Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 22nd European Nutritional Science Congress Hotel Augusta Barcelona Valles, Barcelona, Spain.

Day 1 :

Keynote Forum

Ernesto Tarragon Cros

Universidad Complutense de Madrid, Spain

Keynote: Cannabinoids and food preference: The role of the endocannabinoid system on chemosensory perception

Time : 10:30-11:15

Biography:

Ernesto Tarragon Cros completed his PhD in 2013 from University of Murcia and is currently undergoing his third postdoctoral fellowship in the “Pharmacology, Genetics, and Prevention of Addictive behaviour” research group, at the Universidad Complutense de Madride. He has published 20 papers in international peer reviewed journals.He is also a trained Dietitian and part of the coordinating committee and contributor to the design of the project “Study on the prevalence of obesity, overweight and dietary”,within the strategic framework of the Community of Valencia for the improvement of intervention protocols in primary healthcare.

 

Abstract:

Regulation of feeding behaviour is possible through the coordinated functioning of both central and peripheral mechanisms. Among the systems modulating these mechanisms, the Endo Cannabinoid System (ECS) exerts a prominent role. Its presence in the brain and in peripheral tissues like adipose tissue or the liver helps regulate relevant aspects of eating behaviour, from energy homoeostasis to hedonic response to food. Taste and flavour are sensory experiences involving the oral and olfactory perception of food-derived chemicals. These processes can drive a primal sense of acceptance or rejection for what is sampled, thus influencing food choice and, ultimately, food preference. The learning process that is acquiring a (food) preference is influenced by environmental (i.e. availability) and internal (i.e. palatability) factors, and it is also affected by the ECS. Chronic overeating of highly palatable foods is among the main contributors to obesity. Despite the elegant doings of the various systems regulating eating behaviour, the progressive increase in highly processed, highly available, and highly palatable foods occurring in the last decades facilitate the dysregulation of the natural components that help to orchestrate and maintain a healthy weight. Given the importance of dietary choices in promoting a healthy metabolism, understanding the role of the ECS in the chemosensory response to food seems relevant in order to appropriately target one of the predominant systems involved in such metabolic conditions.

 

Biography:

Grace George is a Biochemist who obtained her PhD from Central Food Technological Research Institute, Mysore, one of the premier research institutions of CSIR (India). She is a Professor of Medical Biochemistry in the Faculty of Health Sciences at Walter Sisulu University, Mthatha, South Africa. She has published over 40 papers in reputed journals and actively involved in Postgraduate training. Her current research interests include oxidative stress and antioxidants in health and disease; modulation of oxidative stress in type 2 diabetes; bioactives of lesser known indigenous food plants and human geophagia.

 

Abstract:

According to the International Diabetes Federation’s (IDF) Atlas 2015, 415 million people in the world were diabetic in 2015, a figure that is likely to increase upto 642 million people by 2040. Most affected patients are unaware of the fact that they face the risks of developing secondary complications of diabetes. One of the major predisposing conditions to the development of diabetes is obesity which is increasing in epidemic proportions in both the developed and developing world. Both macro and micro vascular complications resulting as a consequence of diabetes are said to be increased by high levels of oxidized Low-Density Lipoproteins (LDLs) and low paraoxonase enzyme (PON1) levels. Oxidized LDL which is one of the major atherogenic lipids significantly elevated in diabetic patients in the region was reported. Present study reports a comparative study of paraoxonase enzyme activity in diabetes and obesity. Sixty participants were recruited for the study after informed consent. Thirty of them were known type 2 diabetic patients between the ages of 40 and 65 years on oral hypoglycemic treatment in a rural clinic in Mthatha. Type 2 diabetes patients on insulin/cholesterol lowering treatments and on multivitamins were excluded. Diabetes duration was less than five years. Thirty years age and gender matched individuals from the same community who were not at medication served as control. Results indicated statistically significant difference only in fasting blood glucose (p<0.001) and glycated haemoglobin (p<0.001). Other parameters like BMI, W/H ratio, lipid profile, oxidized LDL, total antioxidant capacity, paraoxonase concentration and activity did not differ significantly between the groups. In conclusion the trend observed in obese apparently healthy controls is cause for concern as they are equally at risk of developing macro-vascular complications. Details of this investigation and possible modulation of paraoxonase enzyme will be discussed.

