Skip to main content
×
×
Home

Diet, nutrition and the prevention of osteoporosis

  • A Prentice (a1)
Abstract
Objective:

To review the evidence on diet and nutrition relating to osteoporosis and provide recommendations for preventing osteoporosis, in particular, osteopototic fracture.

Approach:

Firstly, to review the definition, diagnosis and epidemiology of osteoporosis, to discuss the difficulties in using bone mineral density to define osteoporosis risk in a world-wide context and to propose that fragility fracture should be considered as the disease endpoint. Secondly, to provide an overview of the scientific data, the strengths and weaknesses of the evidence and the conceptual difficulties in interpreting studies linking diet, nutrition and osteoporosis. The following were considered: calcium, vitamin D, phosphorus, magnesium, protein and fluorine. Other potential dietary influences on bone health were also discussed, including vitamins, trace elements, electrolytes, acid–base balance, phyto-oestrogens, vegetarianism and lactose intolerance.

Conclusions:

There is insufficient knowledge linking bone mineral status, growth rates or bone turnover in children and adolescents to long-term benefits in old age for these indices to be used as markers of osteoporotic disease risk. For adults, the evidence of a link between intakes of any dietary component and fracture risk is not sufficiently secure to make firm recommendations, with the exception of calcium and vitamin D. For other aspects of the diet, accumulating evidence suggests that current healthy-eating advice to decrease sodium intake, to increase potassium intake, and to consume more fresh fruits and vegetables is unlikely to be detrimental to bone health and may be beneficial.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Diet, nutrition and the prevention of osteoporosis
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Diet, nutrition and the prevention of osteoporosis
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Diet, nutrition and the prevention of osteoporosis
      Available formats
      ×
Copyright
Corresponding author
*Corresponding author: Email ann.prentice@mrc-hnr.cam.ac.uk
References
Hide All
1Consensus Development Conference. Diagnosis, prophylaxis and treatment of osteoporosis. American Journal of Medicine 1991; 90: 107–10.
2Prentice, A. Is nutrition important in osteoporosis?. Proceedings of the Nutrition Society 1997; 56: 357–67.
3Compston, J. Osteoporosis. In: Crisp, A, ed. The Management of Common Metabolic Bone Disorders. Cambridge: Cambridge University Press. 1993; 2962.
4Johnell, O. The socioeconomic burden of fractures: today and in the 21st century. American Journal of Medicine 1997; 103: 20S–5S.
5World Health Organization. Assessment of Fracture Risk and its Application to Screening for Postmenopausal Osteoporosis. WHO Technical Report Series 843. Geneva: World Health Organization, 1994;
6Aspray, TJ, Prentice, A, Cole, TJ, Sawo, Y, Reeve, J, Francis, RM. Low bone mineral content is common but osteoporotic fractures are rare in elderly rural Gambian women. Journal of Bone and Mineral Research 1996; 11: 1018–24.
7Prentice, A, Parsons, TJ, Cole, TJ. Uncritical use of bone mineral density in absorptiometry may lead to size-related artifacts in the identification of bone mineral determinants. American Journal of Clinical Nutrition 1994; 60: 837–42.
8Russel-Aulet, M, Wang, J, Thornton, JC, Colt, EWD, Pierson, RN. Bone mineral density and mass in a cross-sectional study of White and Asian women. Journal of Bone and Mineral Research 1993; 8: 575–82.
9Yan, L, Zhou, B, Prentice, A, Hou, J, Wang, X, Golden, MHN. Epidemiological study of hip fracture in Shenyang, P.R. China. Bone 1997; 24: 151–5.
10Royal College of Physicians. Fractured Neck of Femur. London: Royal College of Physicians, 1989.
11Sanders, KM, Pasco, JA, Ugoni, AM. et al. The exclusion of high trauma fractures may underestimate the prevalence of bone fragility fractures in the community. The GEELONG osteoporosis study. Journal of Bone and Mineral Research 1998; 13: 1337–42.
12Cooper, C, Campion, G, Melton, LJ. Hip fractures in the elderly: a world-wide projection. Osteoporosis International 1992; 2: 285–9.
