Skip to main content
SpringerLink
Log in

Dietary determinants of post-menopausal bone loss at the lumbar spine: a possible beneficial effect of iron

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. O’Neill TW, Felsenberg D, Varlow J, Cooper C, Kanis JA, Silman AJ, et al (1996) The prevalence of vertebral deformity in European men and women: the European vertebral osteoporosis study. J Bone Miner Res 11:1010–1017

    PubMed  CAS  Google Scholar 

  2. Lunt M, Felsenberg D, Reeve J, Benevolenskaya L, Cannata J, Dequeker J, et al (1997) Bone density variation and its effects on risk of vertebral deformity in men and women studied in 13 European centres: the EVOS study. J Bone Miner Res 12:1883–1894

    Article  PubMed  CAS  Google Scholar 

  3. Black DM, Cummings SR, Melton LJ III (1992) Appendicular bone mineral and a woman’s lifetime risk of hip fracture. J Bone Miner Res 7:639–646

    PubMed  CAS  Google Scholar 

  4. Falch J, Sandvik L (1990) Perimenopausal appendicular bone loss: a 10-year prospective study. Bone 11:425–428

    Article  PubMed  CAS  Google Scholar 

  5. Johnston C Jr, Hui S, Wiske P, Norton J Jr, Epstein S (1980) Bone mass at maturity and subsequent rates of loss as determinants of osteoporosis. In: DeLuca HF, Frost H, Jee W, Johnston Jr CC, Parfitt AM (eds) Osteoporosis: recent advances in pathogenesis and treatment. Baltimore: University Park Press, pp 285–291

    Google Scholar 

  6. Hansen MA, Overgaard K, Christiansen C (1995) Spontaneous postmenopausal bone loss in different skeletal areas – followed up for 15 years. J Bone Miner Res 10:205–210

    PubMed  CAS  Google Scholar 

  7. Krölner B, Nielsen S (1980) Measurement of bone mineral content (BMC) of the lumbar spine. I. Theory and application of a new two-dimensional dual-photon attenuation method. Scand J Clin Lab Invest 40:653–663

    Article  PubMed  Google Scholar 

  8. Reeve J, Pearson J, Mitchell A, Green JR, Nicholls A, Justice J, et al. (1995) Evolution of spinal bone loss and biochemical markers of bone remodelling after menopause in normal women. Calcif Tissue Int 57:105–110

    Article  PubMed  CAS  Google Scholar 

  9. Pouilles J, Tremollieres F, Ribot C (1993) The effects of menopause on longitudinal bone loss from the spine. Calcif Tissue Int 52:40–43

    Google Scholar 

  10. Reeve J, Walton J, Russell LJ, Lunt M, Wolman R, Abraham R, et al (1999) Determinants of the first decade of bone loss after menopause at spine, hip and radius: the Harrow post-menopausal bone loss study. Q J Med 92:261–273

    CAS  Google Scholar 

  11. Abraham R, Pearson J, Reeve J, (1991) Calcium intake:important in early menopause? In: Heaney R, Burckhart P (eds) Nutritional aspects of osteoporosis. Raven Press, New York, pp 191–204

    Google Scholar 

  12. Hudson E, Klenerman L, Hesp R, Justice J, Nicholls A, Charlett A, et al. (1990) Vaginal cell cytology is a poor predictor of rates of bone loss in early postmenopause. In: Christiansen C, Overgaard K (eds) Osteoporosis 1990, vol 2. Osteopress ApS, Copenhagen, pp 582–584

  13. Lowell JP, Mechie JR (1983) Computerised dietary calculations: an interactive approach updated. Hum Nutr Appl Nutr 37:36–40

    PubMed  CAS  Google Scholar 

  14. Paul AA, Southgate DA (1978) McCance and Widdowson’s: The composition of foods. Elsevier/North Holland, Amsterdam

    Google Scholar 

  15. Paul AA, Southgate DA, Buss DH (1986) McCance and Widdowson’s ‘The composition of foods’: supplementary information and review of new compositional data. Hum Nutr Appl Nutr 40:287–299

    PubMed  CAS  Google Scholar 

  16. Reeve J, Abraham R, Walton J, Russell LJ, Wardley-Smith B, Mitchell A (2004) Increasing “bone” mineral density after menopause in individual lumbar vertebrae as a marker for degenerative disease: a pilot study for the effects of body composition and diet. J Rheumatol 31:1986–1993

    PubMed  Google Scholar 

  17. Genant HK, Steiger P, Block JE, Glueer CC, Hinger B, Harris ST (1987) Quantitative computed tomography: update 1987. Calcif Tissue Int 41:179–186

    Article  PubMed  CAS  Google Scholar 

  18. Doyle F, Brown J, Lachance C (1970) Relation between bone mass and muscle weight. Lancet 21:391–393

    Article  Google Scholar 

  19. Prentice A, Parsons TJ, Cole TJ (1994) Uncritical use of bone mineral density in absorptiometry may lead to size-related artifacts in the identification of bone mineral determinants. Am J Clin Nutr 60:837–842

    PubMed  CAS  Google Scholar 

  20. Huopio J, Kroger H, Honkanen R, Saarikoski S, Alhava E (2000) Risk factors for perimenopausal fractures: A prospective study. Osteoporos Int 11:219–227

    Article  PubMed  CAS  Google Scholar 

  21. Sellmeyer DE, Stone KL, Sebastian A, Cummings SR (2001) A high ratio of dietary animal to vegetable protein increases the rate of bone loss and the risk of fracture in postmenopausal women. Am J Clin Nutr 73:118–122

