Nutrient-rich Diet Research Articles

Diet and physical activity as possible mediators of the association between educational attainment and body mass index gain among Australian adults.

To quantify the mediating role of leisure time physical activity (LTPA) and five dietary behaviours on educational differences in 13-year body mass index (BMI) gain across adulthood. Participants from the Melbourne Collaborative Cohort Study (4791 women; 3103 men) who maintained or gained BMI over 1990-1994 to 2003-2007 and met our inclusion criteria were selected. Education, potential mediators and confounders (age, alcohol, and smoking) were measured at baseline. We conducted sex-specific multiple mediation analyses using MacKinnon's product of coefficients method. A higher educational attainment was associated with a 0.27kgm-2 (95% CI 0.14, 0.39) lesser 13-year BMI gain among women only. We observed significant indirect effects of educational attainment on 13-year BMI gain through LTPA and nutrient-rich foods (each associated with a higher educational attainment and lesser 13-year BMI gain) and diet soft drink (associated with a lower educational attainment and greater 13-year BMI gain), which mediated 10, 15 and 20% of this relationship, respectively (45% in total). Nutrient-rich foods, LTPA and diet soft drink may represent effective public health targets to reduce inequities in excess weight across adulthood.

Physical activity, diet and other behavioural interventions for improving cognition and school achievement in children and adolescents with obesity or overweight.

Physical activity, diet and other behavioural interventions for improving cognition and school achievement in children and adolescents with obesity or overweight.

Physical activity, diet and other behavioural interventions for improving cognition and school achievement in children and adolescents with obesity or overweight.

Physical activity, diet and other behavioural interventions for improving cognition and school achievement in children and adolescents with obesity or overweight.

The Association Between Index of Nutritional Quality (INQ) and Gastric Cancer and Evaluation of Nutrient Intakes of Gastric Cancer Patients: A Case-Control Study

Background: Gastric cancer (GC) is the fourth major malignancy and the second leading cause of cancer-related deaths worldwide. Northern and northwestern areas of Iran are among the high risk areas for GC. Studies have shown that dietary components are implicated in the etiology of GC. The index of nutritional quality (INQ) is a method of quantitative and qualitative analysis of single foods, meals, and diets. We aimed to assess the association of INQ with GC, and to evaluate the nutrient intake of GC patients. Methods: The present case-control study included 82 cases and 95 healthy controls attending specialized centers in Tabriz, Iran, from December 2014 to May 2016. INQ scores were computed based on dietary intake assessed using a validated 168-item food frequency questionnaire (FFQ). Logistic regression models were used to estimate multivariable ORs adjusted age, gender, Body Mass Index (BMI), smoking, residency, education, and regular physical activity. Results: After controlling for several covariates, inverse associations were observed between GC risk and INQs of vitamins A, B6, and D (ORvitA = 0.25 (0.06 - 0.98); ORvitB6 = 0.10 (0.04 - 0.28); and ORvitD = 0.14 (0.02 - 0.84)). Cases had higher intake of total fat, saturated fatty acids, beef, lamb meat, salt, and paprika compared to controls. On the other hand, controls had higher intake of vitamin A, vitamin, vitamin B6, copper, poultry, low fat milk, tea, coffee, turmeric, and saffron compared to cases. Conclusions: Subjects who follow a more healthy and nutrient-rich diet, especially in terms of vitamins A, B6, and D, are at lower risk of having GC, compared to those who consume a more unhealthy, nutrient-poor diet.

Nutrient density: addressing the challenge of obesity.

Obesity rates are increasing worldwide. Potential reasons include excessive consumption of sugary beverages and energy-dense foods instead of more nutrient-rich options. On a per kJ basis, energy-dense grains, added sugars and fats cost less, whereas lean meats, seafood, leafy greens and whole fruit generally cost more. Given that consumer food choices are often driven by price, the observed social inequities in diet quality and health can be explained, in part, by nutrition economics. Achieving a nutrient-rich diet at an affordable cost has become progressively more difficult within the constraints of global food supply. However, given the necessary metrics and educational tools, it may be possible to eat better for less. New metrics of nutrient density help consumers identify foods, processed and unprocessed, that are nutrient-rich, affordable and appealing. Affordability metrics, created by adding food prices to food composition data, permit calculations of both kJ and nutrients per penny, allowing for new studies on the economic drivers of food choice. Merging dietary intake data with local or national food prices permits the estimation of individual-level diet costs. New metrics of nutrient balance can help identify those food patterns that provide optimal nutritional value. Behavioural factors, including cooking at home, have been associated with nutrition resilience, defined as healthier diets at lower cost. Studies of the energy and nutrient costs of the global food supply and diverse food patterns will permit a better understanding of the socioeconomic determinants of health. Dietary advice ought to be accompanied by economic feasibility studies.

