Copper Intake Research Articles

Dietary Trace Element Intake and Risk of Breast Cancer: A Mini Review.

Trace elements are essentially required for various physiological and metabolic functions, and any disturbance in the trace elements homeostasis may result in the development of chronic diseases including breast cancer. Breast cancer is the most prevalent cancer type reported in women equally affecting both the high-income and low-income countries. This review therefore aimed to evaluate the impact of dietary trace element intake in relation to the incidence of breast cancer. We focused on five trace elements, thus emphasizing dietary selenium, zinc, iron, copper, and cadmium intake and risk of breast cancer. A systematic approach was applied to perform this review through entering a search term in PubMed and Scopus databases. A total of 24 articles were included after meeting the inclusion and exclusion criteria. Most of the studies regarding dietary iron intake showed a detrimental effect of increased dietary heme iron on breast cancer incidence risk. In addition, there is a limited evidence of high dietary intake of selenium and zinc to reduce the risk of breast cancer. Also, a few studies showed a relationship between high cadmium consumption and risk of breast cancer. More studies related to cadmium and copper exposure are needed to confirm this relationship. As a result, the findings of this review suggested that high dietary heme iron is a potential risk factor for breast cancer.

Intake of divalent copper and nickel onto natural zeolite from aqueous solutions: a study in mono- and dicomponent systems.

In this study, the noncompetitive and competitive adsorption process of copper (II) and nickel (II) ions on the natural zeolite were examined in simulated wastewater in a batch system with respect to concentration, pH and temperature. Optimum pH values were found as 5,0 for adsorption of copper and nickel ions on the zeolite. The effect of initial concentration and ambient temperature on the yield of adsorption was examined at this pH value. The equilibrium adsorption data of Cu (II) and Ni (II) onto the zeolite were analyzed by the Langmuir's and Freundlich's isotherms, and the experimental metal uptake data fitted well with both isotherm models. In case of the presence of simultaneous multimetal ions in the aqueous phase, the adsorption capacity of the adsorbent is slightly low probably due to the competitive uptake of each metal ion by the adsorbent. For the metal sorption system, the negative Gibbs free energy values show the applicability and spontaneous nature of the metal uptake treatment by the zeolite. The activation energy and enthalpy change of divalent cation adsorption demonstrate that the intake of Cu (II) and Ni (II) onto the zeolite involves not only a chemical adsorption process but also a physical adsorption process.

Copper nutriture and ischemic heart disease: a brief review

The idea that dietary fat is poisonous arose nearly ¾ of a century ago. Criteria for associating disease incidence with environmental change were published a couple decades later. Intakes of dietary fat did not increase while ischemic heart disease risk was increasing; in contrast, dietary copper decreased. Intakes of copper calculated from food tables are falsely high by an average of 77%. Approximately half of adults consume less than 0.9 mg of copper per day when chemical analyses are done. This amount is less than nutritional guidelines. When hypercholesterolemia was discovered in copper deficient rats, a search was begun for anatomical, chemical and physiological similarities between animals deficient in copper and people with ischemic heart disease; more than 80 of these similarities have been identified. The copper deficiency theory on the etiology and pathophysiology of ischemic heart disease is the simplest and most general theory that has been proposed because it incorporates other theories on fetal programming, homocysteine and iron overload. It satisfies classical criteria of nutritional deficiency and association of an environmental characteristic with disease prevalence.

Dietary Copper Intake and the Prevalence of Kidney Stones Among Adult in the United States

Dietary Copper Intake and the Prevalence of Kidney Stones Among Adult in the United States

U-shaped association between dietary copper intake and new-onset hypertension

To investigate the relationship of dietary copper intake with new-onset hypertension among Chinese adults. A total of 12,245 participants who were free of hypertension at baseline from the China Health and Nutrition Survey (CHNS) were included. Dietary intake was measured by 3 consecutive 24-hdietary recalls combined with a household food inventory. New-onset hypertension was defined as systolic blood pressure ≥140mmHg and/or diastolic blood pressure ≥90mmHg or diagnosed by a physician or under antihypertensive treatment during the follow-up. During a median follow-up of 6.1 years, 4304 participants developed new-onset hypertension. Overall, the associations between dietary copper intake and new-onset hypertension followed a U-shape (P for nonlinearity <0.001). The risk of new-onset hypertension significantly decreased with the increment of dietary copper intake (per SD increment: HR, 0.71; 95% CI, 0.57-0.88) in participants with copper intake <1.57mg/day, and increased with the increment of dietary copper intake (per SD increment: HR, 1.09; 95% CI: 1.07-1.12) in participants with copper intake ≥1.57mg/day. There was a U-shaped association between dietary copper intake and new-onset hypertension in general Chinese adults, with an inflection point at about 1.57mg/day. Our results emphasized the importance of maintaining optimal copper intake levels for the primary prevention of hypertension.