13Melton, LJ 3rd. Epidemiology of fractures. In: Melton, LJ, ed. Osteoporosis: Etiology, Diagnosis, and Management. 2nd ed. Philadelphia Lippincott-Raven 1995; 225–47.
14Ellfors, L, Allander, E, Kanis, JA, Gullberg, B, Johnell, O, Dequeker, J. The variable incidence of hip fracture in southern Europe. The MEDOS study. Osteoporosis International 1994; 4: 253–63.
15Maggi, S, Kelsey, JL, Litvak, J, Heyse, SP. Incidence of hip fracture in the elderly: a cross-national analysis. Osteoporosis International 1991; 1: 232–41.
16Eastell, R, Boyle, IT, Compston, J, et al. Management of male osteoporosis: report of the UK Consensus Group. Quarterly Journal of Medicine 1998; 91: 7192.
17Royal College of Physicians. Osteoporosis. Clinical Guidelines for Prevention and Treatment. London: Royal College of Physicians of London, 1999.
18Kannus, P, Parkkari, J, Sievanen, H, Heinonen, A, Vuori, I, Jarvinen, M. Epidemiology of hip fractures. Bone 1996; 18(Suppl. 1): 57S63S.
19Lau, EMC, Cooper, C. The epidemiology of osteoporosis. The oriental perspective in a world context. Clinical Orthopaedics and Related Research 1996; 323: 6574.
20Kanis, J. The epidemiology of hip fracture in Europe. The MEDOS study. Revista Clinica Espanola 1991; 188(Suppl. 1) 12–4.
21O'Neill, TW, Felsenberg, D, Varlow, J, Cooper, C, Kanis, JA, Silman, AJ. The prevelance of vertebral deformity in European men and women: the European Vertebral Osteoporosis Study. Journal of Bone and Mineral Research 1996; 11: 1010–8.
22Gardsell, P, Johnell, O, Nilsson, BE, Sernbo, I. Bone mass in an urban and a rural population: a comparative, population-based study in southern Sweden. Journal of Bone and Mineral Research 1991; 6: 6775.
23Ross, PD, Davis, JW, Vogel, JM, Wasnich, RD. A critical review of bone mass and the risk of fractures in osteoporosis. Calcified Tissues International 1990; 46: 149–61.
24Gardsell, P, Johnell, O, Nilsson, BE. The predictive value of bone loss for fagility fractures in women: a longitudinal study over 15 years. Calcified Tissues International 1991; 49: 90–4.
25Cummings, S, Black, D, Nevitt, M, et al. Bone density at various sites for prediction of hip fractures. Lancet 1993; 341: 72–5.
26Marshall, D, Johnell, O, Wedel, H. Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. British Medical Journal 1996; 312: 1254–9.
27Faulkner, KG. Bone matters: are density increases necessary to reduce fracture risk?. Journal of Bone and Mineral Research 2000; 15: 183–7.
28Prentice, A. Application of DXA and other techniques to the assessment of bone and body composition. In: Cole, TJ, ed. Body Composition Techniques and Assessment in Health and Disease. Society for the Study of Human Biology; vol Soc Study Human Biol Symp Series 36. Cambridge: Cambridge University Press, 1995, 113.
29Cole, TJ, Prentice, A. Bone mineral measurements. British Medical Journal 1992; 305: 1223–4.
30Department of Health. Nutrition and Bone Health: With Particular Reference to Calcium and Vitamin D. Report of the Subgroup on Bone Health, Working Group on the Nutritional Status of the Population of the Committee on Medical Aspects of Food and Nutrition Policy. Report on Health and Social Subjects. Number 49 London: The Stationery Office, 1998.
31Parfitt, AM. Morphologic basis of bone mineral measurements: transient and steady state effects of treatment in osteoporosis. Mineral and Electrolyte Metabolism 1980; 4: 273–87.
32Frost, HM. Bone Remodelling and its Relationship to Metabolic Bone Disease. Springfield: Thomas, 1973.
33Kanis, JA. Calcium requirements for optimal skeletal health in women. Calcified Tissue International 1991; 49: S33–41.
34Heaney, RP. The bone remodeling transient: Interpreting interventions involving bone-related nutrients. Nutrition Reviews 2001; 59: 327–34.
