Abstract
Introduction
Previous studies suggesting different effects of diet on post-menopausal bone loss may have given conflicting results because they sometimes failed to exclude confounding conditions or used imprecise methodology.
Design
To identify dietary determinants of bone loss from the lumbar spine after menopause in women not taking hormone replacement who developed no evidence of spondylotic or sclerotic degenerative disease, forty-three women were followed with repeated (mean = 12) measurements of bone mineral density (BMD) at L2–4 for 11–14 years. Eleven developed evidence suggestive of degenerative disease and were excluded. Diet was assessed at the beginning of the study and 2.5 years later using 3-day and 7-day periods of weighed intakes. Nutrients estimated were: carbohydrate, fat, protein, fibre, calcium, magnesium, iron, phosphorus, copper, zinc and six vitamins. We tested the ability of diet to predict post-menopausal bone loss using stepwise regression.
Results
Each woman’s BMD change was described by a single coefficient after log transformation of the BMD data. The best model for BMD loss including dietary factors alone had two significant determinants: daily energy or protein (p=0.0003) intake was adverse, while dietary iron (p=0.002) was predictive of bone maintenance, an effect that persisted if iron was expressed as a ratio to energy intake. Adding body mass index to the model increased the goodness of fit (R 2adj rose from 0.33 to 0.42) without affecting the statistical significance of the dietary determinants.
Conclusions
Diet may influence bone loss after menopause, with dietary iron (or an associated factor) possibly having a protective effect on bone at the spine.
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Acknowledgements
We thank our study subjects, Nurse Joyce Walker, Mrs. Olive Waldron and other staff for their enthusiastic contributions. We also thank our General Practitioner and statistician colleagues (authors of earlier reports) who developed the database and analysed the earlier results that made this study possible. Funding was provided by direct support from the UK Medical Research Council (MRC), later through MRC Programme grant G9321536 and finally by a small project grant from the UK National Osteoporosis Society.
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Abraham, R., Walton, J., Russell, L. et al. Dietary determinants of post-menopausal bone loss at the lumbar spine: a possible beneficial effect of iron. Osteoporos Int 17, 1165–1173 (2006). https://doi.org/10.1007/s00198-005-0033-6
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DOI: https://doi.org/10.1007/s00198-005-0033-6