 

  • Nutrition and Health | Nutrition and Diabetes | Nutrition and Cancer | Nutrition in Clinical Practice Advancements in the Field of Nutrition
Location: Hotel Augusta Barcelona Valles

Session Introduction

Anke Wesselius

Maastricht University, Netherlands

Title: Milk and dairy product consumption and the risk of developing bladder cancer
Biography:

Anke Wesselius has a PhD in Genetic Epidemiology and a Doctoral degree in Biomedical Science with two majors in epidemiology and pathobiology. Currently, she is working as an Assistant Professor at the Department of Complex Genetics at Maastricht University. Here, she leads the research line nutritional and cancer epidemiology.

 

Abstract:

Background: Controversial results between milk and dairy product consumption and Bladder Cancer (BC) have been shown in various sites of epidemiological studies. This research aims to increase the understanding of the influences between milk and dairy product consumption and BC risk by bringing together the world’s data on this topic.

Methods: In total, 14 cohort studies, included in the Bladder Cancer Epidemiology and Nutritional Determinants (BLEND) study, comprising data of 3,874 BC cases and 569,956 non-cases were eligible for inclusion. The potential association between milk and dairy product consumption and the BC risk was investigated by performing a multilevel mixed effect of logistic regression model fitted for random effects by study centers corrected for relevant factors.

Results: Preliminary results show after correction for gender, age and smoking, a strong inverse association between total dairy product consumption and the BC risk (RR highest vs., lowest tertile: 0.51, 95% CI:0.47-0.57, p trend<0.001). A similar inverse association was found when analyzing the intake of cream, yoghurt and cheese separately. These significant inverse associations however, were only observed among smokers, suggesting a strong interaction between dairy product consumption and smoking. For liquid milk, an increased BC risk was found (RR comparing ≤1 cup (250 ml) vs. 2-3 cups per day: 1.20, 95% CI:1.02-1.43, p trend = 0.52).

Conclusions: We found evidence that dairy product consumption was associated with a decreased BC risk. Associations were significant among smokers. In addition, we showed an increased BC risk for liquid milk consumption.

 

Biography:

Amalia E Yanni has her expertise in health promoting effects of foods, nutrition and metabolism and research interest in the design of functional foods which can advance the quality life of patients with metabolic diseases. For years, she is organizing, supervising and participating in clinical studies of humans and studying animal models which support the synergy and complementarity of food and nutrition with health and wellbeing of patients and apparently healthy individuals. Her research studies include dietary interventions which investigate the effects of nutrients, bioactive compounds and functional foods on atherosclerosis, hypercholesterolemia and diabetes. She along with members of her research group have recently designed and studied functional cereal products with low glycemic index appropriate for diabetic patients and general population. She has years of experience in research, evaluation, teaching and administration in university and research centers.

 

Abstract:

Statement of the Problem: Intake of yogurt is associated with lower incidence of diabetes mellitus while beneficial effects of vitamin D and Ca fortified yogurt on metabolic regulation of Type 2 Diabetic (T2D) patients have been reported. Low fat, non-sugar sweetened yogurt facilitates energy balance and body weight management. In addition, the flexibility of yogurt’s structure enables it to accommodate supplementation with micronutrients which are potentially required by diabetic patients. However, clinical studies are very restricted and the effects of fortification with other vitamins beyond vitamin D on glycemic control have not been examined. Group B vitamins hold key role in macronutrients’ metabolism while low levels have been associated with insulin resistance. The study aims to investigate the possible beneficial effects of a dietary intervention with low fat, low sugar yogurt fortified with group B vitamins on metabolic control of T2D patients.

Methodology: Ten overweight patients with T2D were enrolled in the study and were guided to consume daily, two servings (2x200 g) of fruit yogurt (0% fat, 6% sugars) enriched with group B vitamins for 12 weeks. Measurement of anthropometric characteristics, biochemical parameters, glycosylated hemoglobin (HbA1C), vitamin B and homocysteine as well as Oral Glucose Tolerance Test (OGTT) were performed at the beginning and the end of the dietary intervention.

Findings: Intake of vitamins B fortified yogurt resulted in significant reduction of body weight, body mass index and body fat without affecting free fat mass. A marginally significant reduction of HbA1c was also observed. Blood concentrations of vitamins B were increased while glycemic response of patients in OGTT was ameliorated after the dietary intervention.