Comparison of X-ray absorption spectra from copper-loaded bovine and ovine livers

BackgroundCopper toxicity and hepatic copper accumulation pose a serious risk to ruminant health and production. Differences in the copper-handling mechanisms of cattle and sheep have been noted, not only in comparison to each other, but also in comparison to ‘copper-tolerant’ monogastric species. Ruminants appear less able to cope with rising liver copper concentration than monogastric counterparts, with sheep in general less able to cope with elevated copper intake than cattle. MethodsX-ray absorption spectroscopy (XAS) was used to investigate the differences between the livers of these species at high copper status. ResultsThe X-ray absorption fine structure (XAFS) and X-ray absorption near edge structure (XANES) spectra indicated that the hepatic copper compound is most likely to be bound to metallothionein; consistent with monogastric species. ConclusionAlthough, most likely stored as copper-metallothionein, there may be a role for glutathione as a short-term, intermediate copper buffer which may have more relevance to sheep than cattle. The potential that thiomolybdate bound copper can be stored in the liver could not be ruled out.

Iron, Zinc and Copper from Cereal Food Sources and Cognitive Performance in Older Adults in China.

Background:We aimed to determine the risk factors associated with cognitive performance in older adults in China.Methods:A longitudinal study was conducted in a group of 1,898 adults aged 60 yr and over in China, Cognitive score was determined by a modified Telephone Interview for Cognitive Status (TICSM). The dietary intake of iron (Fe), zinc (Zn) and copper (Cu) from cereal source foods (CSF) were calculated by using Food Frequency Questionnaire (FFQ) and Chinese Food Composition Tables. Descriptive statistics and multivariate mixed regression models were utilized to explore the association between the intake of these elements and cognitive function.Results:The mean dietary intakes of Fe, Zn and Cu from CSF were 12.01, 6.90 and 1.30 mg/d respectively. Compared with participants in the high-cognitive group, those in the low-cognitive group had lower total dietary intakes of Fe, Zn and Cu. However, with respect to ratios of CSF-Zn, CSF-Fe and CSF-Cu to their respective total values, participants in the low-cognitive group had significantly higher ratios than those in the high-cognitive group. The results of multivariate mixed regression model revealed that although total dietary Zn intake was positively linked with cognitive function, the CSF-Zn/Zn ratio was negatively associated with cognitive performance.Conclusion:Excessive intake of Zn from a specific food source, such as CSF, was found to be negatively associated with cognitive status. Avoiding over-intake of Zn from CSF foods and diversifying intake of Zn from different food sources seemed to protect individuals from cognitive decline.

A new method for calculating copper content and determining appropriate copper levels in foods

Since the amount of food can affect the copper content, the copper content of different amounts of food (except foods without copper) is different. The copper content of some foods is inappropriately calculated per 100 kcal, 100 g or 100 mL, or the reference amount customarily consumed (RACC). Thus, making some food choices based on these calculations to achieve adequate copper intake may increase the risk of some chronic diseases. Calculating the copper content and determining appropriate copper levels (to achieve adequate copper intake) based on U.S. Food and Drug Administration (FDA), Codex Alimentarius Commission (CAC), and the proposed method were performed in 7,379 food items. Making some food choices based on the FDA and CAC per serving (the serving is derived from the RACC) or CAC per 100 g or 100 mL to achieve adequate copper intake exceeded energy needs, which could lead to overweight or obesity. Making some food choices based on the CAC per 100 kcal or CAC per 100 g or 100 mL to achieve adequate copper intake did not meet copper requirements, which could lead to copper deficiency. Some foods that met copper requirements were not appropriate food choices based on the CAC per 100 g or 100 mL or CAC per serving to achieve adequate copper intake. On the basis of the proposed method, calculating the copper content and determining appropriate copper levels in foods are performed by considering RACCs and the energy content of foods. Thus, making food choices based on the proposed method met copper requirements and did not exceed energy needs.