Food components and ocular pathophysiology: a critical appraisal of the role of oxidative mechanisms.

Three of the major ocular diseases, namely cataracts, age-related macular degeneration and glaucoma are associated with oxidative damage. Disease risk and progression may be reduced through consumption of dietary components. To critically examine the literature on dietary and supplemental intakes of fruit and vegetables, meat, antioxidants (vitamins C, E and A), calcium, folate, iron, and their association with ocular disease. Google Scholar and key references from texts and publications were searched using search terms (eye disease, antioxidants), (vision, nutrition), no date restriction, only articles in English were included. We found probable evidence that dietary intake of fruits and vegetables, and vitamin C lowered incidence of cataracts and age-related macular degeneration. In high supplemental doses, vitamin C increases macular degeneration risk. Vitamin A from food was protective for cataracts and glaucoma, but not in supplemental form. Vitamin A was associated with lower incidence of macular degeneration. We also found probable evidence that higher intakes of meat increased the risk of cataracts and macular degeneration. Dietary calcium and iron appeared protective against glaucoma, but not in supplemental form. While a nutrient rich diet high in fruit and vegetables, and associated antioxidants appeared to be protective, we would caution intake of supplementary antioxidants for those with ocular disease.

Contrasting diets reveal metabolic plasticity in the tree-killing beetle, Anoplophora glabripennis (Cerambycidae: Lamiinae).

Wood-feeding insects encounter challenging diets containing low protein quantities, recalcitrant carbohydrate sources, and plant defensive compounds. The Asian longhorned beetle (Anoplophora glabripennis) is a wood-feeding insect that attacks and kills a diversity of hardwood tree species. We compared gene expression of midguts collected from larvae feeding in a preferred tree, sugar maple, to those consuming a nutrient-rich artificial diet, to identify genes putatively involved in host plant utilization. Anoplophora glabripennis larvae exhibited differential expression of ~3600 genes in response to different diets. Genes with predicted capacity for plant and microbial carbohydrate usage, detoxification, nutrient recycling, and immune-related genes relevant for facilitating interactions with microbial symbionts were upregulated in wood-feeding larvae compared to larvae feeding in artificial diet. Upregulation of genes involved in protein degradation and synthesis was also observed, suggesting that proteins incur more rapid turnover in insects consuming wood. Additionally, wood-feeding individuals exhibited elevated expression of several mitochondrial cytochrome C oxidase genes, suggesting increased aerobic respiration compared to diet-fed larvae. These results indicate that A. glabripennis modulates digestive and basal gene expression when larvae are feeding in a nutrient-poor, yet suitable host plant compared to a tractable and nutrient-rich diet that is free of plant defensive compounds.

Phenotypes optimized for early-life reproduction exhibit faster somatic deterioration with age, revealing a latent cost of high condition.

High condition enables individuals to express a phenotype with greater reproductive potential. However, life-history theory predicts that reproduction will trade off with somatic maintenance and viability, and several studies have reported faster age-related decline in performance in high-condition individuals, suggesting that high condition in early life is associated with accelerated somatic deterioration. This trade-off may be especially pronounced in males, which often express condition-dependent secondary sexual traits that can impose viability costs during development and through damage-inflicting adult sexual behaviours. To test this prediction, we reared larvae of the neriid fly Telostylinus angusticollis on diets of varying nutrient content and quantified somatic deterioration in solitary males, males housed in all-male or mixed-sex groups and immobilized males subjected to mechanical stress. We found that males reared on a nutrient-rich larval diet (high-condition males) suffered a higher rate of somatic deterioration with age, particularly when housed in groups. Perhaps as a result of accelerated somatic deterioration, high-condition males did not outlive low-condition males. In addition, high-condition males housed in all-male groups experienced a greater reduction in escape response with age than males housed in mixed-sex groups, suggesting that male-male combat promotes somatic deterioration. However, even when immobilized, high-condition males were still found to be more susceptible to somatic damage than low-condition males. Our findings suggest that a high-condition male phenotype is more prone to somatic damage, both as a result of associated behaviours such as combat, and because of the inherent fragility of the high-condition body.

