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Skeletal muscle and pediatric bone development

Kindler, Joseph M.a; Lewis, Richard D.a; Hamrick, Mark W.b

Current Opinion in Endocrinology, Diabetes and Obesity: December 2015 - Volume 22 - Issue 6 - p 467–474
doi: 10.1097/MED.0000000000000201

Purpose of review The purpose of this review is to summarize the recent clinical findings surrounding the muscle–bone relationships in children, while considering muscle adiposity, endocrine factors, and lifestyle influences (i.e., diet and exercise) involved in pediatric musculoskeletal development.

Recent findings Positive relationships between cortical bone geometry and muscle mass, size and function have been reported. Prospective studies in particular have helped clarify some of the inconsistent relationships between muscle and cortical bone volumetric density. Muscle fat is associated with impaired glucose handling and muscular functionality, which may in turn have a downstream effect on cortical bone growth during adolescence. Lifestyle factors such as healthful diets and higher impact physical activities can promote optimal skeletal development by improving the muscular phenotype and endocrine profile.

Summary Muscle and bone are two intricately-related tissue types; however, factors such as sex, maturation, study design, and outcome measures studied can modify this relationship. Further research is warranted to understand the impact of muscle adiposity on cardiometabolic health, muscle function and, subsequently, pediatric musculoskeletal development and fracture risk. Following age-specific diet and physical activity recommendations should be a major focus in obtaining optimal muscle and bone development throughout maturation.

aDepartment of Foods and Nutrition, College of Family and Consumer Sciences, University of Georgia, Athens

bDepartment of Cellular Biology and Anatomy, Medical College of Georgia, Georgia Regents University, Augusta, Georgia, USA

Correspondence to Mark W. Hamrick, Department of Cellular Biology and Anatomy, Georgia Regents University, R&E Building, CB1116, Augusta, GA 30912, USA. Tel: +1 706 721 1958; e-mail:

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