Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-17T07:03:54.581Z Has data issue: false hasContentIssue false
  • English
  • Français

Greater fruit and vegetable intake is associated with increased bone mass among postmenopausal Chinese women

Published online by Cambridge University Press:  08 March 2007

Yu-ming Chen ,
Suzanne C. Ho  and
Jean L.F. Woo
Yu-ming Chen
Affiliation:
Department of Community & Family Medicine and School of Public Health, The Chinese University of Hong Kong, 4th Floor, School of Public Health, Prince of Wales Hospital, Shatin, N.T., Hong Kong SAR Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Peoples Republic of China
Suzanne C. Ho*
Affiliation:
Department of Community & Family Medicine and School of Public Health, The Chinese University of Hong Kong, 4th Floor, School of Public Health, Prince of Wales Hospital, Shatin, N.T., Hong Kong SAR
Jean L.F. Woo
Affiliation:
Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Clinical Sciences Building, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR
*
*Corresponding author: Prof. Suzanne C. Ho, fax +852 2602 6986, email suzanneho@cuhk.edu.hk
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Although studies in Caucasian populations have reported the beneficial effects of intakes of fruit and vegetables on bone mass, limited data are available in the Asian populations. We examined the association of the intake of fruits and vegetables with bone mineral density (BMD) in a population-based cross-sectional study of 670 postmenopausal Chinese women aged 48–63 years. Habitual dietary intakes were assessed using a food frequency questionnaire. BMD at the whole body, lumbar spine and left hip were measured with dual-energy X-ray absorptiometry. Univariate regression analyses showed that the total intake of fruits and vegetables was significantly associated with greater BMD at the whole body, lumbar spine (L1–L4), total hip, trochanter and intertrochanter. An independently positive association between fruit and vegetable intake and BMD at the whole body (P=0·005), lumbar spine (P<0·001) and total hip (P=0·024) remained even after adjusting for age, years since menopause, body weight and height, dietary energy, protein and Ca, and physical activities. A daily increase of 100 g fruit and vegetable intake was associated with 0·0062 (95 % CI 0·0019, 0·0105) g/cm2, 0·0098 (95 % CI 0·0041, 0·0155) g/cm2 and 0·0060 (95 % CI 0·0011, 0·0109) g/cm2 increases in BMD at the whole body, lumbar spine and total hip, respectively. In conclusion, greater fruit and vegetable intake is independently associated with better BMD among postmenopausal Chinese women.

Keywords

FruitsVegetablesBone mineral densityPostmenopausal womenChinese
Type
Research Article
Information
British Journal of Nutrition , Volume 96 , Issue 4 , October 2006 , pp. 745 - 751
Copyright
Copyright © The Nutrition Society 2006

