Skip to main content
SpringerLink
Log in

The effects of β-carotene on osteoporosis: a systematic review and meta-analysis of observational studies

  • Review
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Purpose

The aim is to evaluate the effect of β-carotene for osteoporosis and provide quantitative evidence.

Method

PubMed, Embase, Web of Science, and Cochrane Library were searched for eligible studies. Fifteen studies were included. Random-effect model was applied to pool the odds ratio (OR). The risk of osteoporosis and fracture were compared between low β-carotene intake group and high β-carotene intake group.

Result

The intake of β-carotene was unassociated with the overall risk of osteoporosis [OR = 0.733, 95% Cl (0.528, 1.018), p = 0.064]. Subgroup analysis showed that the intake of β-carotene was negatively associated with the risk of osteoporosis in both male subgroup [OR = 0.7, 95% Cl (0.549, 0.893), I2 = 40.40%, p = 0.004] and female subgroup [OR = 0.684, 95% Cl (0.487, 0.960), I2 = 86.40%, p = 0.028]. There was also a negative association between β-carotene intake and osteoporosis in Asia subgroup [OR = 0.512, 95% Cl (0.403, 0.650), I2 = 0.00%, p = 0], whereas no association was observed in Western subgroup [OR = 1.107, 95% Cl (0.908, 1.350), I2 = 2.30%, p = 0.314]. In addition, random-effect model was adopted to pool the standard mean difference (SMD), and the results showed that β-carotene intake was positively associated with overall bone mineral density (BMD) [SMD =  − 0.213, 95% Cl (− 0.391, − 0.034), I2 = 87.30%, p = 0.019]. Subgroup analysis showed that β-carotene intake was positively associated with BMD in Asian participants [SMD =  − 0.394, 95% Cl (− 0.461, − 0.328), I2 = 0, p = 0], while unassociated in Western participants [SMD =  − 0.047, 95% Cl (− 0.314, 0.219), I2 = 78.9%, p = 0.727].

Conclusion

β-carotene may improve BMD and reduce the risk of osteoporosis and fracture. However, these effects could vary by gender and race and need to be further validated by longitudinal studies.

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

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

Data availability

All data generated or analyzed during this study are included in this published article or are available from the corresponding author on reasonable request.

References

  1. Ensrud KE, Crandall CJ (2017) Osteoporosis. Ann Intern Med 167:Itc17-itc32

    Article  PubMed  Google Scholar 

  2. Sandhiya L, Zipse H (2021) Conformation-dependent antioxidant properties of β-carotene. Org Biomol Chem 20:152–162

    Article  CAS  PubMed  Google Scholar 

  3. Shete V, Costabile BK, Kim YK, Quadro L (2016) Low-density lipoprotein receptor contributes to β-carotene uptake in the maternal liver. Nutrients 8

  4. Matsumoto Y, Tousen Y, Ishimi Y (2018) β-carotene prevents bone loss in hind limb unloading mice. J Clin Biochem Nutr 63:42–49

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Dabouian A, Bakhshi H, Irani S, Pezeshki-Modaress M (2018) β-carotene: a natural osteogen to fabricate osteoinductive electrospun scaffolds. RSC Adv 8:9941–9945

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Nishide Y, Tousen Y, Tadaishi M, Inada M, Miyaura C, Kruger MC, Ishimi Y (2015) Combined effects of soy isoflavones and β-carotene on osteoblast differentiation. Int J Environ Res Public Health 12:13750–13761

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Vimalraj S (2020) Alkaline phosphatase: structure, expression and its function in bone mineralization. Gene 754:144855

    Article  CAS  PubMed  Google Scholar 

  8. Kan B, Guo D, Yuan B, Vuong AM, Jiang D, Zhang M, Cheng H, Zhao Q, Li B, Feng L et al (2021) Dietary carotenoid intake and osteoporosis: the National Health and Nutrition Examination Survey, 2005–2018. Arch Osteoporos 17:2

    Article  PubMed  Google Scholar 

  9. Feskanich D, Singh V, Willett WC, Colditz GA (2002) Vitamin A intake and hip fractures among postmenopausal women. JAMA 287:47–54

    Article  CAS  PubMed  Google Scholar 

  10. Cao WT, Zeng FF, Li BL, Lin JS, Liang YY, Chen YM (2018) Higher dietary carotenoid intake associated with lower risk of hip fracture in middle-aged and elderly Chinese: a matched case-control study. Bone 111:116–122

    Article  CAS  PubMed  Google Scholar 

  11. Barker ME, McCloskey E, Saha S, Gossiel F, Charlesworth D, Powers HJ, Blumsohn A (2005) Serum retinoids and β-carotene as predictors of hip and other fractures in elderly women. J Bone Miner Res 20:913–920

    Article  CAS  PubMed  Google Scholar 

  12. Regu GM, Kim H, Kim YJ, Paek JE, Lee G, Chang N, Kwon O (2017) Association between dietary carotenoid intake and bone mineral density in korean adults aged 30–75 years using data from the Fourth and Fifth Korean National Health and Nutrition Examination Surveys (2008–2011). Nutrients 9

  13. Sugiura M, Nakamura M, Ogawa K, Ikoma Y, Ando F, Shimokata H, Yano M (2011) Dietary patterns of antioxidant vitamin and carotenoid intake associated with bone mineral density: findings from post-menopausal Japanese female subjects. Osteoporos Int 22:143–152