Conclusions & Significance: Regular consumption of low fat, low sugar yogurt enriched with group B vitamins facilitates body weight management and improves glycemic control in patients with T2D.

 

Biography:

Vijay Ganji has completed his MS and PhD from the University of Nebraska, Lincoln, USA. He worked as a Faculty in the US for 25 years. Since 2016, he has been with the Qatar University. He has published more than 35 papers in reputed journals and has been serving as an Editor in Chief of Nutrition and Food Science, Emerald publishing company, UK.

 

Abstract:

In the US, the FDA mandated folic acid fortification of processed cereals commenced on January 1, 1998. The intent of folic acid fortification was to reduce the risk of having children with Neural Tube Defects (NTD). This nationwide fortification effort reduced the prevalence of NTD by ~20%. However, the non-target populations such as older women are exposed to high amounts of folic acid regardless of their need. Because the folic acid fortification resulted in more than the FDA predicted intake of folic acid, there was a concern regarding the Unmetabolized Folic Acid (UFA). Although the effect of UFA on health is not clearly known, there is a concern that it may have deleterious effects on health in non-target population. The purpose of this present study was to investigate the relation between UFA, serum folate and all cancers and breast cancer in older US women (≥60 y old) using the data from the National Health and Nutrition Examination Survey, 1999-2002. In US older adults, the risk of having all cancers in UFA negative subjects was significantly lower than in subjects with UFA positive (OR 0.76 vs. 1.0) (n=2682). The risk of having cancer in the highest quartile serum folate group was significantly higher compared to those who were in the lowest quartile group (OR: 1.4 vs. 1.0; P<0.01) (n=7981). The breast cancer risk in the fourth quartile serum folate group was significantly higher compared to those in the first quartile group (OR: 1.81 vs. 1.0) (n=4007). Increased risk for cancer in those with high folate status and in those positive for UMF is a cause for concern. Because little data exist on the safety of folic acid, it is important to monitor the folate status in non-target population such as older adults, specifically in post-menopausal women.

 

Biography:

Agim Rysha has completed his PhD at Kassel University in Germany. Currently, he works as an Assistant Professor at the Department of Food Technology, Haxhi Zeka University, Kosovo. He did his research in Food Technology and Nutrition Sciences. Their most recent publication is in dietary habits and food frequency intake of preschool children.

 

Abstract:

Statement of the Problem: A balanced diet and knowledge of children’s intake of energy and macronutrients is important for normal growth as well as for nutritional interventions to prevent childhood malnutrition. Understanding preschool children’s food consumption in kindergartens of Kosovo may be one possibility to find out whether Kosovo preschool children’s energy is adequate. This work aimed to observe the menu designs and to evaluate for the first times the macronutrient intake by children attending public and private kindergartens of Kosovo for a full day programme of 8 hours.

Methodology: Preschool children (n=469) aged 4<7 years from kindergartens in Kosovo have participated in a dietary intake assessment through weighted dietary record method. The program PRODI and SPSS version 17 were used for calculation and comparison of nutrient values with dietary reference values. The one way analysis of variance (ANOVA) was used for determination of differences between the mean intake values according to age and gender and according to public and private kindergartens.

Findings: The total energy intake derived from carbohydrates, fat and protein was approximately the same for 1<4 and 4<7 years old children: carbohydrates 58%; fat 27% and proteins 15%. The mean energy intake values covered between 36% and 79% of the recommended daily intake. The consumption of amino acids is higher than that required for preschool aged children and the mean percentage of energy derived from Monounsaturated Fatty Acids (MUFA) and Polyunsaturated Fatty Acids (PUFA) was not more than 35% of Reference Daily Intake (RDI). The total fiber intake covered between 30% and 46% of RDI.

Conclusion & Significance: Meals that are served in kindergartens are not nutrient balanced and children when at kindergartens in Kosovo consume more foods with high energy density and less high-fiber foods.

