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Dietary patterns, bone resorption and bone mineral density in early post-menopausal Scottish women

European Journal of Clinical Nutrition volume 65, pages 378–385 (2011)Cite this article

Subjects

Abstract

Background/Objectives:

Several nutrients affect bone turnover. Dietary patterns may provide insights into which foods are important and how nutrition affects bone health. The aim of this study was to investigate the associations between dietary patterns, bone turnover and bone mineral density (BMD).

Subjects/Methods:

This cross-sectional study examined 3236 Scottish women age 50–59 years, who were members of the Aberdeen Prospective Osteoporosis Screening Study. They had hip and spine BMD measurements (dual-energy X-ray absorptiometry) and provided samples for bone turnover markers. Diet was assessed by a validated food frequency questionnaire encompassing 98 foods, from which 35 food groups were systematically created. Dietary patterns were defined by principal components analysis. The bone measures were regressed onto the dietary pattern and adjusted for potential confounders.

Results:

Five dietary patterns were identified, three of which were associated with bone health. The ‘healthy’ pattern was associated with decreased bone resorption (r=0.081, P<0.001). Two other patterns (processed foods and snack food) were associated with lower BMD (femoral neck r=−0.056, r=−0.044, P<0.001, respectively).

Conclusions:

Dietary pattern may influence bone turnover and BMD. A healthy dietary pattern with high intakes of fruit and vegetables may lead to less bone resorption, and a poor dietary pattern rich in processed foods is associated with a decrease in BMD. This study confirms that a healthy diet is required for strong bones, and highlights that a nutrient-poor diet is a risk factor for osteoporosis.

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References

  • Balder HF, Virtanen M, Brants HA, Krogh V, Dixon LB, Tan F et al. (2003). Common and country-specific dietary patterns in four European cohort studies. J Nutr 133, 4246–4251.

    Article  CAS  Google Scholar 

  • Bolton-Smith C, Casey CE, Gey KF, Smith WC, Tunstall-Pedoe H (1991). Antioxidant vitamin intakes assessed using a food-frequency questionnaire: correlation with biochemical status in smokers and non-smokers. Br J Nutr 65, 337–346.

    Article  CAS  Google Scholar 

  • Bonjour JP, Schurch MA, Rizzoli R (1997). Proteins and bone health. Pathol Biol (Paris) 45, 57–59.

    CAS  Google Scholar 

  • Cockayne S, Adamson J, Lanham-New S, Shearer MJ, Gilbody S, Torgerson DJ (2006). Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials. Arch Intern Med 166, 1256–1261.

    Article  CAS  Google Scholar 

  • Garton MJ, Torgerson DJ, Donaldson C, Russell IT, Reid DM (1992). Recruitment methods for screening programmes: trial of a new method within a regional osteoporosis study. BMJ 305, 82–84.

    Article  CAS  Google Scholar 

  • Hannan MT, Tucker KL, Dawson-Hughes B, Cupples LA, Felson DT, Kiel DP (2000). Effect of dietary protein on bone loss in elderly men and women: the framingham osteoporosis study. J Bone Miner Res 15, 2504–2512.

    Article  CAS  Google Scholar 

  • Heaney RP (1996). Age considerations in nutrient needs for bone health: older adults. J Am Coll Nutr 15, 575–578.

    Article  CAS  Google Scholar 

  • Heaney RP (1998). Excess dietary protein may not adversely affect bone. J Nutr 128, 1054–1057.

    Article  CAS  Google Scholar 

  • Hegarty VM, May HM, Khaw KT (2000). Tea drinking and bone mineral density in older women. Am J Clin Nutr 71, 1003–1007.

    Article  CAS  Google Scholar 

  • Hingorjo MR, Syed S, Qureshi MA (2008). Role of exercise in osteoporosis prevention--current concepts. J Pak Med Assoc 58, 78–81.

    PubMed  Google Scholar 

  • Holick MF (2006). The role of vitamin D for bone health and fracture prevention. Curr Osteoporos Rep 4, 96–102.

    Article  Google Scholar 

  • Hu FB, Rimm E, Smith-Warner SA, Feskanich D, Stampfer MJ, Ascherio A et al. (1999). Reproducibility and validity of dietary patterns assessed with a food-frequency questionnaire. Am J Clin Nutr 69, 243–249.

    Article  CAS  Google Scholar 

  • Huda MS, Durham BH, Wong SP, Dovey TM, McCulloch P, Kerrigan D et al. (2007). Lack of an acute effect of ghrelin on markers of bone turnover in healthy controls and post-gastrectomy subjects. Bone 41, 406–413.

    Article  CAS  Google Scholar 

  • Kant AK (2004). Dietary patterns and health outcomes. J Am Diet Assoc 104, 615–635.

    Article  Google Scholar 

  • MacDonald AG, Birkinshaw G, Durham B, Bucknall RC, Fraser WD (1997). Biochemical markers of bone turnover in seronegative spondylarthropathy: relationship to disease activity. Br J Rheumatol 36, 50–53.

    Article  CAS  Google Scholar 

  • Macdonald HM, Black AJ, Aucott L, Duthie G, Duthie S, Sandison R et al. (2008). Effect of potassium citrate supplementation or increased fruit and vegetable intake on bone metabolism in healthy postmenopausal women: a randomized controlled trial. Am J Clin Nutr 88, 465–474.

    Article  CAS  Google Scholar 

  • Macdonald HM, Hardcastle AC, Fraser WD (2009). Meta-analysis of the quantity of calcium excretion associated with net acid excretion: caution advised. Am J Clin Nutr 89, 926–927; author reply 927.

