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Dietary magnesium and potassium intakes and circulating magnesium are associated with heel bone ultrasound attenuation and osteoporotic fracture risk in the EPIC-Norfolk cohort study.
Am J Clin Nutr 2015; 102(2):376-84AJ

Abstract

BACKGROUND

In our aging population, maintenance of bone health is critical to reduce the risk of osteoporosis and potentially debilitating consequences of fractures in older individuals. Among modifiable lifestyle and dietary factors, dietary magnesium and potassium intakes are postulated to influence bone quality and osteoporosis, principally via calcium-dependent alteration of bone structure and turnover.

OBJECTIVE

We investigated the influence of dietary magnesium and potassium intakes, as well as circulating magnesium, on bone density status and fracture risk in an adult population in the United Kingdom.

DESIGN

A random subset of 4000 individuals from the European Prospective Investigation into Cancer and Nutrition-Norfolk cohort of 25,639 men and women with baseline data was used for bone density cross-sectional analyses and combined with fracture cases (n = 1502) for fracture case-cohort longitudinal analyses (mean follow-up 13.4 y). Relevant biological, lifestyle, and dietary covariates were used in multivariate regression analyses to determine associations between dietary magnesium and potassium intakes and calcaneal broadband ultrasound attenuation (BUA), as well as in Prentice-weighted Cox regression to determine associated risk of fracture. Separate analyses, excluding dietary covariates, investigated associations of BUA and fractures with serum magnesium concentration.

RESULTS

Statistically significant positive trends in calcaneal BUA for women (n = 1360) but not men (n = 968) were apparent across increasing quintiles of magnesium plus potassium (Mg+K) z score intake (P = 0.03) or potassium intake alone (P = 0.04). Reduced hip fracture risk in both men (n = 1958) and women (n = 2755) was evident for individuals in specific Mg+K z score intake quintiles compared with the lowest. Statistically significant trends in fracture risk in men across serum magnesium concentration groups were apparent for spine fractures (P = 0.02) and total hip, spine, and wrist fractures (P = 0.02). None of these individual statistically significant associations remained after adjustment for multiple testing.

CONCLUSIONS

These findings enhance the limited literature studying the association of magnesium and potassium with bone density and demonstrate that further investigation is warranted into the mechanisms involved and the potential protective role against osteoporosis.

Authors+Show Affiliations

Department of Population Health and Primary Care, Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom; and.Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Strangeways Research Laboratory, Cambridge, United Kingdom.Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Strangeways Research Laboratory, Cambridge, United Kingdom.Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Strangeways Research Laboratory, Cambridge, United Kingdom.Department of Population Health and Primary Care, Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom; and a.welch@uea.ac.uk.

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26135346

Citation

Hayhoe, Richard P G., et al. "Dietary Magnesium and Potassium Intakes and Circulating Magnesium Are Associated With Heel Bone Ultrasound Attenuation and Osteoporotic Fracture Risk in the EPIC-Norfolk Cohort Study." The American Journal of Clinical Nutrition, vol. 102, no. 2, 2015, pp. 376-84.
Hayhoe RP, Lentjes MA, Luben RN, et al. Dietary magnesium and potassium intakes and circulating magnesium are associated with heel bone ultrasound attenuation and osteoporotic fracture risk in the EPIC-Norfolk cohort study. Am J Clin Nutr. 2015;102(2):376-84.
Hayhoe, R. P., Lentjes, M. A., Luben, R. N., Khaw, K. T., & Welch, A. A. (2015). Dietary magnesium and potassium intakes and circulating magnesium are associated with heel bone ultrasound attenuation and osteoporotic fracture risk in the EPIC-Norfolk cohort study. The American Journal of Clinical Nutrition, 102(2), pp. 376-84. doi:10.3945/ajcn.114.102723.
Hayhoe RP, et al. Dietary Magnesium and Potassium Intakes and Circulating Magnesium Are Associated With Heel Bone Ultrasound Attenuation and Osteoporotic Fracture Risk in the EPIC-Norfolk Cohort Study. Am J Clin Nutr. 2015;102(2):376-84. PubMed PMID: 26135346.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary magnesium and potassium intakes and circulating magnesium are associated with heel bone ultrasound attenuation and osteoporotic fracture risk in the EPIC-Norfolk cohort study. AU - Hayhoe,Richard P G, AU - Lentjes,Marleen A H, AU - Luben,Robert N, AU - Khaw,Kay-Tee, AU - Welch,Ailsa A, Y1 - 2015/07/01/ PY - 2014/11/07/received PY - 2015/05/27/accepted PY - 2015/7/3/entrez PY - 2015/7/3/pubmed PY - 2015/10/20/medline KW - bone density KW - dietary minerals KW - epidemiology KW - fractures KW - osteoporosis KW - quantitative ultrasound SP - 376 EP - 84 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 102 IS - 2 N2 - BACKGROUND: In our aging population, maintenance of bone health is critical to reduce the risk of osteoporosis and potentially debilitating consequences of fractures in older individuals. Among modifiable lifestyle and dietary factors, dietary magnesium and potassium intakes are postulated to influence bone quality and osteoporosis, principally via calcium-dependent alteration of bone structure and turnover. OBJECTIVE: We investigated the influence of dietary magnesium and potassium intakes, as well as circulating magnesium, on bone density status and fracture risk in an adult population in the United Kingdom. DESIGN: A random subset of 4000 individuals from the European Prospective Investigation into Cancer and Nutrition-Norfolk cohort of 25,639 men and women with baseline data was used for bone density cross-sectional analyses and combined with fracture cases (n = 1502) for fracture case-cohort longitudinal analyses (mean follow-up 13.4 y). Relevant biological, lifestyle, and dietary covariates were used in multivariate regression analyses to determine associations between dietary magnesium and potassium intakes and calcaneal broadband ultrasound attenuation (BUA), as well as in Prentice-weighted Cox regression to determine associated risk of fracture. Separate analyses, excluding dietary covariates, investigated associations of BUA and fractures with serum magnesium concentration. RESULTS: Statistically significant positive trends in calcaneal BUA for women (n = 1360) but not men (n = 968) were apparent across increasing quintiles of magnesium plus potassium (Mg+K) z score intake (P = 0.03) or potassium intake alone (P = 0.04). Reduced hip fracture risk in both men (n = 1958) and women (n = 2755) was evident for individuals in specific Mg+K z score intake quintiles compared with the lowest. Statistically significant trends in fracture risk in men across serum magnesium concentration groups were apparent for spine fractures (P = 0.02) and total hip, spine, and wrist fractures (P = 0.02). None of these individual statistically significant associations remained after adjustment for multiple testing. CONCLUSIONS: These findings enhance the limited literature studying the association of magnesium and potassium with bone density and demonstrate that further investigation is warranted into the mechanisms involved and the potential protective role against osteoporosis. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/26135346/Dietary_magnesium_and_potassium_intakes_and_circulating_magnesium_are_associated_with_heel_bone_ultrasound_attenuation_and_osteoporotic_fracture_risk_in_the_EPIC_Norfolk_cohort_study_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.114.102723 DB - PRIME DP - Unbound Medicine ER -