 

Biography:

Sabji Mohamed Sultan, studied B-Pharm; MBBS; DPM from Madras Medical College Hospitals, Institute of Neural Sciences, Madras, India and did Diploma in Homeopathic Medicine from a Homeopathic Medical College Hospitals near Kottayam, Kerala, India in 1970s. From 1980s onwards, worked in Psychiatry in Nigeria. In London, the UK, at the Institute of Psychiatry/Maudsley Hospital. Did training in Psychiatry, worked as Registrar and was awarded a Specialist l Approved Medical Officer status, for compulsory management of patients, under various sections of health acts, as some patients lacked insight into their mental illnesses. Later in 1987, secured Accreditations from Joint Committee of Post Graduate Training in General Practice, London, the U.K., following Specialist training in General Practice and gained experience from various, teaching hospitals in and around London, in the U.K. Assumed duties of multi speciality General Practioner. Studied MSc, in Community Pediatrics, in Warwick in the University of Warwickshire. Then did MSc in ENT from the Oto-rhinology Institute of London and went on to do MSc in Pediatric Audiology at the University of Manchester. Have extensive experience in Accident & Emergency Care in Worksop, Basildon and Greenwhich Teaching Hospitals, in London, the UK. Served as a GP lead fellow at Whittington Teaching Hospital in London. Have worked in other specialized departments like Rheumatology and Gynecology at St. Georges Hospital, London, Also worked in Ophthalmology as a Clinical Fellow at the Royal Free Teaching Hospital in London, the U.K.

 

Abstract:

Prebiotics, in the of Prebiotik M & T, is a natural, nutrition , pure, plant oligosaccharide from Acacia Senegal and Seyal. This has been proven clinically effective, while being 4 times superior to Inulin and FOS. FDA (USA), European Food and Environment Safety, Food and Agricultural Organization, have certified that Prebiotics, these Acacia products, Prebiotik M & T, are safe for human consumption. Recent research ,by from Professor Elinay of Israel; Janet Street Porter, Jeanette –Hyde ,Jen Mills ,Nutritionists, and North Indian clinical studies, prove that synthetic probiotics are useless and harmful, as human natural probiotics are Genome or DNA specific for each and every bacteria. Prebiotics, Prebiotik M& T, from Acacia gum, a natural, nutritional, plant extract, using “zero” technology, have proven to, be beneficial, 4 times superior to Inulin and FOS. They improve Immunity, wellness, good health. Antimicrobial potency of these prebiotics products Prebiotik M& T, enable treating bacterial infections. Bye products, metabolites are Short Chain Fatty acids, when fermentation of these prebiotics by natural probiotics. They act as immune modulators, help controlling diabetes, hyper lipids syndrome, ulcerative colitis, Crohn’s disease, diarrhea, constipation, carcinomas, fatty liver, cirrhosis, skin atopy and Psoriasis. Genomes /DNA of good bacteria in our gastrointestinal, natural probiotics, are DNA specific. It can only be assessed by DNA testing of human excreta. According to Alison George, editor of New Scientist, artificial or synthetic probiotics, which, are not Genome or DNA specific, do not increase the population of good and natural bacteria (probiotics of our gut), even after six months of trials. So synthetic probiotics, are utterly useless and harmful. The clinical research studies by Professor Eran Segal Elinay, an immunologist at the Institute of Wizzman in Israel; Janet Street Porter, Jeanette–Hyde, Jen Mills and a few North Indian Clinical researchers, have proven this beyond doubt. European Food & Environment Safety-Journal Of Food Engineering, Stefancel Mare University- Suceava. Volume XIV, Issue 2- 2015. Did a comparative review of Prebiotics, including Inulin, and Acacia gum along with controlled water treatment study, for 4 weeks at 10 grams, in dose of each, prove that Acacia gum produced an increase of 4 times of Bifidobacterium/ Lactobacilli than Inulin, after six weeks of trial. So a review of latest scientific data and evidences, are discussed, to show how natural, nutrition, 100% oligo-sacchrides, in Prebiotik M&T, with “zero” technology extraction of pulp from Acacia gum plants of Acacia Senegal and Acacia Seyal, are 4 times more superior, effective, safe and functionally better than Inulin, a (FOS) fructo(se)- oligo-sachhrides. Sadly, Inulin could not be recommended for human consumption, according to Prof U.C. Davis of USA, in 2013, due to lack of sufficient data. The short chain fatty acids, bye products, metabolites, Butyric, Acetic and Propionic acids and their salts produced when, natural gut probiotics, ferment upon prebiotics, like Prebitik M&T, from Acacia gum, act as Immunity modulators, increase Serotonin production, improve REM sleep, fertility, male erections; helps central nervous system abate schizophrenia, mania, depression, autism, dementia and parkinsonism. Insulin and its sensitivity, increases to manage diabetes and its complications These short chain fatty acids also inhibit glucose, LDL and Triglycerides' syntheses and help reduce obesity and protects heart. psoriasis, atopy and eczema of skin too.