35Garnero, P, Sornay-Rendu, E, Claustrat, B, Delmas, PD. Biochemical markers of bone turnover, endogenous hormones and the risk of fractures in postmenopausal women: the OFELY study. Journal of Bone and Mineral Research 2000; 15: 1526–36.
36Gunnes, M, Lehmann, EH, Mellstrom, D, Johnell, O. The relationship between anthropometric measurements and fractures in women. Bone 1996; 19: 407–13.
37Bass, S, Delmas, PD, Pearce, G, Hendrich, E, Tabensky, A, Seeman, E. The differing tempo of growth in bone size, mass, and density in girls is region-specific. Journal of Clinical Investigation 1999; 104: 795804.
38Cooper, C, Fall, C, Egger, P, Hobbs, R, Eastell, R, Barker, D. Growth in infancy and bone mass in later life. Annals of the Rheumatic Diseases 1997; 56: 1721.
39Fewtrell, MS, Prentice, A, Jones, SC, et al. Bone mineralisation and turnover in preterm infants at 8–12 years of age: the effect of early diet. Journal of Bone and Mineral Research 1999; 14(5): 810–20.
40Slemenda, CW, Peacock, M, Hui, S, Zhou, L, Johnston, CC. Reduced rates of skeletal remodeling are associated with increased bone mineral density during the development of peak bone mass. Journal of Bone and Mineral Research 1997; 12: 676–82.
41Compston, JE. Pharmacological interventions for the prevention of vertebral and nonvertebral fractures in women with postmentopausal osteoporosis: does site-specificity exist?. Bone 2000; 27: 765–8.
42Wilkin, TJ, Devendra, D. Bone densitometry is not a good predictor of hip fracture: for. British Medical Journal 2001; 323: 795–7.
43Dequeker, J, Luyten, F. Bone densitometry is not a good predictor of hip fracture: against. British Medical Journal 2001; 323: 797–9.
44Chesnut, CH, 3rd Rosen, CJ. For the Bone Quality Discussion Group. Reconsidering the effects of antiresportive therapies in reducing osteoporotic fracture. Journal of Bone and Mineral Research 2001; 16: 2163–72.
45Bjarnason, NH, Sarkar, S, Duong, T, Mitlak, B, Delmas, PD, Christiansen, C. Six and twelve month changes in bone turnover are related to reduction in vertebral fracture risk during 3 years of raloxifene treatment in postmenopausal osteoporosis. Osteoporosis International 2001; 12: 922–30.
46Riggs, BL, Melton, LJ, 3rd. Bone turnover matters: the raloxifene treatment paradox of dramatic decreases in vertebral fractures without commensurate increases in bone density. Journal of Bone and Mineral Research 2002; 17: 11–4.
47Pfeifer, M, Begerow, B, Minne, HW, Abrams, C, Nachtigall, D, Hansen, C. Effects of short-term vitamin D and calcium supplementation on body sway and secondary hyperparathyroidism. Journal of Bone and Mineral Research 2000; 15: 1113–8.
48Sogaard, CH, Mosekilde, L, Richards, A, Mosekilde, L. Marked decrease in trabecular bone quality after five years on sodium fluoride therapy assessed by biomechanical testing of iliac crest bone biopsies in osteoporotic patients. Bone 1994; 15: 393400.
49Dargent Molina, P, Favier, F, Grandjean, H, et al. Fall-related factors and risk of hip fracture: the EPIDOS prospective study. Lancet 1996; 348: 145–9.
50Nguyen, T, Sambrook, P, Kelly, P, et al. Prediction of osteoporotic fractures by postural instability and bone density. British Medical Journal 1993; 307: 1111–5.
51De Laet, CE, van Hout, BA, Burger, H, Hofman, A, Pols, HA. Bone density and risk of hip fracture in men and women: cross-sectional analysis. British Medical Journal 1997; 26: 221–5.
52Prentice, A. The relative contribution of diet and genotype to bone development. Proceedings of the Nutrition Society 2001; 60: 18.
53Cooper, C, Aihie, A. Osteoporosis: recent advances in pathogenesis and treatment. Quarterly Journal of Medicine 1994; 87: 203–9.
54Institute of Medicine Food and Nutrition Board. Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. Washington, DC: National Academy Press, 1997.