Chelation therapy in liver diseases of childhood: Current status and response.

Chelation is the mainstay of therapy in certain pediatric liver diseases. Copper and iron related disorders require chelation. Wilson’s disease (WD), one of the common causes of cirrhosis in children is treated primarily with copper chelating agents like D-penicillamine and trientine. D-Penicillamine though widely used due its high efficacy in hepatic WD is fraught with frequent adverse effects resulting discontinuation. Trientine, an alternative drug has comparable efficacy in hepatic WD but has lower frequency of adverse effects. The role of ammonium tetra-thiomolybdate is presently experimental in hepatic WD. Indian childhood cirrhosis is related to excessive copper ingestion, rarely seen in present era. D-Penicillamine is effective in the early part of this disease with reversal of clinical status. Iron chelators are commonly used in secondary hemochromatosis of liver in hemolytic anemias. There are strict chelation protocols during bone marrow transplant. The role of iron chelation in neonatal hemochromatosis is presently not in vogue due to its poor efficacy and availability of other modalities of therapy. Hereditary hemochromatosis is rare in children and the use of iron chelators in this condition is limited.

Daily Intake and Serum Levels of Copper, Selenium and Zinc According to Glucose Metabolism: Cross-Sectional and Comparative Study.

Trace elements play an important role in metabolism. We compared the daily intake and serum concentrations of copper (Cu), selenium (Se), and zinc (Zn) across a spectrum of glucose tolerance status in a representative U.S. population. Daily intake and serum concentrations of Cu, Zn and Se in 5087 adults from the 2011–2016 National Health and Nutrition Examination Survey (NHANES) were examined and compared to normal (NGT) and abnormal (AGT) glucose tolerance and the presence of diabetes mellitus (DM). Other than Zn deficiency (21.15%), the prevalence of Zn, Se, and Cu excess and Se and Cu deficiency were low (<4.00%). As compared to the NGT group, Cu and Se supplementation was higher in the AGT and DM groups (p < 0.0001 for all). Serum Se and Zn, but not Cu, concentrations were highly correlated with daily intake (p < 0.0001 for both). As compared to the NGT group, serum Cu concentration was highest in the AGT group (p = 0.03), serum Se concentration was highest in the DM group (p < 0.0001), and serum Zn concentration was highest in the AGT group (p < 0.0001). Serum Se and Zn concentration was correlated with daily Se and Zn intake. Even within the reference range for serum Cu, Se, and Zn concentrations, a higher serum concentration of Cu, Se, and Zn was associated with abnormal glucose metabolism. Although the casual relationship remains to be elucidated, these data suggest caution in Cu, Se and Zn supplementation in non-deficient individuals.

Health Risk Associated with Copper Intake through Vegetables in Different Countries

Sustainable development goals aim to attain food security by 2030. To attain food security, it becomes extremely important to target various aspects of food security where safety of food is a major factor. In order to meet the growing population demand, efforts are being made to increase production of food and thus the safety aspect is often ignored. Irrational anthropogenic activities have impacted and deteriorated the ambient environment. Degradation of soil and water has resulted in buildup of contaminants in these spheres and further transfer of contaminants into the food chain. Increase in heavy metals in our surroundings is reported in many parts of the world. Further, increase in concentration of metals in soil and water result in the transfer of these metals into food chain. Unlike other metals copper is although is an essential element for living organisms but excessive consumption of copper is known to cause toxic impacts to living organisms. Green leafy vegetables are considered as hyperaccumulators for copper. The excessive concentration of copper in vegetables is not limited to any one region of the world. The present review summarizes the reports of copper content in vegetables in various parts of the world and health effects associated with it.

Cake Decorating Luster Dust Associated with Toxic Metal Poisonings - Rhode Island and Missouri, 2018-2019.

