To examine the effects of food groups and dietary nutrients on bone loss in elderly Chinese population.
Prospective cohort study. Setting: A longitudinal study started at 2001 in Hong Kong.
1225 Chinese men and 992 women aged 65 years and over in the community.
Daily intake of food groups and dietary nutrients at baseline was assessed by a food frequency questionnaire. Nutrient intake was adjusted for energy intake by residual method. Linear regression was used to examine the association of BMD change and food group or energy-adjusted nutrient intake with adjustment for demographic, anthropometric, lifestyle factors, and daily energy intake (for food group only).
Higher fish intake was associated with smaller bone loss in hip (B=−0.611, p=0.004) and femoral neck (B=−0.724, p=0.040) in men. None of the food groups were associated with bone loss in both measured sites in women. For men, lower intake of protein (B=−0.012, p=0.003), phosphorus (B=−0.0008, p=0.001), sodium (B=−0.0002, p=0.023) and isoflavone (B=−1.084, p=0.030) was associated with greater BMD loss in hip, whereas lower intake of protein (B=−0.018, p=0.006) and sodium (B=−0.0004, p=0.018) was associated with greater BMD loss in femoral neck. However, these significant associations disappeared after further adjustment for energy-adjusted calcium and vitamin D intakes. None of the nutrients were associated with BMD loss in both measured sites in women.
Greater fish intake may help to reduce bone loss in this sample of elderly Chinese men. The significant association between various nutrients and bone loss in elderly Chinese men was likely due to the influence of dietary calcium and vitamin D intakes. The role of food groups and dietary nutrients on bone health in this sample of elderly Chinese women seems to be minimal.
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Lau EM, Cooper C. The epidemiology of osteoporosis. The oriental perspective in a world context. Clinical Orthopaedics & Related Research 1996;323:65–74.
Lau EM, Woo J. Osteoporosis—is it really preventable? Hong Kong Medical Journal 1998;4:395–399.
Abrams SA. Normal acquisition and loss of bone mass. Hormone Research 2003;60Suppl 3:71–76.
Prentice A. Diet, nutrition and the prevention of osteoporosis. Public Health Nutrition 2004;7:227–243.
Greer FR, Krebs NF, American Academy of Pediatrics Committee on Nutrition. Optimizing bone health and calcium intakes of infants, children, and adolescents. Pediatrics 2006;117:578–585.
Massey LK. Dietary animal and plant protein and human bone health: a whole foods approach. Journal of Nutrition 2003;133:862S–865S.
Alexy U, Remer T, Manz F, Neu CM, Schoenau E. Long-term protein intake and dietary potential renal acid load are associated with bone modeling and remodeling at the proximal radius in healthy children. American Journal of Clinical Nutrition 2005;82:1107–1114.
Palacios C. The role of nutrients in bone health, from A to Z. Critical Reviews in Food Science & Nutrition 2006;46:621–628.
Burger H, de Laet CE, van Daele PL, et al. Risk factors for increased bone loss in an elderly population: the Rotterdam Study. American Journal of Epidemiology 1998;147:871–879.
Hui SL, Zhou L, Evans R, et al. Rates of growth and loss of bone mineral in the spine and femoral neck in white females. Osteoporosis International 1999;9:200–205.
Nguyen TV, Sambrook PN, Eisman JA. Bone loss, physical activity, and weight change in elderly women: the Dubbo Osteoporosis Epidemiology Study. Journal of Bone & Mineral Research 1998;13:1458–1467.
Jones G, Nguyen T, Sambrook P, Kelly PJ, Eisman JA. Progressive loss of bone in the femoral neck in elderly people: longitudinal findings from the Dubbo osteoporosis epidemiology study. BMJ 1994;309:691–695.
Tucker KL. Dietary intake and bone status with aging. Current Pharmaceutical Design 2003;9:2687–2704.
Zalloua PA, Hsu YH, Terwedow H, et al. Impact of seafood and fruit consumption on bone mineral density. Maturitas 2007;56:1–11.
Chen YM, Ho SC, Woo JL. Greater fruit and vegetable intake is associated with increased bone mass among postmenopausal Chinese women. British Journal of Nutrition 2006;96:745–751.
Kaptoge S, Welch A, McTaggart A, et al. Effects of dietary nutrients and food groups on bone loss from the proximal femur in men and women in the 7th and 8th decades of age. Osteoporosis International 2003;14:418–428.
Woo J, Woo KS, Leung SS, et al. The Mediterranean score of dietary habits in Chinese populations in four different geographical areas. European Journal of Clinical Nutrition 2001;55:215–220.
Washburn RA, Smith KW, Jette AM, Janney CA. The Physical Activity Scale for the Elderly (PASE): development and evaluation. Journal of Clinical Epidemiology 1993;46:153–162.
Paul AA, Southgate DAT. McCance & Widdowson’s: The Composition of Foods. 4th ed. London: HMSO, 1 1978.
Yang Y, Wang G, Pan X. China Food Composition 2002. 2002 ed. Peking: University Medical Press, 2002.