IMPACT OF NUTRITION DURING PREGNANCY UPON HEALTH OF PREGNANT WOMEN

Pregnancy is a period of considerable physiological and nutritional stress, during which the maternal requirements of almost all the nutrients are greatly increased. Pregnant women are considered as a vulnerable group because of increased physiological demands. Diet during pregnancy is one of the most important factors in achieving a successful outcome of pregnancy in terms of healthy baby and maintenance of her own health, as the overall development of child is determined to a great extent by the type of nourishment it receives right from the conception. By keeping in mind about the importance of nutritional diet the study was conducted with following objectives i.e. to study the knowledge about diet amongst pregnant women as well as diet taken by pregnant women (24 hour dietary recall) health problems among pregnant women as well as comparison between RDA and actual intake of nutrients. Results showed that near about 50% respondents has no idea about which nutrient rich diet should be taken during pregnancy. On the basis of 24 hour dietary recall it was found that more than 60%respondents do not gave importance to the inclusion of pulses, cereal, green leafy vegetables, fruits and milk in their diet. Besides this it was also found that 63.33 %respondents were having low hemoglobin level. There were 63.33% women having low blood pressure and 16.66% were having high blood pressure. In case of blood sugar level it was found that 60% were having low sugar level and 26.66 % were having high level.

Current Concepts of Maternal Nutrition.

BackgroundA nutrient-rich maternal diet before and during pregnancy is associated with improved fetal health, more appropriate birth weight, and increased rates of maternal and infant survival. Physicians need a better understanding of the role of diet in shaping fetal outcomes. Given this background, we reviewed and summarized articles on maternal nutrition found in MEDLINE since 1981, written in English, and limited to human subjects.For the OffspringMaternal diets high in sugar and fat lead to an increased incidence of metabolic syndrome, diabetes, and cardiovascular disease later in life. Folic acid should be supplemented prior to conception and continued through at least the first 28 days of fetal life to prevent neural tube defects, and vitamin C should be given to women who smoke to lower the incidence of asthma and wheezing in the children. Iodine deficiency is increasing, and iodine should be included in prenatal supplements. If the maternal hemoglobin is 7 g/dL or more, there is no evidence that iron supplementation is needed. Fish intake during pregnancy is protective against atopic outcomes, whereas high-meat diets contribute to elevated adult blood pressure and hypersecretion of cortisol.For the MotherCalcium supplementation lowers the risk of preeclampsia and hypertensive disease in pregnancy.ConclusionsGiven the limits of our current knowledge, a diet rich in whole grains, fruits, vegetables, and selected fish is desirable for the best outcomes. Diets high in sugar and fat lead to higher rates of diabetes, metabolic syndrome, and cardiovascular disease. Folic acid, iodine, and calcium in all pregnant women and vitamin C in smokers are the only supplements so far shown to be of value for routine use. The physician treating a pregnant woman should be ready to advise a healthy diet for the benefit of the fetus.Target AudienceObstetricians and gynecologists, family physiciansLearning ObjectivesAfter participating in this activity, the obstetricians, gynecologists, and family physicians should be better able to discuss the role of various diets in helping with healthy fetal development; understand the role of diet prior to conception and throughout the pregnancy; and develop knowledge of the role of the maternal diet in affecting the risk for development of diabetes, cardiac disease, cancer, and allergic disease in the offspring.

Impact of pollen resources drift on common bumblebees in NW Europe.

Several bee species are experiencing significant population declines. As bees exclusively rely on pollen for development and survival, such declines could be partly related to changes in their host plant abundance and quality. Here, we investigate whether generalist bumblebee species, with stable population trends over the past years, adapted their diets in response to changes in the distribution and chemical quality of their pollen resources. We selected five common species of bumblebee in NW Europe for which we had a precise description of their pollen diet through two time periods ('prior to 1950' and '2004-2005').For each species, we assessed whether the shift in their pollen diet was related with the changes in the suitable area of their pollen resources. Concurrently, we evaluated whether the chemical composition of pollen resources changed over time and experimentally tested the impact of new major pollen species on the development of B. terrestris microcolonies. Only one species (i.e. B. lapidarius) significantly included more pollen from resources whose suitable area expanded. This opportunist pattern could partly explain the expansion of B. lapidarius in Europe. Regarding the temporal variation in the chemical composition of the pollen diet, total and essential amino acid contents did not differ significantly between the two time periods while we found significant differences among plant species. This result is driven by the great diversity of resources used by bumblebee species in both periods. Our bioassay revealed that the shift to new major pollen resources allowed microcolonies to develop, bringing new evidence on the opportunist feature of bumblebee in their diets. Overall, this study shows that the response to pollen resource drift varies among closely related pollinators, and a species-rich plant community ensures generalist species to select a nutrient-rich pollen diet.

