British Journal of Nutrition

Workshop Report

Nutrition and bone health projects funded by the UK Food Standards Agency: have they helped to inform public health policy?

Margaret Ashwella1 c1, Elaine Stonea2, John Mathersa3, Stephen Barnesa4, Juliet Compstona5, Roger M. Francisa6, Tim Keya7, Kevin D. Cashmana8, Cyrus Coopera9, Kay Tee Khawa10, Susan Lanham-Newa11, Helen Macdonalda12, Ann Prenticea13, Martin Shearera14 and Alison Stephena13

a1 Ashwell Associates (Europe) Ltd, Ashwell, Hertfordshire SG7 5PZ and Oxford Brookes University, Oxford OX3 0BP, UK

a2 Food Standards Agency, London WC2 6NH, UK

a3 Human Nutrition Research Centre, School of Clinical Medical Sciences, Newcastle University, Newcastle upon Tyne NE2 4HH, UK

a4 Department of Pharmacology & Toxicology and Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA

a5 Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge CB2 2QQ, UK

a6 Musculoskeletal Unit, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK

a7 Cancer Research UK Epidemiology Unit, University of Oxford, Richard Doll Building, Oxford OX3 7LF, UK

a8 Departments of Food and Nutritional Sciences, and Medicine, University College, Cork, Ireland

a9 MRC Epidemiology Resource Centre (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK

a10 University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK

a11 Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK

a12 Medicine and Therapeutics, Osteoporosis Research Unit, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK

a13 MRC Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge CB1 9NL, UK

a14 Vitamin K Laboratory, Centre for Haemostasis & Thrombosis, St Thomas' Hospital, London SE1 7EH, UK


The UK Food Standards Agency convened an international group of expert scientists to review the Agency-funded projects on diet and bone health in the context of developments in the field as a whole. The potential benefits of fruit and vegetables, vitamin K, early-life nutrition and vitamin D on bone health were presented and reviewed. The workshop reached two conclusions which have public health implications. First, that promoting a diet rich in fruit and vegetable intakes might be beneficial to bone health and would be very unlikely to produce adverse consequences on bone health. The mechanism(s) for any effect of fruit and vegetables remains unknown, but the results from these projects did not support the postulated acid–base balance hypothesis. Secondly, increased dietary consumption of vitamin K may contribute to bone health, possibly through its ability to increase the γ-carboxylation status of bone proteins such as osteocalcin. A supplementation trial comparing vitamin K supplementation with Ca and vitamin D showed an additional effect of vitamin K against baseline levels of bone mineral density, but the benefit was only seen at one bone site. The major research gap identified was the need to investigate vitamin D status to define deficiency, insufficiency and depletion across age and ethnic groups in relation to bone health.

(Received April 18 2007)

(Revised May 07 2007)

(Accepted May 10 2007)


c1 Corresponding author: Dr Margaret Ashwell, email


Abbreviations: BMD, bone mineral density; BUA, bone ultrasound attenuation; Gla, carboxyglutamyl; NDNS, National Diet and Nutrition Surveys; PRAL, potential renal acid load; 25-OHD, 25(OH) vitamin D; RCT, randomised controlled trial