During 2018-2019, the Rhode Island Department of Health (RIDOH) and the Missouri Department of Health and Senior Services (DHSS) investigated cases of metal poisonings associated with commercially and home-prepared cakes decorated with products referred to as luster dust. Several types of glitters and dusts, broadly known as luster dust,* for use on prepared foods can be purchased online and in craft and bakery supply stores (1). Decorating foods with luster dust and similar products is a current trend, popularized on television programs, instructional videos, blogs, and in magazine articles.† Some luster dusts are specifically produced with edible ingredients that can be safely consumed. Companies that make edible luster dust are required by law to include a list of ingredients on the label (2). Luster dusts that are safe for consumption are typically marked "edible" on the label. Some luster dusts used as cake decorations are not edible or food grade; labeled as "nontoxic" or "for decorative purposes only," these luster dusts are intended to be removed before consumption (3). RIDOH (2018) and Missouri DHSS (2019), investigated heavy metal poisonings associated with commercially and home-prepared cakes decorated with luster dust after receiving reports of children (aged 1-11 years) who became ill after consuming birthday cake. Cases in Rhode Island were associated with copper ingestion, and the case in Missouri was associated with a child's elevated blood lead level. In Rhode Island, luster dust products that had been used in cake frosting were found to contain high levels of multiple metals.§ These events indicate that increased vigilance by public health departments and further guidance to consumers and bakeries are needed to prevent unintentional poisonings. Labeling indicating that a product is nontoxic does not imply that the product is safe for consumption. Explicit labeling indicating that nonedible products are not safe for human consumption is needed to prevent illness from inappropriate use of inedible products on foods. Educating consumers, commercial bakers, and public health professionals about potential hazards of items used in food preparation is essential to preventing illness and unintentional poisoning from toxic metals and other nonedible ingredients.

Exposure assessment to essential elements through the consumption of canned fish in Serbia

The aim of this study was to provide a quantitative exposure assessment to essential elements through the consumption of canned fish in Serbia. This objective was fulfilled by analyzing content of essential elements in canned fish and by using data from a food consumption survey. Consumption survey of canned fish was designed and performed to general principles and EFSA guidelines on data collection of national food consumption. The questionnaire was performed on 1,000 respondents during 2018. Determination of copper, zinc and iron levels were performed on 454 canned fish and seafood samples divided into four groups (canned tuna, canned sardines, canned other sea fish and canned seafood) during five consecutive years (2014–2018). This study showed significant association between sex, BMI and weight and consumption patterns. Obtained average weekly consumption of canned fish confirms our assumption that consumption of canned fish is significant in Serbia. Zinc and iron were found in all 454 samples (100%), and copper in 222 samples (48.9%). The average obtained concentration in all samples were 1.268 mg kg–1 for Cu, 5.661 mg kg–1 for Zn and 9.556 mg kg–1 for Fe. The highest concentration for all three minerals were found in canned sardines (Cu — 6.49 mg kg–1, Zn — 37.2 mg kg–1 and Fe — 21.8 mg kg–1). Obtained mean exposure to intake of copper, zinc and iron from canned fish was 1.2241 μg/kg bw/day, 5.4634 μg/kg bw/day and 9.2231 μg/kg bw/day, respectively. Exposure of Serbian population to zinc, copper, and iron through consumption of canned fish is less than recommended daily reference intakes and there is no risk of reaching toxic levels by consuming fish.

α1-Acid Glycoprotein and Dietary Intake in End-Stage Renal Disease Patients

Management of end-stage renal disease (ESRD) patients requires monitoring each of the components of malnutrition–inflammation–atherosclerosis (MIA) syndrome. Restrictive diet can negatively affect nutritional status and inflammation. An acute-phase protein—α1-acid glycoprotein (AGP), has been associated with energy metabolism in animal and human studies. The aim of our study was to look for a relationship between serum AGP concentrations, laboratory parameters, and nutrient intake in ESRD patients. The study included 59 patients treated with maintenance hemodialysis. A 24 h recall assessed dietary intake during four non-consecutive days—two days in the post-summer period, and two post-winter. Selected laboratory tests were performed: complete blood count, serum iron, total iron biding capacity (TIBC) and unsaturated iron biding capacity (UIBC), vitamin D, AGP, C-reactive protein (CRP), albumin, prealbumin, and phosphate–calcium metabolism markers (intact parathyroid hormone, calcium, phosphate). Recorded dietary intake was highly deficient. A majority of patients did not meet recommended daily requirements for energy, protein, fiber, iron, magnesium, folate, and vitamin D. AGP correlated positively with CRP (R = 0.66), platelets (R = 0.29), and negatively with iron (R = −0.27) and TIBC (R = −0.30). AGP correlated negatively with the dietary intake of plant protein (R = −0.40), potassium (R = −0.27), copper (R = −0.30), vitamin B6 (R = −0.27), and folates (R = −0.27), p < 0.05. However, in multiple regression adjusted for confounders, only CRP was significantly associated with AGP. Our results indicate that in hemodialyzed patients, serum AGP is weakly associated with dietary intake of several nutrients, including plant protein.