Experimental Evolution on a Wild Mammal Species Results in Modifications of Gut Microbial Communities.

Comparative studies have shown that diet, life history, and phylogeny interact to determine microbial community structure across mammalian hosts. However, these studies are often confounded by numerous factors. Selection experiments offer unique opportunities to validate conclusions and test hypotheses generated by comparative studies. We used a replicated, 15-generation selection experiment on bank voles (Myodes glareolus) that have been selected for high swim-induced aerobic metabolism, predatory behavior toward crickets, and the ability to maintain body mass on a high-fiber, herbivorous diet. We predicted that selection on host performance, mimicking adaptive radiation, would result in distinct microbial signatures. We collected foregut and cecum samples from animals that were all fed the same nutrient-rich diet and had not been subjected to any performance tests. We conducted microbial inventories of gut contents by sequencing the V4 region of the 16S rRNA gene. We found no differences in cecal microbial community structure or diversity between control lines and the aerobic or predatory lines. However, the cecal chambers of voles selected for herbivorous capability harbored distinct microbial communities that exhibited higher diversity than control lines. The foregut communities of herbivorous-selected voles were also distinct from control lines. Overall, this experiment suggests that differences in microbial communities across herbivorous mammals may be evolved, and not solely driven by current diet or other transient factors.

The Importance of Diet and Gut Health to the Treatment and Prevention of Mental Disorders.

The departure from traditional lifestyles and the rising disease burden of mental disorders are increasing global health concerns. Changes in diet around the world mean that populations are now increasingly reliant on highly processed, poor quality foods, which have been linked to increased risk for mental disorder. Conversely, a nutrient-rich diet is understood to be protective of mental health, and researchers are now aiming to understand the biological underpinnings of this relationship. The gut microbiota has been proposed as a key mediator of this link, given its association with both diet and mental health. Importantly, several critical "windows of opportunity" for prevention and intervention have been identified, particularly early life and adolescence; these are periods of rapid development and transition that provide a foundation for future health. Strategies that promote overall diet quality, high in fiber and nutrients, have been linked to increased microbial diversity and gut health. Improving diet quality and subsequent gut health may have benefits for individuals' mental health, as well as the mental health of future generations. Here we discuss specific, targeted dietary and gut focused strategies for the prevention and treatment of mental disorder.

Moderate stoichiometric homeostasis in the sea urchin Lytechinus variegatus: effects of diet and growth on C:N:P ratios

The influence of dietary elemental contents on consumer stoichiometry was investigated in selected and combined soft tissues (as a proxy of the whole individual) of the omnivorous sea urchin, Lytechinus variegatus. We raised urchins for 4 months in controlled seawater tanks using three different diets with different nutritional contents (from lower to higher: seagrass, red macroalgae, and a formulated diet). Individuals fed the different diets varied an average of 19.7, 19.4, and 38 % in C:N, C:P, and N:P ratios, respectively, with stronger temporal variability for C:P and N:P ratios across tissues and whole individuals. This resulted in homeostasis parameters (1/H) of −0.45, 0.09, and 0.38, respectively, for C:N, C:P, and N:P, indicative of homeostatic to weakly homeostatic organisms, at least for C:P and N:P ratios. Individuals fed the nutrient-rich formulated diet had higher growth rates (14 ± 0.83 g WW month−1) than those fed macroalgae or seagrass (9.3 ± 0.57 and 3.4 ± 0.33 g WW month−1, respectively). However, rapid body increments in more nutritional diets caused both a decrease in the %N and an increase in the %P of soft tissues, which resulted in significant but opposite effects of diet stoichiometry and growth in sea urchin C:N (R = −0.74 and R = 0.93, for diet and growth effects, respectively) and N:P ratios (R = 0.60 and R = −0.63, also, respectively, for diet and growth effects). Among potential compensatory mechanisms helping to preserve certain levels of homeostasis, ingestion rates (g WW diet per g WW of urchin) were higher for seagrass and macroalgae diets than for the nutrient-rich formulated diet. In contrast, absorption and growth efficiencies displayed significant negative associations with nutrient contents in diets and did not exhibit nutritional compensation. Overall, our results suggest that resource stoichiometry strongly determines the growth rate of individuals (R = 0.88, P < 0.01), and moderate variability in C:N:P ratios of sea urchins possibly arise from differences in the allocation of proteins and RNA to body components, similarly to what has been proposed by the growth rate hypothesis.