Woo J, Leung SSF, Ho SC, Lam TH, Janus ED. A food frequency questionnaire for use in the Chinese population in Hong Kong: Description and examination of validity. Nutrition Research 1997;17:1633–1641.
Lau EM, Leung PC, Kwok T, et al. The determinants of bone mineral density in Chinese men—results from Mr. Os (Hong Kong), the first cohort study on osteoporosis in Asian men. Osteoporosis International 2006;17:297–303.
Karasik D, Ferrari SL. Contribution of gender-specific genetic factors to osteoporosis risk. Annals of Human Genetics 2008;72:696–714.
Willett WC, Howe GR, Kushi LH. Adjustment for total energy intake in epidemiologic studies. American Journal of Clinical Nutrition 1997;65:1220S–1228S.
Ishikawa K, Ohta T, Hirano M, Yoshimoto K, Tanaka S, Inoue S. Relation of lifestyle factors to metacarpal bone mineral density was different depending on menstrual condition and years since menopause in Japanese women. European Journal of Clinical Nutrition 2000;54:9–13.
Feskanich D, Willett WC, Colditz GA. Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women. American Journal of Clinical Nutrition 2003;77:504–511.
Suzuki T, Yoshida H, Hashimoto T, et al. Case-control study of risk factors for hip fractures in the Japanese elderly by a Mediterranean Osteoporosis Study (MEDOS) questionnaire. Bone 1997;21:461–467.
Zhang J, Munger RG, West NA, Cutler DR, Wengreen HJ, Corcoran CD. Antioxidant intake and risk of osteoporotic hip fracture in Utah: an effect modified by smoking status. American Journal of Epidemiology 2006;163:9–17.
Buck AC, Davies RL, Harrison T. The protective role of eicosapentaenoic acid in the pathogenesis of nephrolithiasis. Journal of Urology 1991;146:188–194.
Sakaguchi K, Morita I, Murota S. Eicosapentaenoic acid inhibits bone loss due to ovariectomy in rats. Prostaglandins Leukotrienes & Essential Fatty Acids 1994;50:81–84.
Claassen N, Coetzer H, Steinmann CM, Kruger MC. The effect of different n-6/n-3 essential fatty acid ratios on calcium balance and bone in rats. Prostaglandins Leukotrienes & Essential Fatty Acids 1995;53:13–19.
Watkins BA, Li Y, Allen KG, Hoffmann WE, Seifert MF. Dietary ratio of (n-6)/(n-3) polyunsaturated fatty acids alters the fatty acid composition of bone compartments and biomarkers of bone formation in rats. Journal of Nutrition 2000;130:2274–2284.
Watkins BA, Li Y, Lippman HE, Feng S. Modulatory effect of omega-3 polyunsaturated fatty acids on osteoblast function and bone metabolism. Prostaglandins Leukotrienes & Essential Fatty Acids 2003;68:387–398.
van Papendorp DHC, H.; Kruger, M.C. Biochemical profile of osteoporotic patients on essential fatty acid supplementaion. Nutrition Research 1995;15:325–334.
Kruger MC, Coetzer H, de Winter R, Gericke G, van Papendorp DH. Calcium, gamma-linolenic acid and eicosapentaenoic acid supplementation in senile osteoporosis. Aging-Clinical & Experimental Research 1998;10:385–394.
Chen YM, Ho SC, Lam SS. Higher sea fish intake is assoicated with greater bone mass and lower osteoporosis risk in postmenopausal Chinese women. Osteoporosis International 2009;DOI 10.1007/s00198-009-1029-4.
Heaney RP. Calcium, dairy products and osteoporosis. Journal of the American College of Nutrition 2000;19:83S–99S.
Bischoff-Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson-Hughes B. Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA 2005;293:2257–2264.
Tang BM, Eslick GD, Nowson C, Smith C, Bensoussan A. Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet 2007;370:657–666.
Lau EM, Young RP, Ho SC, et al. Vitamin D receptor gene polymorphisms and bone mineral density in elderly Chinese men and women in Hong Kong. Osteoporosis International 1999;10:226–230.
Barrett-Connor E, Goodman-Gruen D. Gender differences in insulin-like growth factor and bone mineral density association in old age: the Rancho Bernardo Study. Journal of Bone & Mineral Research 1998;13:1343–1349.
Brenner H, Blettner M. Controlling for continuous confounders in epidemiologic research. Epidemiology 1997, 8:429–434.
Becher H. The concept of residual confounding in regression models and some applications. Statistic in Medicine 1992, 11:1747–1758.
Vandenbroucke JP, von Elm E, Altman DG, Gøtzsche PC, Mulrow CD, Pocock SJ, Poole C, Schlesselman JJ, Egger M. for the STROBE Initiative. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Explanation and Elaboration. Epidemiology 2007, 18:805–835.
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Chan, R., Woo, J. & Leung, J. Effects of food groups and dietary nutrients on bone loss in elderly Chinese population. J Nutr Health Aging 15, 287–294 (2011). https://doi.org/10.1007/s12603-010-0279-3
- bone mineral density