Tetrahedral Framework Nucleic Acid Delivered RNA Therapeutics Significantly Attenuate Pancreatic Cancer Progression via Inhibition of CTR1-Dependent Copper Absorption.

Copper is vital for various life processes, whereas severely toxic at excess level. Intracellular copper homeostasis is strictly controlled by a set of transporters and chaperones encoded by the copper homeostasis genes. Increasing evidence has shown that copper is usually overloaded in multiple malignancies, including pancreatic cancer, which has an extremely poor prognosis. Recently, silencing the SLC31A1 gene, which encodes a major transmembrane copper transporter (CTR1), has been demonstrated to be an effective means for reducing the malignant degree of pancreatic cancer by downregulating the cellular copper levels. Herein, we utilized tetrahedral framework nucleic acids (tFNAs) as vehicles to overcome the biological barriers for delivering small molecular RNAs and efficiently transferred two kinds of CTR1 mRNA-targeted RNA therapeutics, siCTR1 or miR-124, into PANC-1 cells. Both therapeutic tFNAs, termed t-siCTR1 and t-miR-124, prevented copper intake more effective than the free RNA therapeutics via efficiently suppressing the expression of CTR1, thereby significantly attenuating the progression of PANC-1 cells. In this study, therapeutic tFNAs are constructed to target metal ion transporters for the first time, which may provide an effective strategy for future treatment of other metal metabolism disorders.

Dietary Zinc, Copper, and Selenium Intake and High-Risk Human Papillomavirus Infection among American Women: Data from NHANES 2011–2016

Studies have shown that the micronutrients, zinc (Zn), copper (Cu), and selenium (Se) are associated with the HPV-associated cervical cancer, yet between dietary Zn/Cu/Se intake and high-risk HPV (hrHPV) infection remain unclear. We obtained publicly available data in the present cross-sectional study from the National Health and Nutrition Examination Survey (NHANES) performed between 2011 and 2016. Dietary Zn, Cu, and Se intakes were assessed from two 24-h diet recalls. A total of 4628 female with the age of 18–59 years were included in this secondary analysis. Comparing the highest with the lowest quartiles of Zn intake, the adjusted odds ratio (aOR) for hrHPV infection was 0.72 (95% CI, 0.54–0.98). The aOR upon comparison of the quartile three with the lowest quartile of Cu intake was 0.67 (95% CI, 0.50–0.90). Whereas no significant association was found between intakes of Se and hrHPV infection in multivariate analysis. Moreover, compared with those below the Recommended Dietary Allowance (RDA), hrHPV infection risk was significantly decreased among women who met the RDA for Cu (aOR: 0.74; 95% CI = 0.60–0.92), but not for Zn and Se. In conclusion, high dietary Zn and moderate copper intakes were independently and negatively associated with hrHPV infection in addition to Se.

Ecological and agrochemical features of chemical agents use on soils contaminated with cadmium and copper in the link of vegetable rotation

The article presents mobility coefficients of cadmium and copper, biological absorption coefficients of toxic metals by the main products of potatoes, beetroot and beans, depending on the chemicalization agents used on black soil with a typical heavy loamy granulometric composition. The introduction of lime, the combined application of lime and manure have a positive effect on reducing the coefficient of cadmium mobility. The high content of cadmium and copper in the soil does not have a negative effect on the synthesis of basic organic substances in vegetable products (starch, sugar, protein). The accumulation of nitrates in vegetable products occurs as a result of the mineral and organic fertilizers application; heavy metals do not have a significant effect on the accumulation of nitrate nitrogen during the cultivation of vegetable crops. The coefficient of biological absorption is influenced not only by lime, manure, mineral fertilizers, but also by the physiological characteristics of the crops themselves, which need toxic elements as micro and ultramicroelements for nutrition and synthesis of organic substances. The results of studies on crops of beetroot show that the application of lime, manure and the combined application of lime and manure reduce the intake of cadmium, copper, lead and zinc in root crops and tops of beetroot. A double dose of mineral fertilizers reduces the intake of copper and lead, but insignificantly, and does not have a positive effect on reducing the accumulation of cadmium and zinc. On soils contaminated with heavy metals (Cd, Cu), according to the value of biological absorption coefficient of the studied crops, heavy metals are distributed as follows: when growing potatoes - Cd> Cu; when cultivating table beet - Cu> Cd; when growing beans - Cu> Cd.