    Article  CAS  Google Scholar 

  • Macdonald HM, New SA, Golden MH, Campbell MK, Reid DM (2004). Nutritional associations with bone loss during the menopausal transition: evidence of a beneficial effect of calcium, alcohol, and fruit and vegetable nutrients and of a detrimental effect of fatty acids. Am J Clin Nutr 79, 155–165.

    Article  CAS  Google Scholar 

  • McLoone P (1994). Carstairs Scores for Scottish Postcode Sectors from the 1991 Census. University of Glasgow: Glasgow.

    Google Scholar 

  • New SA (ed) (1995). An Epidemiological Investigation into the Influence of Nutritional Factors on Bone Mineral Density and Bone Metabolism PhD thesis University of Aberdeen: Scotland, UK.

    Google Scholar 

  • New SA, Bolton-Smith C, Grubb DA, Reid DM (1997). Nutritional influences on bone mineral density: a cross-sectional study in premenopausal women. Am J Clin Nutr 65, 1831–1839.

    Article  CAS  Google Scholar 

  • New SA, Robins SP, Campbell MK, Martin JC, Garton MJ, Bolton-Smith C et al. (2000). Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable consumption and bone health? Am J Clin Nutr 71, 142–151.

    Article  CAS  Google Scholar 

  • Okubo H, Sasaki S, Horiguchi H, Oguma E, Miyamoto K, Hosoi Y et al. (2006). Dietary patterns associated with bone mineral density in premenopausal Japanese farmwomen. Am J Clin Nutr 83, 1185–1192.

    Article  CAS  Google Scholar 

  • Prynne CJ, Mishra GD, O’Connell MA, Muniz G, Laskey MA, Yan L et al. (2006). Fruit and vegetable intakes and bone mineral status: a cross sectional study in 5 age and sex cohorts. Am J Clin Nutr 83, 1420–1428.

    Article  CAS  Google Scholar 

  • Sambrook P, Cooper C (2006). Osteoporosis. Lancet 367, 2010–2018.

    Article  CAS  Google Scholar 

  • Schulze MB, Hoffmann K, Kroke A, Boeing H (2001). Dietary patterns and their association with food and nutrient intake in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study. Br J Nutr 85, 363–373.

    Article  CAS  Google Scholar 

  • Torgerson DJ, Garton MJ, Donaldson C, Russell IT, Reid DM (1993). Recruitment methods for screening programmes: trial of an improved method within a regional osteoporosis study. BMJ 307, 99.

    Article  CAS  Google Scholar 

  • Tucker KL, Chen H, Hannan MT, Cupples LA, Wilson PW, Felson D et al. (2002). Bone mineral density and dietary patterns in older adults: the Framingham Osteoporosis Study. Am J Clin Nutr 76, 245–252.

    Article  CAS  Google Scholar 

  • Tucker KL, Hannan MT, Chen H, Cupples LA, Wilson PW, Kiel DP (1999). Potassium, magnesium, and fruit and vegetable intakes are associated with greater bone mineral density in elderly men and women. Am J Clin Nutr 69, 727–736.

    Article  CAS  Google Scholar 

  • Tucker KL, Morita K, Qiao N, Hannan MT, Cupples LA, Kiel DP (2006). Colas, but not other carbonated beverages, are associated with low bone mineral density in older women: the Framingham Osteoporosis Study. Am J Clin Nutr 84, 936–942.

    Article  CAS  Google Scholar 

  • Tunstall-Pedoe H, Smith WC, Crombie IK, Tavendale R (1989). Coronary risk factor and lifestyle variation across Scotland: results from the Scottish Heart Health Study. Scott Med J 34, 556–560.

    Article  CAS  Google Scholar 

  • van Staa TP, Dennison EM, Leufkens HG, Cooper C (2001). Epidemiology of fractures in England and Wales. Bone 29, 517–522.

    Article  CAS  Google Scholar 

  • Wachman A, Bernstein DS (1968). Diet and Osteoporosis. Lancet 1, 958–959.

    Article  CAS  Google Scholar 

  • Willett W, Stampfer MJ (1986). Total energy intake: implications for epidemiologic analyses. Am J Epidemiol 124, 17–27.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was funded by the United Kingdom Food Standards Agency, and their Postgraduate Scholarship Scheme.

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Authors and Affiliations

  1. Division of Applied Medicine, Bone and Musculoskeletal Research Programme, University of Aberdeen, Aberdeen, UK

    A C Hardcastle, L Aucott, D M Reid & H M Macdonald

  2. Department of Clinical Chemistry, Liverpool University, Liverpool, UK

    W D Fraser

Authors
  1. A C Hardcastle
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  2. L Aucott
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  3. W D Fraser
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  4. D M Reid
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  5. H M Macdonald
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Corresponding author

Correspondence to A C Hardcastle.

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The authors declare no conflict of interest.

APPENDIX

APPENDIX

See Table A1 and Table A2.

Table A1 Food groupings used for analyses of dietary patterns
Full size table
Table A2 Mean (±s.d.) intakes of the food groups, and percentage energy contribution of those food groups to the diet
Full size table

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Hardcastle, A., Aucott, L., Fraser, W. et al. Dietary patterns, bone resorption and bone mineral density in early post-menopausal Scottish women. Eur J Clin Nutr 65, 378–385 (2011). https://doi.org/10.1038/ejcn.2010.264

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