    PubMed  CAS  Google Scholar 

  22. Chan HHI, Lau EMC, Woo J, Lin F, Sham A, Leung PC (1996) Dietary calcium intake, physical activity and the risk of vertebral fracture in the Chinese. Osteoporos Int 6:228–232

    Article  PubMed  CAS  Google Scholar 

  23. Lunt M, Masaryk P, Nijs J, Scheidt-Nave C, Poor G, Pols HAP, et al. (2001) The effects of lifestyle and dietary dairy intake on bone density: the EVOS prevalence study. Osteoporosis Int 12:688–698

    Google Scholar 

  24. Arnett TR, Gibbons DC, Utting JC, Orriss IR, Hoebertz A, Rosendaal M (2003) Hypoxia is a major stimulator of osteoclast formation and bone resorption. J Cell Physiol 196:2–8

    Article  PubMed  CAS  Google Scholar 

  25. Arnett T (2003) Regulation of bone cell function by acid-base balance. Proc Nutr Soc 62:511–520

    Article  PubMed  CAS  Google Scholar 

  26. Cesari M, Pahor M, Lauretani F, Penninx BW, Bartali B, Russo R, et al. (2005) Bone density and hemoglobin levels in older persons: results from the InCHIANTI study. Osteoporos Int 16:691–699

    Article  PubMed  CAS  Google Scholar 

  27. Hunt JR, Gallagher S, Johnson LK, Lykken GI (1995) High- versus low-meat diets: effects on zinc absorption, iron status, and calcium, copper, iron, magnesium, manganese, nitrogen, phosphorus, and zinc balance in postmenopausal women. Am J Clin Nutr 62:621–632

    PubMed  CAS  Google Scholar 

  28. Bonjour J-P, Schurch M-A, Chevally T, Ammann P, Rizzoli R (1997) Protein intake, IGF-1 and Osteoporosis. Osteoporos Int 7[Suppl 3]:36–42

    CAS  Google Scholar 

  29. Barzel US (1995) The skeleton as an ion exchange system: Implications for the role of acid-base imbalance in the genesis of osteoporosis. J Bone Miner Res 10:1431–1436

    Article  PubMed  CAS  Google Scholar 

  30. Sebastain A (2005) Isoflavones, protein, and bone. Am J Clin Nutr 81:733–735

    Google Scholar 

  31. Johnell O, O’Neill T, Felsenberg D, Kanis J, Cooper C, Silman A, et al. (1997) Anthropometric measurements and vertebral deformities. Am J Epidemiol 146:287–293

    PubMed  CAS  Google Scholar 

  32. Wolman RL, Clark P, McNally E, Faulmann L, Harries M, Reeve J (1990) Menstrual status and exercise are important determinants of spinal trabecular bone density in female athletes. Br Med J 301:516–518

    Article  CAS  Google Scholar 

  33. Bingham SA, Cassidy A, Cole TJ, Welch A, Runswick SA, Black AE, et al (1995) Validation of weighed records and other methods of dietary assessment using the 24 h urine nitrogen technique and other biological markers. Br J Nutr 73:531–550

    Article  PubMed  CAS  Google Scholar 

  34. Tremollieres F, Pouilles JM, Ribot C (1993) Vertebral post-menopausal bone loss is reduced in overweight women. J Clin Endocrinol Metab 77:683–686

    Article  PubMed  CAS  Google Scholar 

  35. Reid IR, Ames RW, Evans MC, Gamble GD, Sharpe SJ (1993) Effect of calcium supplementation on bone loss in postmenopausal women. New Eng J Med 328:460–464

    Article  PubMed  CAS  Google Scholar 

  36. Eriksen EF (1986) Normal and pathological remodeling of human trabecular bone: three dimensional reconstruction of the remodeling sequence in normal and in metabolic bone disease. Endocr Rev 7:379–407

    Article  PubMed  CAS  Google Scholar 

  37. Gibson JH, Harries M, Mitchell A, Godfrey R, Lunt M, Reeve J (2000) Determinants of bone density and prevalence of osteopenia among female runners in their second to seventh decades of age. Bone 26:591–598

    Article  PubMed  CAS  Google Scholar 

  38. Dequeker J, Pearson J, Reeve J, Henley M, Bright J, Felsenberg D, et al (1995) Dual X-ray absorptiometry: cross-calibration and normative reference ranges for the spine: results of a European community concerted action. Bone 17:247–254

    Article  PubMed  CAS  Google Scholar 

  39. Ruston D, Hoare J, Henderson L, Gregory J, Bates CJ, Prentice A, et al. (2004) The national diet and nutrition survey: Adults aged 19 to 64 years, vol. 4. Her Majesty’s Stationery Office, London, p 156

    Google Scholar 

Download references

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.

Author information

Author notes

  1. R. Wolman

    Present address: Royal National Orthopaedic Hospital (RNOH), Stanmore, Middlesex, UK

Authors and Affiliations

  1. Northwick Park Hospital, Harrow, UK

    R. Abraham, R. Wolman, B. Wardley-Smith & J. R. Green

  2. Department of Medicine, University of Cambridge, Cambridge, UK

    J. Walton, L. Russell, A. Mitchell & J. Reeve

  3. Addenbrooke’s Hospital, University Department of Medicine, Hills Road, P.O. Box 157, CB2 2QQ, Cambridge, UK

    J. Reeve

Authors
  1. R. Abraham
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Walton
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. Russell
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. Wolman
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. B. Wardley-Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J. R. Green
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. A. Mitchell
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. J. Reeve
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Reeve.

Rights and permissions

Reprints and permissions

About this article

Cite this article

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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-005-0033-6

Keywords

Search

Navigation