Intake of Potatoes Is Associated with Higher Diet Quality, and Improved Nutrient Intake and Adequacy among US Adolescents: NHANES 2001-2018 Analysis.

Potatoes are nutrient rich white vegetables, however, research on their impact on public health is limited. The objective of this study was to provide updated evaluation of the cross-sectional association between potato consumption and diet quality, nutrient intake and adequacy. Twenty-four hour diet recall data from adolescents (n = 16,633; age 9–18 years) were used to assess intakes. Usual intakes of nutrients were determined using the National Cancer Institute method and diet quality was calculated using the Healthy Eating Index-2015 (HEI-2015) after adjusting for demographic factors. Consumers of potatoes (baked or boiled potatoes, mashed potatoes and potato mixtures, fried potatoes, and potato chips) had higher (p < 0.05) HEI-2015 total score and subcomponent scores for total vegetables, total protein foods, and refined grain than non-consumers. Consumers also had higher (p < 0.05) intake of energy, dietary fiber, protein, copper, magnesium, phosphorus, potassium, selenium, sodium, zinc, niacin, vitamin B6, vitamin C, vitamin K and total choline; and higher (p < 0.05) adequacy for protein, copper, magnesium, phosphorus, potassium, zinc, thiamine, niacin, vitamin B6, vitamin C, and vitamin K than non-consumers. In conclusion, adolescent potato consumption was associated with higher diet quality, nutrient intake, and adequacy and therefore encouraging their consumption may be an effective strategy for improving nutritional status.

Dietary Copper/Zinc Ratio and Type 2 Diabetes Risk in Women: The E3N Cohort Study.

The serum copper (Cu) to zinc (Zn) ratio could be an important determinant of Type 2 diabetes (T2D) risk, but prospective epidemiological data are scarce. We aimed to investigate the association between T2D incidence and the dietary Cu/Zn ratio. A total of 70,991 women from the E3N cohort study were followed for 20 years. The intakes of copper and zinc were estimated at baseline using a validated food frequency questionnaire. We identified and validated 3292 incident T2D cases. Spline analysis showed that a Cu/Zn ratio < 0.55 was associated with a lower risk of T2D. Subgroup analyses comparing women in the highest versus the lowest quintile of Cu/Zn ratio showed the same pattern of association for obese women and those with zinc intake ≥8 mg/day. However, for women with zinc intake <8 mg/day, higher Cu/Zn ratio appeared to be associated with higher T2D risk. Our findings suggest that a lower dietary Cu/Zn ratio is associated with a lower T2D risk, especially among obese women and women with zinc intake >8 mg/day. Further studies are warranted to validate our results.

Associations of Copper Intake with Bone Mineral Density and Osteoporosis in Adults: Data from the National Health and Nutrition Examination Survey.

Some studies have suggested an association between serum copper and bone density. Few studies have explored the association between copper intake and osteoporosis and bone mineral density (BMD). Our research aims to assess the associations of copper intake with the risk of osteoporosis in United States adults using the National Health and Nutritional Examination Surveys (NHANES). A total of 8224 individuals were included in our study. Osteoporosis was defined that BMD values surpass 2.5 standard deviations (SD) below the mean of the young adult reference group. Copper intake from diets and supplements was estimated by using two 24-h recall surveys. After adjustment for all the covariates of interest, the odds ratios (ORs) (95% confidence interval (CI)) between the risk of osteoporosis and total copper intake across quartiles 3 and 4 compared with quartile 1 were 0.48 (0.31-0.74) (P < 0.01) and 0.41 (0.26-0.65) (P < 0.01), respectively. The mean total femur BMD and total spine BMD of the highest dietary copper intake quartile (Cu 1.51mg/d) was 0.03g/cm2 and 0.02g/cm2 greater than the lowest quartile. Our results indicate that dietary and total copper intake was positively associated with increasing BMD in US adults and negatively associated with the risk of osteoporosis in US adults.