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Bone and nutrition in elderly women: protein, energy, and calcium as main determinants of bone mineral density.
Eur J Clin Nutr 2003; 57(4):554-65EJ

Abstract

OBJECTIVE

Nutrition is an important factor in the prevention and treatment of osteoporosis. Our goal was to examine the relationship between various nutrients and bone mass of several skeletal sites in elderly women, taking into account possible confounding variables.

DESIGN/METHODS

A cross-sectional study in 136 healthy Caucasian, postmenopausal women, free of medications known to affect bone was carried out. Bone mineral density (BMD) and body composition (lean and fat tissue) were measured by dual X-ray absorptiometry using specialized software for different skeletal sites. Parathyroid hormone (PTH) and vitamin D, 25(OH)D, as possible confounders, were determined in serum samples. Dietary intake, including all supplements, was assessed by 3-day dietary record and analyzed using Food Processor. Past physical activity and present walking were examined as well and accounted for as potential confounders. Simple and multiple regression models were created to assess the relationships between nutrients and BMD. To examine the co-linear variables and their possible independent association with bone, subgroup analyses were performed.

RESULTS

: Showed independent influence of calcium, energy, and protein, examined separately and in multiple regression models on BMD of several skeletal sites. Magnesium, zinc and vitamin C were significantly related to BMD of several skeletal sites in multiple regression models (controlled for age, fat and lean tissue, physical activity and energy intake), each contributing more than 1% of variance. Serum PTH and 25(OH)D did not show significant association with bone mass.

CONCLUSIONS

Despite the cross-sectional nature of our study we were able to show a significant relationship between BMD and several critical nutrients: energy, protein, calcium, magnesium, zinc and vitamin C. The exact involvement of these nutrients and their clinical significance in bone health need to be further elucidated in humans and conclusions about the effects of a single nutrient on bone mass must be given cautiously, taking into account its interaction and co-linearity with others. Understanding relationships among nutrients, not just limited to calcium and vitamin D, but others that have not been investigated to such extent, is an important step toward identifying preventive measures for bone loss and prevention of osteoporosis.

Authors+Show Affiliations

University of Connecticut, School of Allied Health, Storrs, Connecticut 06269, USA. ernst@uconn.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

12700617

Citation

Ilich, J Z., et al. "Bone and Nutrition in Elderly Women: Protein, Energy, and Calcium as Main Determinants of Bone Mineral Density." European Journal of Clinical Nutrition, vol. 57, no. 4, 2003, pp. 554-65.
Ilich JZ, Brownbill RA, Tamborini L. Bone and nutrition in elderly women: protein, energy, and calcium as main determinants of bone mineral density. Eur J Clin Nutr. 2003;57(4):554-65.
Ilich, J. Z., Brownbill, R. A., & Tamborini, L. (2003). Bone and nutrition in elderly women: protein, energy, and calcium as main determinants of bone mineral density. European Journal of Clinical Nutrition, 57(4), pp. 554-65.
Ilich JZ, Brownbill RA, Tamborini L. Bone and Nutrition in Elderly Women: Protein, Energy, and Calcium as Main Determinants of Bone Mineral Density. Eur J Clin Nutr. 2003;57(4):554-65. PubMed PMID: 12700617.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bone and nutrition in elderly women: protein, energy, and calcium as main determinants of bone mineral density. AU - Ilich,J Z, AU - Brownbill,R A, AU - Tamborini,L, PY - 2002/02/28/received PY - 2002/05/08/revised PY - 2002/06/11/accepted PY - 2003/4/18/pubmed PY - 2003/8/2/medline PY - 2003/4/18/entrez SP - 554 EP - 65 JF - European journal of clinical nutrition JO - Eur J Clin Nutr VL - 57 IS - 4 N2 - OBJECTIVE: Nutrition is an important factor in the prevention and treatment of osteoporosis. Our goal was to examine the relationship between various nutrients and bone mass of several skeletal sites in elderly women, taking into account possible confounding variables. DESIGN/METHODS: A cross-sectional study in 136 healthy Caucasian, postmenopausal women, free of medications known to affect bone was carried out. Bone mineral density (BMD) and body composition (lean and fat tissue) were measured by dual X-ray absorptiometry using specialized software for different skeletal sites. Parathyroid hormone (PTH) and vitamin D, 25(OH)D, as possible confounders, were determined in serum samples. Dietary intake, including all supplements, was assessed by 3-day dietary record and analyzed using Food Processor. Past physical activity and present walking were examined as well and accounted for as potential confounders. Simple and multiple regression models were created to assess the relationships between nutrients and BMD. To examine the co-linear variables and their possible independent association with bone, subgroup analyses were performed. RESULTS: : Showed independent influence of calcium, energy, and protein, examined separately and in multiple regression models on BMD of several skeletal sites. Magnesium, zinc and vitamin C were significantly related to BMD of several skeletal sites in multiple regression models (controlled for age, fat and lean tissue, physical activity and energy intake), each contributing more than 1% of variance. Serum PTH and 25(OH)D did not show significant association with bone mass. CONCLUSIONS: Despite the cross-sectional nature of our study we were able to show a significant relationship between BMD and several critical nutrients: energy, protein, calcium, magnesium, zinc and vitamin C. The exact involvement of these nutrients and their clinical significance in bone health need to be further elucidated in humans and conclusions about the effects of a single nutrient on bone mass must be given cautiously, taking into account its interaction and co-linearity with others. Understanding relationships among nutrients, not just limited to calcium and vitamin D, but others that have not been investigated to such extent, is an important step toward identifying preventive measures for bone loss and prevention of osteoporosis. SN - 0954-3007 UR - https://www.unboundmedicine.com/medline/citation/12700617/Bone_and_nutrition_in_elderly_women:_protein_energy_and_calcium_as_main_determinants_of_bone_mineral_density_ L2 - http://dx.doi.org/10.1038/sj.ejcn.1601577 DB - PRIME DP - Unbound Medicine ER -