and to document calcium and vitamin D intake as well as the adherence to supplementation in this population. Bone mineral density did not differ significantly between groups. However, low bone mass, as defined by a z score between -1,0 and -2,0 for gender and age, was detected in over 30% of cow's milk allergic children and in over 16% of allergic controls. Calcium intake was significantly lower in children with CMA. Overall, nearly 90% of our study population failed to meet daily recommended intakes for vitamin D, with over 50% of cow's milk allergic children presenting vitamin D status below 75 nmol/L. No difference was detected regarding vitamin D status between groups. Finally, the majority of children with CMA presented a good adherence to calcium and vitamin D supplementation, ≧ 4 days per week, a factor that was associated with a better overall dietary intake of these nutrients. It is therefore important to follow bone health of children with CMA as well as with multiple food allergies, as they present a risk for low bone mass during a period of skeletal growth. Nutrition interventions should monitor supplement adherence in children with CMA to optimize dietary intake of calcium and vitamin D, which are presently insufficient.