Anti-oxidative nutrient rich diet protects against acute ischemic brain damage in rats

We evaluated the neuroprotective effects of an anti-oxidative nutrient rich enteral diet (AO diet) that contained rich polyphenols (catechins and proanthocyanidins) and many other anti-oxidative ingredients. Wistar rats were treated with either vehicle, normal AO diet (containing 100kcal/100mL, catechin 38.75mg/100mL and proanthocyanidin 19mg/100mL, 1mL/day), or high AO diet (containing 10 times the polyphenols of the normal AO diet) for 14 days, and were subjected to 90min of transient middle cerebral artery occlusion. The AO diet improved motor function, reduced cerebral infarction volume, and decreased both peroxidative markers such as 4-hydroxynonenal, advanced glycation end products, 8-hydroxy-2-deoxyguanosine and inflammatory markers such as monocyte chemotactic protein-1, ionized calcium-binding adapter molecule-1, and tumor necrosis factor-α. Our study has shown that an AO diet has neuroprotective effects through both anti-oxidative and anti-inflammatory mechanisms, indicating that nutritional control with polyphenols could be useful for patients with acute ischemic stroke.

The Immunomodulating Effect of a Diet Consisting of Green Vegetables, Beef, Whole Milk and Full-Fat Butter for Children with Non-Specific Elevated IgE.

Non-specific elevated IgE and allergies are common in children, and their prevalence is increasing. Dietary changes could be an explanation for this increase. Zinc, iron, vitamins A, C and E, and polyunsaturated fatty acids all play possible roles in the etiology and possible treatment of allergies due to their numerous immunomodulating properties. To investigate the immunomodulating effect of recommending a nutrient-rich diet consisting of green vegetables, beef, whole milk and full-fat butter. We conducted a case-controlled, non-randomized, retrospective study. Children between the ages of 1 and 18 years with non-specific elevated IgE were included. Baseline and follow-up measurements of serum total IgE and clinical outcomes were retrospectively collected and compared for 49 children who received the dietary advice (to eat green vegetables, beef, whole milk and full-fat butter) and 56 children who did not. The initial analysis showed a significantly greater decrease in IgE in the intervention group compared to the control group; a 9.2 kU/l versus a 0.1 kU/l decrease, respectively (P = 0.02). When supplement (vitamin D) use was taken into account, however, no significant difference was produced by the dietary effect alone (unstandardized coefficient = 71.3 kU/l, P = 0.16). 53.2 % of participants in the intervention group reported considerable improvement in symptoms versus 28.6 % in the control group (P < 0.001). Overall, the effects of nutrients and vitamins on the decrease in IgE are promising. The separate contributions of dietary advice and/or supplements need to be investigated in the future.

Diet quality among women participating in the Pregnancy, Exercise, and Nutrition Feasibility Study (1021.8)

Background: A nutrient‐rich diet during pregnancy is critical to optimize gestation and birth outcomes. The PEN program, a team‐based, peer‐led, 20‐session curriculum was used to promote healthy dietary choices and activity during pregnancy to reduce gestational diabetes risk.Methods: The Healthy Eating Index (HEI) and the Diet Quality Index for Pregnancy (DQI‐P) were used to assess diet quality of 14 control (CG) and 12 intervention (IG) participants based on food intake measured by the Automated Self‐Administered‐24 Hour Dietary Recall. Mean changes in HEI and DQI‐P scores from baseline (BL) to the 2nd and 3rd trimesters (T) were calculated and differences within and between groups were determined using t‐tests.Results: Although no significant differences or changes in mean total HEI or DQI‐P scores were observed between groups at BL, T2, or T3, added sugar consumption was 47.9% lower in the IG (8.7 ± 8.2 tsp‐equivalent) than the CG (16.7 ± 10.6 tsp‐equivalent) at T3 (P=0.045). Mean DQI‐P fruit score, was higher in the IG, but not significantly, at T2 (6.1 ± 3.7, P=0.16) and T3 (6.3 ± 3.0, P=0.08) than BL (4.9 ± 3.3).Conclusions: These preliminary analyses provide information on variation and effect size of diet quality indices to support a large‐scale, adequately powered, hypothesis‐driven effectiveness trial of the PEN program. Diet Quality Indices BL BL ‐ T2 Change BL ‐ T3 Change HEI(max 100) CG 64 ± 16 ‐0.7 ± 26 ‐0.5 ± 18 IG 60 ± 11 4.3 ± 18 0.8 ± 9 DQI‐P(max 80) CG 56 ± 10 1.0 ± 13 ‐1.7 ± 13 IG 52 ± 7 6.9 ± 9 4.1 ± 12 Mean ± SD