55National Institutes of Health Consensus Development Panel. Optimal calcium intake. Journal of the American Medical Association 1994; 272: 1942–8.
56Cumming, RG. Calcium intake and bone mass: a quantitative review of the evidence. Calcified Tissues International 1990; 47: 194201.
57Welten, DC, Kemper, HCG, Post, GB, Van Staveren, WA. A meta-analysis of the effect of calcium intake on bone mass in young and middle aged females and males. Journal of Nutrition 1995; 125: 2802–13.
58Kreiger, N, Gross, A, Hunter, G. Dietary factors and fracture in postmenopausal women: a case-control study. International Journal of Epidemiology 1992; 21(5): 953–8.
59Cummings, SR, Nevitt, MC, Browner, WS, et al. Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group. New England Journal of Medicine 1995; 332(12): 767–73.
60Wickham, CA, Walsh, K, Cooper, C, et al. Dietary calcium, physical activity, and risk of hip fracture: a prospective study. British Medical Journal 1989; 299(6704): 889–92.
61Cooper, C, Barker, DJ, Wickham, C. Physical activity, muscle strength, and calcium intake in fracture of the proximal femur in Britain. British Medical Journal 1988; 297(6661): 1443–6.
62Cumming, RG, Klineberg, RJ. Case-control study of risk factors for hip fractures in the elderly. American Journal of Epidemiology 1994; 139(5): 493503.
63Hannan, MT, Felson, DT, Dawson-Hughes, B, et al. Risk factors for longitudinal bone loss in elderly men and women: the Framingham Osteoporosis Study. Journal of Bone and Mineral Research 2000; 15(4): 710–20.
64Lau, E, Donnan, S, Barker, DJ, Cooper, C. Physical activity and calcium intake in fracture of the proximal femur in Hong Kong. British Medical Journal 1988; 297(6661): 1441–3.
65Holbrook, TL, Barrett-Connor, E, Wingard, DL. Dietary calcium and risk of hip fracture: 14-year prospective population study. Lancet 1988; 2(8619): 1046–9.
66Johnell, O, Gullberg, B, Kanis, JA, et al. Risk factors for hip fracture in European women: the MEDOS Study. Mediterranean Osteoporosis Study. Journal of Bone and Mineral Research 1995; 10(11): 1802–15.
67Kanis, J, Johnell, O, Gullberg, B, et al. Risk factors for hip fracture in men from southern Europe: the MEDOS study. Mediterranean Osteoporosis Study. Osteoporosis International 1999; 9(1): 4554.
68Cumming, RG, Nevitt, MC. Calcium for prevention of osteoporotic fractures in postmenopausal women. Journal of Bone and Mineral Research 1997; 12: 1321–9.
69Prentice, A. What are the dietary requirements for calcium and vitamin D?. Calcified Tissue International 2002; 70: 83–8.
70Riis, B, Thomsen, K, Christiansen, C. Does calcium supplementation prevent postmenopausal bone loss?. New England Journal of Medicine 1987; 316: 173–7.
71Elders, PJM, Lips, P, Netelenbos, JC, et al. Long-term effect of calcium supplementation on bone loss in perimenopausal women. Journal of Bone and Mineral Research 1994; 9: 963–70.
72Dawson-Hughes, B, Dallal, GE, Krall, EA, Sadowski, L, Sahyoun, N, Tannenbaum, S. A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women. New England Journal of Medicine 1990; 323: 878–83.
73Riggs, BL, O'Fallon, WM, Muhs, J, O'Connor, MK, Kumar, R, Melton, LJ 3rd . Long-term effects of calcium supplementation on serum parathyroid hormone level, bone turnover, and bone loss in elderly women. Journal of Bone and Mineral Research 1998; 13: 168–74.
74Reid, IR, Ames, RW, Evans, MC, Gamble, GD, Sharpe, SJ. Effect of calcium supplementation on bone loss in postmenopausal women. New England Journal of Medicine 1993; 328: 460–4.
75Prince, RP, Devine, A, Dick, I, et al. The effects of calcium supplementation (milk powder or tablets) and exercise on bone density in postmenopausal women. Journal of Bone and Mineral Research 1995; 10: 1068–75.