Results: Prebiotics, Prebiotik M&T, is 100 % natural, pure, nutrition, oligosaccharide, from Acacia gum, extracts from Acacia Senegal and Acacia Seyal, retained, intact in its original sap form, by "zero" technology, preserving, all natural minerals, vitamins, proteins (amino acids)., Function as food or fertilizers for probiotics in the gastrointestinal tracts of human beings. When the good bacteria ferment on Prebiotics, produces short chain fatty acids, which, confer immune modulator effects, increase Serotonin, inhibit synthesis of glucose, thereby, help to reduce diabetes and its complications. Inhibition of synthesis of LDL/Triglycerides by short chain fatty acids, enable to prevent atherosclerosis, reducing obesity and become cardio protective too. Prebiotik M & T, so, found to be helpful in alleviating skin atopy, eczema, Psoriasis, CNS disorders like mania, depression, schizophrenia, autism and Parkinsonism.

Conclusions: Prebiotics, in the form of Prebiotim M&T, natural , pure, nutrition from Acacia Senegal and Acacia Seyal functions effectively, 4 times superiorly than Inulin, FOS and synthetic probiotics. So they can be successfully used, to improve health, Immunity, manage, disorders like ulcerative colitis, IBS, Crohn’s, diarrhea, constipation, cancers and Diabetic complications, CNS disorders like depression, mania, schizophrenia, dementia, autism and Parkinsonism, skin disorders such as atopy, eczema and Psoriasis too.

 

Biography:

Ibironke A Ajayi obtained her PhD in Industrial Chemistry from University of Ibadan, Ibadan, Nigeria in 2002. She is presently a Senior Lecturer in the same university. She has published more than 60 papers in reputed journals and has been serving as reviewer of repute journals.

 

Abstract:

The nutritional and toxicological evaluation of Neocarya macrophylla Seed Oil (NMSO) was carried out in order to determine the suitability of the oil for nutritional purposes using Wistar rats. A total of 28 Wistar albino rats were divided into four groups of seven rats each. Group A was fed with an industrially purchased feed and group B with a control diet compounded with 10% (w/v) groundnut oil containing 22.84±0.12% of protein, 4.80±0.01% of fat, 44.8±0.14% of carbohydrate and energy value of 1328.11±0.69. Groups C and D were fed with diet compounded with 5% (w/v) and 10% (w/v) NMSO respectively. After six weeks, the rats were sacrificed and their blood samples and organs were collected for analysis. The growth parameters of the rats in the four groups appeared considerably good at the end of the experiment. Rats in group C had the highest weight gain. No significant difference was observed between the average values obtained for LDL in the total lipid profile analysis for the four groups. The blood biochemistry result showed no significant difference in the average values of total protein (7.90±0.66-8.07±0.32), albumin (2.63±0.85-3.10±0.72), globulin (4.80±0.10-5180±0.89), AST (40.00±1.73-41.67±13.22), ALT (28.00±2.65-30.00±3.00) and creatinine (0.73±0.23-0.77±0.21). No significant difference was also observed in the haematological parameters of the rats across the treatments. No major lesion was found in the kidney and heart of both the control and experimental rats. NMSO at 10% (w/v) appeared to be non-toxic and might cheaply replace conventional vegetable oils such as groundnut oil.

 

  • Young Researchers Forum
Location: Hotel Augusta Barcelona Valles
Biography:

Vahideh Aghamohammadi is a PhD candidate in Nutrition Sciences, Ahvaz Jundishapur University of Medical Sciences. Completed her B.Sc: Nutrition science; Tabriz University of medical sciences, M.Sc: Nutrition science; Tabriz University of medical sciences.