How Firebrats (Thysanura: Lepismatidae) Detect and Nutritionally Benefit From Their Microbial SymbiontsEnterobacter cloacaeandMycotypha microspora

The phylogenetically ancient firebrats, Thermobia domestica (Packard) (Thysanura: Lepismatidae), lack any form of long-distance communication, yet are able to locate mates in sustained hot and humid microhabitats, typically within human habitations where they feed on dried goods, including cellulosic substrates. We have recently shown that firebrats aggregate in response to two symbiotic microorganisms in their feces, the bacterium Enterobacter cloacae and the fungus Mycotypha microspora. Our objectives were to determine how firebrats detect M. microspora and E. cloacae, and whether these microbial symbionts nutritionally benefit firebrats. Applied to a glass surface in bioassays, E. cloacae as well as the isolated exopolysaccharide of E. cloacae induced arrestment of firebrats, whereas M. microspora induced arrestment only in the presence of cellulosic substrate. When M. microspora and E. cloacae were grown aerobically on cellulose agar, only M. microspora yielded zones of clearing indicative of enzymatic cellulose degradation. Firebrats also arrested in response to d-glucose, which is a constituent of the exopolysaccharide and which is produced by the cellulase of M. microspora during cellulose degradation. First- to third-instar nymphs of firebrats that were fed E. cloacae, M. microspora, or a nutrient-rich diet developed equally well. By consuming E. cloacae and M. microspora, and by spreading them through feces, firebrats appear able to occupy nutrient-poor habitats that otherwise would not support development of their offspring.

Paternal Effects on Offspring Fitness Reflect Father’s Social Environment

In many species, males influence phenotypic traits in their offspring through non-genetic paternal effects. Such effects can represent a form of paternal investment, and males may benefit by adjusting the effects depending on environmental parameters, such as operational sex ratio, so as to maximize offspring fitness. In the neriid fly Telostylinus angusticollis, fathers reared on a nutrient-rich larval diet produce larger offspring, independent of the rearing environment of the offspring. Here we asked whether this paternal effect was influenced by the social environment to which fathers were exposed. We found significant interactions of the effects of paternal larval diet quality and social environment (same-sex vs. mixed-sex groups) on offspring fitness-related traits. Fathers reared on a nutrient-rich diet produced larger male offspring when housed in mixed-sex groups. However, fathers reared on a nutrient-rich diet produced more viable offspring (or more viable sperm) when housed in same-sex groups prior to mating. These results suggest that fitness-enhancing paternal effects can trade off, consistent with parental investment theory on the offspring size-number trade-off, which suggests that these traits represent alternative investment options and parents are selected to optimize the balance based on a range of environmental variables. This is the first study to show that males can facultatively modulate paternal effects based on the social environment.

Skeletal effects of nutrients and nutraceuticals, beyond calcium and vitamin D

There is a need to understand the role of nutrition, beyond calcium and vitamin D, in the treatment and prevention of osteoporosis in adults. Results regarding soy compounds on bone density and bone turnover are inconclusive perhaps due to differences in dose and composition or in study population characteristics. The skeletal benefit of black cohosh and red clover are unknown. Dehydroepiandrosterone (DHEA) use may benefit elderly individuals with low serum dehydroepiandrosterone-sulfate levels, but even in this group, there are inconsistent benefits to bone density (BMD). Higher fruit and vegetable intakes may relate to higher BMD. The skeletal benefit of flavonoids, carotenoids, omega-3-fatty acids, and vitamins A, C, E and K are limited to observational data or a few clinical trials, in some cases investigating pharmacologic doses. Given limited data, it would be better to get these nutrients from fruits and vegetables. Potassium bicarbonate may improve calcium homeostasis but with little impact on bone loss. High homocysteine may relate to fracture risk, but the skeletal benefit of each B vitamin is unclear. Magnesium supplementation is likely only required in persons with low magnesium levels. Data are very limited for the role of nutritional levels of boron, strontium, silicon and phosphorus in bone health. A nutrient rich diet with adequate fruits and vegetables will generally meet skeletal needs in healthy individuals. For most healthy adults, supplementation with nutrients other than calcium and vitamin D may not be required, except in those with chronic disease and the frail elderly.