76Chevalley, T, Rizzoli, R, Nydegger, V, et al. Effects of calcium supplements on femoral bone mineral density and vertebral fracture rate in vitamin D replete elderly patients. Osteoporosis International 1994; 4: 245–52.
77Peacock, M, Liu, G, Carey, M, et al. Effect of a calcium or 25OHD vitamin D3 dietary supplementation on bone loss at the hip in men and women over the age of 60. Journal of Clinical Endocrinology and Metabolism 2000; 85: 3011–9.
78Dibba, B, Prentice, A, Ceesay, M, Stirling, DM, Cole, TJ, Poskitt, EME. Effect of calcium supplementation on bone mineral accretion in Gambian children accustomed to a low calcium diet. American Journal of Clinical Nutrition 2000; 71: 544–9.
79Cadogan, J, Eastell, R, Jones, N, Barker, ME. Milk intake and bone mineral acquisition in adolescent girls: randomised, controlled intervention trial. British Medical Journal 1997; 315: 1255–60.
80Recker, R, Hinders, S, Davies, KM, et al. Correcting calcium nutritional deficiency prevents spine fractures in elderly women. Journal of Bone and Mineral Research 1996; 11: 1961–6.
81Reid, IR, Ames, RW, Evans, MC, Gamble, GD, Sharpe, SJ. Long-term effects of calcium supplementation on bone loss and fractures in postmenopausal women: a randomised controlled trial. American Journal of Medicine 1995; 98: 331–5.
82Orimo, H, Shiraki, M, Hayashi, T, Nakamura, T. Reduced occurrence of verterbral crush fractures in senile osteoporosis treated with 1(OH)-vitamin D 3. Bone and Mineral 1987; 3: 4752.
83Commission of the European Communities. Nutrient and Energy Intakes for the European Community. Reports of the Scientific Committee for Food. Luxembourg: Office for Official Publications of the European Communities, 1993.
84Garn, SM, Rohmann, CG, Wagner, B. Bone loss is a general phenomenon in man. Federation Proceedings 1967; 26: 1729–36.
85Lee, WTK, Leung, SSF, Wang, S-H, et al. Double-blind, controlled calcium supplementation and bone mineral accretion in children accustomed to a low-calcium diet. American Journal of Clinical Nutrition 1994; 60: 744–50.
86Lau, EMC, Woo, J, Leung, PC, Swaminathan, R, Leung, D. The effects of calcium supplementation and exercise on bone density in elderly Chinese women. Osteoporosis International 1992; 2: 168–73.
87Prentice, A, Jarjou, LMA, Cole, TJ, Stirling, DM, Dibba, B, Fairweather-Tait, S. Calcium requirements of lactating Gambian mothers: effects of a calcium supplement on breastmilk calcium concentration, maternal bone mineral content, and urinary calcium excretion. American Journal of Clinical Nutrition 1995; 62: 5867.
88Prentice, A. Calcium requirements of children. Nutrition Reviews 1995; 53(2): 3740.
89Prentice, A. Calcium supplementation during breast-feeding. New England Journal of Medicine 1997; 337: 558–9.
90Nordin, BEC, Marshall, DH. Dietary requirements for calcium. In: Nordon, BEC, ed. Calcium in Human Biology. London: Springer-Verlag, 1988.
91Bates, CJ, Carter, GD, Mishra, GD, O'Shea, D, Jones, J, Prentice, A. In a population study, can parathyroid hormone aid the definition of adequate vitamin D status? A study of people aged 65 years and over from the British National Diet and Nutrition Survey. Osteoporosis International 2003; 14: 152–9.
92Finch, S, Doyle, W, Lowe, C, et al. National Diet and Nutrition Survey: People Aged 65 years and Over. Volume 1: Report of the Diet and Nutrition Survey. London: The Stationery Office, 1998, 637.
93Chapuy, MC, Preziosi, P, Maamer, M, et al. Prevalence of vitamin D insufficiency in an adult normal population. Osteoporosis International 1997; 7(5): 439–43.
94Khaw, KT, Sneyd, MJ, Compston, J. Bone density, parathyroid hormone and 25-hydroxyvitamin D. British Medical Journal 1992; 350: 263–7.