 

Abstract:

Besides the effects of dietary long chain Polyunsaturated Fatty Acids (PUFA) on circulating endocannabinoids concentration, the impact of other nutrients on these system is not known and whether changes in plasma endocannabinoids levels correlated with changes in body composition and biochemical metabolic risk factors in obese individuals however, still remains to be characterized. Sixteen obese women for two months randomized clinical trial. All subjects followed a hypocaloric diet of 800 kcal below estimated energy needs. For the intervention group, isocaloric weight loss diet and whey protein powders (30 g/day) were given. Anthropometric, demographic, physical activity and nutrient intakes data were obtained from each subject. Three subjects in the intervention group and one participant in the control group were lost to follow. But, all analyses were performed by using the intention to treat principle. There were no significant differences in energy and macronutrient intakes, except Monounsaturated Fatty Acids (MUFA) intake, among the study groups at baseline and the end of study (p>0.05). Results of analysis of covariance didn’t show significant reductions in body weight and BMI of the intervention group compared to the control group (p>0.05). Whey supplementation in intervention group significantly decrease levels of AEA, 2-AG and TNF- α compared to the control group in obese women after two months intervention (tested by ANCOVA after adjusting for covariates). Due to strong association between endocannabinoids level and metabolic diseases and obesity, we showed the other benefits of whey protein supplementation on health, by mechanisms other than weight loss can reduce endocannabinoids and metabolic risk factors.

 

  • Poster Presentation
Location: Hotel Augusta Barcelona Valles
Biography:

Yoichi Tachi has completed his PhD from University of Tsukuba in Japan. He is Associate Professor at Laboratory of Nutritional Physiology, Tokyo Kasei University. He has published more than 35 papers in reputed journals.

 

Abstract:

The aim of the present study was to identify Vitamin D Receptor (VDR) gene polymorphism and life¬style factors (nutrition and exercise) associated with bone mass in Japanese female college students. The subjects comprised 317 female college students aged between 20 and 24 all of whom were living in the Kanto region at the time of the study. Bone mass measurement was based on Qualitative Ultra Sound (QUS). The subjects were asked what type of sport they used to play in their junior high school and high school days. The subjects’ current nutrient intake was surveyed using food frequency questionnaire based on food groups (FFQG) ver. 3.0 software, an add-in software of Excel Eiyou-kun (Kenpakusha). The daily intake of three nutrients (calcium, vitamin D, and vitamin K) was calculated per 1,000 k.cal. Gene polymorphism for the restriction enzyme TaqI digestion site (rs731236) were detected by real-time PCR using TaqMan probes. No significant difference in the bone mass was observed between the VDR polymorphisms (TT versus TC + CC). The present study did not demonstrate any correlation between VDR polymorphism and bone mass. Similarly, no correlation was observed between nutritional intake and bone mass. Meanwhile, the results of multiple linear regression analysis ascertain that high BMI levels and the experience of high-impact exercise during junior high school or high school have an independent positive effect on bone mass. These results suggest that BMI and exercise are likely high to be important factors in increasing bone mass.

 

Biography:

Yoichi Tachi has completed his PhD from University of Tsukuba in Japan. He is Associate Professor at Laboratory of Nutritional Physiology, Tokyo Kasei University. He has published more than 35 papers in reputed journals.

 

Abstract:

The aim of the present study was to identify Vitamin D Receptor (VDR) gene polymorphism and life¬style factors (nutrition and exercise) associated with bone mass in Japanese female college students. The subjects comprised 317 female college students aged between 20 and 24 all of whom were living in the Kanto region at the time of the study. Bone mass measurement was based on Qualitative Ultra Sound (QUS). The subjects were asked what type of sport they used to play in their junior high school and high school days. The subjects’ current nutrient intake was surveyed using food frequency questionnaire based on food groups (FFQG) ver. 3.0 software, an add-in software of Excel Eiyou-kun (Kenpakusha). The daily intake of three nutrients (calcium, vitamin D, and vitamin K) was calculated per 1,000 k.cal. Gene polymorphism for the restriction enzyme TaqI digestion site (rs731236) were detected by real-time PCR using TaqMan probes. No significant difference in the bone mass was observed between the VDR polymorphisms (TT versus TC + CC). The present study did not demonstrate any correlation between VDR polymorphism and bone mass. Similarly, no correlation was observed between nutritional intake and bone mass. Meanwhile, the results of multiple linear regression analysis ascertain that high BMI levels and the experience of high-impact exercise during junior high school or high school have an independent positive effect on bone mass. These results suggest that BMI and exercise are likely high to be important factors in increasing bone mass.