References

Alexy, U, Remer, T, Manz, F, Neu, CM & Schoenau, E (2005) Long-term protein intake and dietary potential renal acid load are associated with bone modeling and remodeling at the proximal radius in healthy children. Am J Clin Nutr 82, 1107–1114.CrossRefGoogle ScholarPubMed
Arjmandi, BH & Smith, BJ (2002) Soy isoflavones' osteoprotective role in postmenopausal women: mechanism of action. J Nutr Biochem 13, 130–137.CrossRefGoogle ScholarPubMed
Bazzano, LA, He, J, Ogden, LG, Loria, CM, Vupputuri, S, Myers, L & Whelton, PK (2002) Fruit and vegetable intake and risk of cardiovascular disease in US adults: the first National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. Am J Clin Nutr 76, 93–99.CrossRefGoogle ScholarPubMed
Binkley, NC & Suttie, JW (1995) Vitamin K nutrition and osteoporosis. J Nutr 125, 1812–1821.CrossRefGoogle ScholarPubMed
Booth, SL, Broe, KE, Gagnon, DR, Tucker, KL, Hannan, MT, McLean, RR, Dawson-Hughes, B, Wilson, PW, Cupples, LA & Kiel, DP (2003) Vitamin K intake and bone mineral density in women and men. Am J Clin Nutr 77, 512–516.CrossRefGoogle ScholarPubMed
Chen, YM, Ho, SC, Lam, SSH, Ho, SSS & Woo, JLF (2003) Soy isoflavones have a favorable effect on bone loss in Chinese postmenopausal women with lower bone mass: a double-blind, randomized, controlled trial. J Clin Endocrinol Metab 88, 4740–4747.CrossRefGoogle Scholar
Djousse, L, Arnett, DK, Coon, H, Province, MA, Moore, LL & Ellison, RC (2004) Fruit and vegetable consumption and LDL cholesterol: the National Heart, Lung, and Blood Institute Family Heart Study. Am J Clin Nutr 79, 213–217.CrossRefGoogle ScholarPubMed
Flood, A, Velie, EM, Chaterjee, N, Subar, AF, Thompson, FE, Lacey, JV Jr, Schairer, C, Troisi, R & Schatzkin, A (2002) Fruit and vegetable intakes and the risk of colorectal cancer in the Breast Cancer Detection Demonstration Project follow-up cohort. Am J Clin Nutr 75, 936–943.CrossRefGoogle ScholarPubMed
Frassetto, L, Morris, RC Jr & Sebastian, A (2005) Long-term persistence of the urine calcium-lowering effect of potassium bicarbonate in postmenopausal women. J Clin Endocrinol Metab 90, 831–834.CrossRefGoogle ScholarPubMed
Ho, SC, Chan, SG, Yi, Q, Wong, E & Leung, PC (2001) Soy intake and the maintenance of peak bone mass in Hong Kong Chinese women. J Bone Miner Res 16, 1363–1369.CrossRefGoogle ScholarPubMed
Ho, SC, Chen, YM & Woo, JLF (2005) Educational level and osteoporosis risk in postmenopausal Chinese women. Am J Epidemiol 161, 680–690.CrossRefGoogle ScholarPubMed
Ho, SC, Chen, YM, Woo, JLF & Lam, SSH (2004) High habitual calcium intake attenuates bone loss in early postmenopausal Chinese women: an 18-month follow-up study. J Clin Endocrinol Metab 89, 2166–2170.CrossRefGoogle ScholarPubMed
Ho, SC, Leung, PC, Swaminathan, R, Chan, C, Chan, SS, Fan, YK & Lindsay, R (1994) Determinants of bone mass in Chinese women aged 21–40 years. II. Pattern of dietary calcium intake and association with bone mineral density. Osteoporos Int 4, 167–175.CrossRefGoogle ScholarPubMed
Ho, SC, Wong, E, Chan, SG, Lau, J, Chan, C & Leung, PC (1997) Determinants of peak bone mass in Chinese women aged 21–40 years. III. Physical activity and bone mineral density. J Bone Miner Res 12, 1262–1271.CrossRefGoogle ScholarPubMed
Ho, SC, Woo, J, Lam, S, Chen, YM, Sham, A & Lau, J (2003) Soy protein consumption and bone mass in early postmenopausal Chinese women. Osteoporos Int 14, 835–842.CrossRefGoogle ScholarPubMed
Hong Kong Census and Statistics Department (2002) Hong Kong 2001 Population Census Main Report, vol. I. Hong Kong: Hong Kong Census and Statistics Department.Google Scholar
Johnsen, SP, Overvad, K, Stripp, C, Tjonneland, A, Husted, SE & Sorensen, HT (2003) Intake of fruit and vegetables and the risk of ischemic stroke in a cohort of Danish men and women. Am J Clin Nutr 78, 57–64.CrossRefGoogle Scholar
Kaptoge, S, Welch, A, McTaggart, A, Mulligan, A, Dalzell, N, Day, N, Bingham, S, Khaw, K & Reeve, J (2003) Effects of dietary nutrients and food groups on bone loss from the proximal femur in men and women in the 7th and 8th decades of age. Osteoporos Int 14, 418–428.Google Scholar
Lachnicht, D, Brevard, P, Wagner, T & DeMars, C (2002) Dietary oxygen radical absorbance capacity as a predictor of bone mineral density. Nutr Res 22, 1389–1399.CrossRefGoogle Scholar
Lampe, JW (1999) Health effects of vegetables and fruit: assessing mechanisms of action in human experimental studies. Am J Clin Nutr 70 475S – 490SCrossRefGoogle ScholarPubMed
