Abstract
Increased consumption of vegetables/herbs/fruit may reduce bone turnover and urinary calcium loss in post-menopausal women because of increased intake of polyphenols and potassium, but comparative human studies are lacking. The main aim was to compare bone turnover markers and urinary calcium excretion in two randomised groups (n = 50) of healthy post-menopausal women consuming ≥9 servings of different vegetables/herbs/fruit combinations (three months). Group A emphasised a generic range of vegetables/herbs/fruit, whereas Group B emphasised specific vegetables/herbs/fruit with bone resorption-inhibiting properties (Scarborough Fair Diet), with both diets controlled for potential renal acid load (PRAL). Group C consumed their usual diet. Plasma bone markers, urinary electrolytes (24 h) and estimated dietary PRAL were assessed at baseline and 12 weeks. Procollagen type I N propeptide (PINP) decreased (−3.2 μg/L, p < 0.01) in the B group only, as did C-terminal telopeptide of type I collagen (CTX) (−0.065 μg/L, p < 0.01) in women with osteopenia compared to those with normal bone mineral density (BMD) within this group. Intervention Groups A and B had decreased PRAL, increased urine pH and significantly decreased urinary calcium loss. Urinary potassium increased in all groups, reflecting a dietary change. In conclusion, Group B demonstrated positive changes in both turnover markers and calcium conservation.
Highlights
Loss of bone mass leading to bone fragility, disability and fracture risk in the elderly is a public health issue due to increased life expectancy paralleling rapid ageing of the world’s population [1,2,3]
Bi-weekly diaries kept by intervention group participants (A and B) indicate compliance with dietary counselling to increase the consumption of vegetables/herbs/fruit, and this was confirmed with increases in urinary potassium excretion
The main finding of our study was a decrease in bone turnover markers in Group B osteopenic women consuming the Scarborough Fair dietary mix of vegetables/herbs and fruit
Summary
Loss of bone mass leading to bone fragility, disability and fracture risk in the elderly is a public health issue due to increased life expectancy paralleling rapid ageing of the world’s population [1,2,3]. Maintenance of bone health with ageing is attributed to genetics, sun exposure (maintaining vitamin D levels), exercise and diet. Diets rich in vegetables and fruit [4] are important for bone health through provision of nutrients: potassium [5], phytochemicals, such as polyphenols [6] and fibre [7], and decreased sodium intake [8]. Increased consumption of vegetables and fruit provides a favourable ratio of sodium/potassium and reduces dietary acidity [9], which alleviates associated hypercalciuria [10]. Increased phytochemical intake may suppress the pro-inflammatory milieu and bone loss associated with ageing [11]. The significant association between better bone health and higher consumption of fruit and vegetables was noted in the literature over forty years ago. Researchers suggested a means of decreasing the attrition rate of bone was to “emphasise fruit and vegetables, vegetable protein and moderate amounts of milk”
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