The effect of two doses of dried plum on bone density and bone biomarkers in osteopenic postmenopausal women: a randomized, controlled trial

Abstract

Summary

Daily consumption of 50 g of dried plum (equivalent to 5–6 dried plums) for 6 months may be as effective as 100 g of dried plum in preventing bone loss in older, osteopenic postmenopausal women. To some extent, these results may be attributed to the inhibition of bone resorption with the concurrent maintenance of bone formation.

Introduction

The objective of our current study was to examine the possible dose-dependent effects of dried plum in preventing bone loss in older osteopenic postmenopausal women.

Methods

Forty-eight osteopenic women (65–79 years old) were randomly assigned into one of three treatment groups for 6 months: (1) 50 g of dried plum; (2) 100 g of dried plum; and (3) control. Total body, hip, and lumbar bone mineral density (BMD) were evaluated at baseline and 6 months using dual-energy X-ray absorptiometry. Blood biomarkers including bone-specific alkaline phosphatase (BAP), tartrate-resistant acid phosphatase (TRAP-5b), high-sensitivity C-reactive protein (hs-CRP), insulin-like growth factor-1 (IGF-1), and sclerostin were measured at baseline, 3 months, and 6 months. Osteoprotegerin (OPG), receptor activator of nuclear factor kappa-B ligand (RANKL), calcium, phosphorous, and vitamin D were measured at baseline and 6 months.

Results

Both doses of dried plum were able to prevent the loss of total body BMD compared with that of the control group (P < 0.05). TRAP-5b, a marker of bone resorption, decreased at 3 months and this was sustained at 6 months in both 50 and 100 g dried plum groups (P < 0.01 and P < 0.04, respectively). Although there were no significant changes in BAP for either of the dried plum groups, the BAP/TRAP-5b ratio was significantly (P < 0.05) greater at 6 months in both dried plum groups whereas there were no changes in the control group.

Conclusions

These results confirm the ability of dried plum to prevent the loss of total body BMD in older osteopenic postmenopausal women and suggest that a lower dose of dried plum (i.e., 50 g) may be as effective as 100 g of dried plum in preventing bone loss in older, osteopenic postmenopausal women. This may be due, in part, to the ability of dried plums to inhibit bone resorption. This clinical trial was registered at ClinicalTrials.gov: NCT02325895.

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Abbreviations

BMD:

Bone mineral density

TRAP-5b:

Tartrate-resistant acid phosphatase-5b

BAP:

Bone-specific alkaline phosphatase

25-OH vitamin D:

25-hydroxy vitamin D

IGF-1:

Insulin-like growth factor-1

hs-CRP:

High-sensitivity C-reactive protein

RANKL:

Receptor activator of nuclear factor kappa-B ligand

OPG:

Osteoprotegerin

SOST:

Sclerosteosis gene

CRP:

C-reactive protein

P1NP:

Procollagen type 1N-terminal propeptide

CTX:

Collagen type 1 C-telopeptide

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Acknowledgments

We gratefully acknowledge the valuable assistance of the following students at San Diego State University: Mariana Beleche, Sofie Blicher, Jayme Brisco, Bich Thuy Callens, Zachary Clayton, Amanda Cravinho, Jennifer Cullison, Sofia Garcia, Jackie Gaylis, Montserrat Gonzalez, Mairi McLachlan, Tasnim El Mezain, Rose Miller, Ivette Navarro, Dawn Ortiz and, Yenina Vereda. This project was supported by the SDSU Research Foundation grant no. 242409 and a grant from the California Dried Plum Board (grant no. 57114A). The authors thank the California Dried Plum Board for providing us with dried plums and we gratefully acknowledge Nutrisystem, Inc. supplying calcium and vitamin D supplements for the study. The authors’ responsibilities were as follows: SH, MK, and BHA designed the research; SH, DM, and PS conducted the research; SH, MK, and SCC analyzed data; MEP performed statistical analysis; SH, DM, PS, SAJ, and BH wrote the paper; MK, SAJ, and BHA had substantial involvement in manuscript revision before submission; SH had primary responsibility for final content. All authors edited and approved the final version. Shirin Hooshmand, Dina Metti, Pouneh Shamloufard, Mark Kern, Bahram H. Arjmandi, Sheau C. Chai, Sarah A. Johnson, and Mark E. Payton declared that they had no conflict of interest.

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Correspondence to S. Hooshmand.

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The Institutional Review Board at San Diego State University approved all procedures involving human subjects. Written informed consent was obtained from all subjects.

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Hooshmand, S., Kern, M., Metti, D. et al. The effect of two doses of dried plum on bone density and bone biomarkers in osteopenic postmenopausal women: a randomized, controlled trial. Osteoporos Int 27, 2271–2279 (2016). https://doi.org/10.1007/s00198-016-3524-8

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Keywords

  • Bone turnover biomarkers
  • Estrogen
  • Osteopenia
  • Osteoporosis
  • Prune