    Article  CAS  PubMed  Google Scholar 

  14. Sugiura M, Nakamura M, Ogawa K, Ikoma Y, Ando F, Yano M (2008) Bone mineral density in post-menopausal female subjects is associated with serum antioxidant carotenoids. Osteoporos Int 19:211–219

    Article  CAS  PubMed  Google Scholar 

  15. Sugiura M, Nakamura M, Ogawa K, Ikoma Y, Yano M (2012) High serum carotenoids associated with lower risk for bone loss and osteoporosis in post-menopausal Japanese female subjects: prospective cohort study. PLoS One 7:e52643

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Sun LL, Li BL, Xie HL, Fan F, Yu WZ, Wu BH, Xue WQ, Chen YM (2014) Associations between the dietary intake of antioxidant nutrients and the risk of hip fracture in elderly Chinese: a case-control study. Br J Nutr 112:1706–1714

    Article  CAS  PubMed  Google Scholar 

  17. Dai Z, Wang R, Ang LW, Low YL, Yuan JM, Koh WP (2014) Protective effects of dietary carotenoids on risk of hip fracture in men: the Singapore Chinese Health Study. J Bone Miner Res 29:408–417

    Article  CAS  PubMed  Google Scholar 

  18. Hayhoe RPG, Lentjes MAH, Mulligan AA, Luben RN, Khaw KT, Welch AA (2017) Carotenoid dietary intakes and plasma concentrations are associated with heel bone ultrasound attenuation and osteoporotic fracture risk in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk cohort. Br J Nutr 117:1439–1453

    Article  CAS  PubMed  Google Scholar 

  19. Ambrosini GL, Bremner AP, Reid A, Mackerras D, Alfonso H, Olsen NJ, Musk AW, de Klerk NH (2013) No dose-dependent increase in fracture risk after long-term exposure to high doses of retinol or beta-carotene. Osteoporos Int 24:1285–1293

    Article  CAS  PubMed  Google Scholar 

  20. Maggio D, Polidori MC, Barabani M, Tufi A, Ruggiero C, Cecchetti R, Aisa MC, Stahl W, Cherubini A (2006) low levels of carotenoids and retinol in involutional osteoporosis. Bone 38:244–248

    Article  CAS  PubMed  Google Scholar 

  21. Rejnmark L, Vestergaard P, Charles P, Hermann AP, Brot C, Eiken P, Mosekilde L (2004) No effect of vitamin A intake on bone mineral density and fracture risk in perimenopausal women. Osteoporos Int 15:872–880

    Article  CAS  PubMed  Google Scholar 

  22. Yang Z, Zhang Z, Penniston KL, Binkley N, Tanumihardjo SA (2008) Serum carotenoid concentrations in postmenopausal women from the United States with and without osteoporosis. Int J Vitam Nutr Res 78:105–111

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Yee MMF, Chin KY, Ima-Nirwana S, Wong SK (2021) Vitamin A and bone health: a review on current evidence. Molecules 26

  24. Agidigbi TS, Kim C (2019) Reactive oxygen species in osteoclast differentiation and possible pharmaceutical targets of ROS-mediated osteoclast diseases. Int J Mol Sci 20

  25. Wang F, Wang N, Gao Y, Zhou Z, Liu W, Pan C, Yin P, Yu X, Tang M (2017) β-carotene suppresses osteoclastogenesis and bone resorption by suppressing NF-κB signaling pathway. Life Sci 174:15–20

    Article  CAS  PubMed  Google Scholar 

  26. Kim DE, Cho SH, Park HM, Chang YK (2016) Relationship between bone mineral density and dietary intake of β-carotene, vitamin C, zinc and vegetables in postmenopausal Korean women: a cross-sectional study. J Int Med Res 44:1103–1114

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Charkos TG, Liu Y, Oumer KS, Vuong AM, Yang S (2020) Effects of β-carotene intake on the risk of fracture: a Bayesian meta-analysis. BMC Musculoskelet Disord 21:711

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Esmailian S, Irani S, Bakhshi H, Zandi M (2018) Biodegradable bead-on-spring nanofibers releasing β-carotene for bone tissue engineering. Mater Sci Eng C Mater Biol Appl 92:800–806

    Article  CAS  PubMed  Google Scholar 

  29. Park CK, Ishimi Y, Ohmura M, Yamaguchi M, Ikegami S (1997) Vitamin A and carotenoids stimulate differentiation of mouse osteoblastic cells. J Nutr Sci Vitaminol (Tokyo) 43:281–296

    Article  CAS  PubMed  Google Scholar 

  30. Burton GW, Mogg TJ, Riley WW, Nickerson JG (2021) β-carotene oxidation products - function and safety. Food Chem Toxicol 152:112207

    Article  CAS  PubMed  Google Scholar 

  31. Djordjević VB (2004) Free radicals in cell biology. Int Rev Cytol 237:57–89

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to thank the database search support.

Author information

Authors and Affiliations

  1. Shi’s Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China

    Sa Sa Gao & Yongfang Zhao

  2. Institute of Traumatology & Orthopedics, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China

    Sa Sa Gao & Yongfang Zhao

  3. Science and Technology Department, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Pudong New Area, Shanghai, China

    Yongfang Zhao

Authors
  1. Sa Sa Gao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yongfang Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yongfang Zhao.

Ethics declarations

Consent for publication

Not applicable.

Conflicts of interest

None.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 24 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gao, S.S., Zhao, Y. The effects of β-carotene on osteoporosis: a systematic review and meta-analysis of observational studies. Osteoporos Int 34, 627–639 (2023). https://doi.org/10.1007/s00198-022-06593-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-022-06593-7

Keywords

Search

Navigation