95Ooms, ME, Roos, JC, Bezemer, PD, Van Der Vijch, WJF, Bouter, LM, Lips, P. Prevention of bone loss by vitamin D supplementation in elderly women: a randomised double blind trial. Journal of Clinical Endocrinology and Metabolism 1995; 80: 1052–8.
96Lips, P, Graafman, WC, Ooms, ME, Bezemer, D, Bouter, LM. Vitamin D supplementation and fracture incidence in elderly persons. A randomized, placebo-controlled clinical trial. Annals of Internal Medicine 1996; 124: 400–6.
97Heikinheimo, RJ, Inkovaara, JA, Harju, EJ, et al. Annual injection of vitamin D and fractures of aged bones. Calcified Tissues International 1992; 51: 105–10.
98Dawson-Hughes, B, Harris, SS, Krall, EA, Dallal, GE. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. New England Journal of Medicine 1997; 337: 670–6.
99Chapuy, MC, Arlot, ME, Duboeuf, F, et al. Vitamin D3 and calcium to prevent hip fractures in elderly women. New England Journal of Medicine 1992; 327: 1637–42.
100Chapuy, MC, Arlot, ME, Delmas, PD, Meunier, PJ. Effect of calcium and cholecalciferol treatment for three years on hip fractures in elderly women. British Medical Journal 1994; 308: 1081–2.
101Lau, EM, Woo, J, Lam, V, Hong, A. Milk supplementation of the diet of postmenopausal Chinese women on a low calcium intake retards bone loss. Journal of Bone and Mineral Research 2001; 16(9): 1704–9.
102Parfitt, AM. Osteoporosis: 50 years of change, mostly in the right direction. In: Ralston, SH, ed. Osteoporosis and Bone Biology: The State of the Art. London: International Medical Press, 2000, 113.
103American Society for Bone and Mineral Research. Primer of the Metabolic Bone Diseases and Disorders of Mineral Metabolism. In: Favus, M, ed. 4th ed. Philadelphia: Lippincott Williams & Wilkins, 1999.
104Department of Health. Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. Report on Health and Social Subjects. vol. 41 London: Her Majesty's Stationery Office, 1991.
105Calvo, MS, Kumar, R, Heath, H 3rd. Persistently elevated parathyroid hormone secretion and action in young women after four weeks of ingesting high phosphorus, low calcium diets. Journal of Clinical Endocrinology and Metabolism 1990; 70: 1334–40.
106Bizik, BK, Ding, W, Cerlewski, FL. Evidence that bone resorption of young men is not increased by high dietary phosphorus obtained from milk and cheese. Nutrition Research 1996; 16: 1143–6.
107Heaney, RP, Rafferty, K. Carbonated beverages and urinary calcium excretion. American Journal of Clinical Nutrition 2001; 74: 343–7.
108New, SA, Robins, SP, Campbell, MK, et al. Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable intake and bone health?. American Journal of Clinical Nutrition 2000; 71: 142–51.
109Stendig-Lindberg, G, Tepper, R, Leichter, I. Trabecular bone density in a two year controlled trial of oeroral magnesium in osteoporosis. Magnesium Research 1993; 6: 155–63.
110Abelow, BJ, Holford, TR, Insogna, KL. Cross-cultural association between dietary animal protein and hip fracture: a hypothesis. Calcified Tissue International 1992; 50: 14–8.
111Hunt, JR, Gallagher, SK, Johnson, LK, Lykken, GI. High- versus low-meat diets: effects on zinc absorption, iron status, and calcium, copper, iron magnesium, manganese, nitrogen, phosphorus, and zinc balance in postmenopausal women. American Journal of Clinical Nutrition 1995; 62: 621–32.
112Hannan, MT, Tucker, KL, Dawson-Hughes, B, Cupples, LA, Felson, DT, Kiel, DP. Effect of dietary protein on bone loss in elderly men and women: the Framingham Osteoporosis Study. Journal of Bone and Mineral Research 2000; 15(12): 2504–12.
113Sellmeyer, DE, Stone, KL, Sebastian, A, Cummings, SR. For the Study of Osteoporotic Fractures Research Group. A high ratio of dietary animal to vegetable protein increases the rate of bone loss and the risk of fracture in postmenopausal women. American Journal of Clinical Nutrition 2001; 73(1): 118–22.