Lean, J, Davies, J, Fuller, K, Jagger, C, Kirstein, B, Partington, G, Urry, Z & Chambers, T (2003) A crucial role for thiol antioxidants in estrogen-deficiency bone loss. J Clin Invest 112, 915–923.CrossRefGoogle ScholarPubMed
Leung, SS, Ho, SC, Woo, J, Lam, TH & Janus, ED (1997) Hong Kong Adult Dietary Survey. Hong Kong: The Chinese University of Hong Kong.Google Scholar
Ma, W (2004) The Dietary and Nutritional Status of Guangdong Chinese Population: 2002 National Nutrition Survey. Guangzhou: Guangdong People's Publishing House.Google Scholar
Macdonald, HM, New, SA, Fraser, WD, Campbell, MK & Reid, DM (2005 a) Low dietary potassium intakes and high dietary estimates of net endogenous acid production are associated with low bone mineral density in premenopausal women and increased markers of bone resorption in postmenopausal women. Am J Clin Nutr 81, 923–933.CrossRefGoogle ScholarPubMed
Macdonald, HM, New, SA, Golden, MH, Campbell, MK & Reid, DM (2004) Nutritional associations with bone loss during the menopausal transition: evidence of a beneficial effect of calcium, alcohol, and fruit and vegetable nutrients and of a detrimental effect of fatty acids. Am J Clin Nutr 79, 155–165.CrossRefGoogle ScholarPubMed
Macdonald, HM, New, SA & Reid, DM (2005 b) Longitudinal changes in dietary intake in Scottish women around the menopause: changes in dietary pattern result in minor changes in nutrient intake. Public Health Nutr 8, 409–416.CrossRefGoogle ScholarPubMed
McGartland, CP, Robson, PJ, Murray, LJ, Cran, GW, Savage, MJ, Watkins, DC, Rooney, MM & Boreham, CA (2004) Fruit and vegetable consumption and bone mineral density: the Northern Ireland Young Hearts Project. Am J Clin Nutr 80, 1019–1023.CrossRefGoogle ScholarPubMed
Morton, D, Barrett-Connor, E & Schneider, D (2001) Vitamin C supplement use and bone mineral density in postmenopausal women. J Bone Miner Res 16, 135–140.CrossRefGoogle ScholarPubMed
New, SA & Bonjour, JP (2003) Nutritional Aspects of Bone Health. Cambridge: The Royal Society of Chemistry.Google Scholar
New, SA, Robins, SP, Campbell, MK, Martin, JC, Garton, MJ, Bolton-Smith, C, Grubb, DA, Lee, SJ & Reid, DM (2000) Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable consumption and bone health? Am J Clin Nutr 71, 142–151.CrossRefGoogle Scholar
Sebastian, A (2005) Dietary protein content and the diet's net acid load: opposing effects on bone health. Am J Clin Nutr 82, 921–922.CrossRefGoogle ScholarPubMed
Shearer, MJ (1997) The roles of vitamins D and K in bone health and osteoporosis prevention. Proc Nutr Soc 56, 915–937.CrossRefGoogle Scholar
Terry, P, Terry, JB & Wolk, A (2001) Fruit and vegetable consumption in the prevention of cancer: an update. J Intern Med 250, 280–290.CrossRefGoogle ScholarPubMed
Tucker, KL, Chen, H, Hannan, MT, Cupples, LA, Wilson, PW, Felson, D & Kiel, DP (2002) Bone mineral density and dietary patterns in older adults: the Framingham Osteoporosis Study. Am J Clin Nutr 76, 245–252.CrossRefGoogle ScholarPubMed
Tucker, KL, Hannan, MT, Chen, H, Cupples, LA, Wilson, PW & Kiel, DP (1999) Potassium, magnesium, and fruit and vegetable intakes are associated with greater bone mineral density in elderly men and women. Am J Clin Nutr 69, 727–736.CrossRefGoogle ScholarPubMed
Tucker, KL, Hannan, MT & Kiel, DP (2001) The acid-base hypothesis: diet and bone in the Framingham Osteoporosis Study. Eur J Nutr 40, 231–237.CrossRefGoogle ScholarPubMed
Tylavsky, FA, Holliday, K, Danish, R, Womack, C, Norwood, J & Carbone, L (2004) Fruit and vegetable intakes are an independent predictor of bone size in early pubertal children. Am J Clin Nutr 79, 311–317.CrossRefGoogle ScholarPubMed
US Department of Health, Education and Welfare & Food & Agriculture Organization of the United Nations (1972) Food Composition Table for Use in East Asia. Bethesda, MD: National Institutes of Health.Google Scholar
Vatanparast, H, Baxter-Jones, A, Faulkner, RA, Bailey, DA & Whiting, SJ (2005) Positive effects of vegetable and fruit consumption and calcium intake on bone mineral accrual in boys during growth from childhood to adolescence: the University of Saskatchewan Pediatric Bone Mineral Accrual Study. Am J Clin Nutr 82, 700–706.CrossRefGoogle Scholar
Wang, G (1991) Food Composition Tables ( in Chinese ) Beijing People's Medical Publishing HouseGoogle Scholar
Wattanapenpaiboon, N, Lukito, W, Wahlqvist, M & Strauss, B (2003) Dietary carotenoid intake as a predictor of bone mineral density. Asia Pac J Clin Nutr 12, 467–473.Google ScholarPubMed
Weaver, CM, Heaney, RP, Nickel, KP & Packard, PI (1997) Calcium bioavailability from high oxalate vegetables: Chinese vegetables, sweet potatoes and rhubarb. J Food Sci 62, 524–525.CrossRefGoogle Scholar