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Dietary Mineral Intake Ratios and Bone Health in Adults

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Nutritional Influences on Bone Health

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Abstract

Fruit and vegetable consumption has consistently been identified as a favorable dietary strategy for bone health. Diets high in fruits and vegetables tend to be high in several minerals that are advantageous for bone health, including potassium, calcium, and magnesium, and low in sodium. The role of calcium in bone health has been well-characterized. However, there are few studies examining the link between potassium, magnesium, and sodium and bone. Moreover, characterizing the relationships between individual mineral intakes and their ratios and health outcomes is important due to the interactive effects of these minerals. Therefore, the aim of this study was to characterize the relationships between sodium, potassium, calcium, and magnesium intake and their ratios and bone mineral density and fracture incidence in a representative sample of US adults. We used data from the National Health and Nutrition Examination Survey (NHANES), 2013–2014, for these analyses. We included adult men and women ≥40 years of age, who were not pregnant or lactating, with complete and plausible data (n = 2617). Diet was assessed using two 24-h dietary recalls. Total femur and femoral neck areal bone mineral density (aBMD) were assessed using DXA, and fracture incidence after age 20 years was determined by self-report. A model for predicting bone outcomes was developed using the following explanatory variables: age, race, height, weight, and smoking status (yes/no). Relationships between individual mineral intakes and mineral intake ratios and bone outcomes were assessed by adding each of these terms to the basic regression model separately. Body weight explained the largest proportion of the variance in total femur aBMD (29% in women, 21% in men) and femoral neck aBMD (22% in women, 15% in men), and race explained the largest proportion of the variance in fracture incidence in both women (3%) and men (2%). Sodium, potassium, calcium, and magnesium intakes were positive predictors of aBMD in men (all p < 0.05), but not in women. Mineral intake ratios were not predictive of aBMD, and individual minerals and intake ratios were not predictive of fracture incidence (all p > 0.05). Randomized, controlled, full-feeding studies are required to determine the effect of mineral consumption from food as well as the ratio of their intakes on bone outcomes. Such findings would have important implications for making dietary recommendations and designing dietary interventions for reducing fracture risk.

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Acknowledgments

Author contributions: Drs. Weaver and G. McCabe had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Weaver, Bailey, and G. McCabe. Acquisition, analysis, or interpretation of data: All authors. Drafting of the manuscript: Lobene, Kindler, Stone, and Weaver. Critical revision of the manuscript for important intellectual content: All authors. Statistical analysis: L. McCabe and G McCabe. Conflict of interest disclosures: Weaver is a scientific advisor for Pharmavite and Pfizer and is on the Board of the International Life Sciences Institute. Funding/support: The present work was supported by International Life Sciences Institute-North America. The funder had no role in the conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Department of Nutrition Science, Purdue University, West Lafayette, IN, USA

    Andrea J. Lobene, Linda D. McCabe, Michael S. Stone, Joseph M. Kindler, Regan L. Bailey & Connie M. Weaver

  2. Food Surveys Research Group, USDA, ARS, Beltsville, MD, USA

    Alanna J. Moshfegh, Donna G. Rhodes & Joseph D. Goldman

  3. Department of Statistics, Purdue University, West Lafayette, IN, USA

    George P. McCabe

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  1. Andrea J. Lobene
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  9. George P. McCabe
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Correspondence to Connie M. Weaver .

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Editors and Affiliations

  1. Nutrition and Science, Purdue University, West Lafayette, IN, USA

    Connie M. Weaver

  2. Geriatrics and Aging Research, University of Zurich, Zurich, Switzerland

    Heike Bischoff-Ferrari

  3. Institute for Physical Activity and Nutrition, Deakin University , Melbourne, VIC, Australia

    Robin M. Daly

  4. Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Hong Kong

    Man-Sau Wong

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Lobene, A.J. et al. (2019). Dietary Mineral Intake Ratios and Bone Health in Adults. In: Weaver, C., Bischoff-Ferrari, H., Daly, R., Wong, MS. (eds) Nutritional Influences on Bone Health. Springer, Cham. https://doi.org/10.1007/978-3-319-98464-3_6

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  • DOI: https://doi.org/10.1007/978-3-319-98464-3_6

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