114Heaney, RP. Protein intake and bone health: the influence of belief systems on the conduct of nutritional science. American Journal of Clinical Nutrition 2001; 73(1): 56.
115Sebastian, A, Sellmeyer, DE, Stone, KL, Cummings, SR. Dietary ratio of animal to vegetable protein and rate of bone loss and risk of fracture in postmenopausal women (letter). American Journal of Clinical Nutrition 2001; 74: 411–2.
116Heaney, RP. Reply to A Sebastian et al. (letter). American Journal of Clinical Nutrition 2001; 74: 412.
117Mowe, M, Bohmer, T, Kindt, E. Reduced nutritional status in an elderly population (>70 year) is probable before disease and possibly contributes to the development of disease. American Journal of Clinical Nutrition 1994; 59: 317–24.
118Larsson, J, Unosson, M, Ek, A-C, Nilsson, L, Thorslund, S, Bjurulf, P. Effect of dietary supplement on nutritional status and clinical outcome in 501 geriatric patients—a randomised study. Clinical Nutrition 1990; 9: 179–84.
119Lipschitz, DA. Nutritonal assessment and interventions in the elderly. In: Burckhardt, P, Heaney, RP, ed. Nutritional Aspects of Osteoporosis /94. Rome: Ares-Serono Symposia Publications, Challenges of Modern Medicine vol. 7, 1995 177–91.
120Schurch, MA, Rizzoli, R, Slosman, D, Vadas, L, Vergnaud, P, Bonjour, JP. Protein supplements increase serum insulin-like growth factor-1 levels and attenuate proximal femur bone loss in patients with recent hip fracture. Annals of Internal Medicine 1998; 128: 801–9.
121Rizzoli, R, Bonjour, JP. Determinants of peak bone mass and mechanisms of bone loss. Osteoporosis International 1999; 9(Suppl 2): S17–23.
122World Health Organization. Diet, Nutrition, and the Prevention of Chronic Diseases. WHO Technical Report Series no. 797. Geneva: World Health Organization, 1990.
123Gordon, SL, Corbin, SB. Summary of workshop on drinking water fluoride influence on hip frature and on bone health. Osteoporosis International 1992; 2: 109–17.
124Szulc, P, Arlot, M, Chapuy, MC, Duboeuf, F, Meunier, PJ, Delmas, PD. Serum undercarboxylated osteocalcin correlates with hip bone mineral density in elderly women. Journal of Bone and Mineral Research 1994; 9: 1591–5.
125Shearer, MJ. Role of vitamin K and Gla proteins in the pathophysiology of osteoporosis and vascular calcification. Current Opinion in Clinical Nutrition and Metabolic Care 2000 3: 433–8.
126Melhus, H, Michaelsson, K, Kindmark, A, et al. Excessive dietary intake of vitamin A is associated with reduced bone mineral density and increased risk for hip fracture. Annals of Internal Medicine 1998; 129: 770–8.
127Prentice, A, Bates, CJ. Adequacy of dietary mineral supply for human bone growth and mineralisation. European Journal of Clinical Nutrition 1994; 48S: 161–77.
128Eaton-Evans, J, McIlrath, EM, Jackson, WE, McCartney, H, Strain, JJ. Copper supplementation, and the maintenance of bone mineral density in middle-aged women. Journal of Trace Element Experimental Medicine 1996; 9: 8794.
129Strause, L, Saltman, P, Smith, KT, Bracker, M, Andon, MB. Spinal bone loss in postmenopausal women supplemented with calcium and trace minerals. Journal of Nutrition 1994; 124: 1060–4.
130Meacham, SL, Taper, LJ, Volpe, SL. Effects of boron supplementation on bone mineral density and dietary, blood and urinary calcium, phosphorus, magnesium and boron in female athletes. Environment and Health Perspectives 1994; 102: 7982.
131Dawson-Hughes, B, Fowler, SE, Dalsky, G, Gallagher, C. Sodium excretion influences calcium homeostasis in elderly men and women. Journal of Nutrition 1996; 126: 2107–12.
132Evans, CE, Chugtai, AY, Blumsohn, A, Giles, M, Eastell, R. The effects of dietary sodium on calcium metabolism in premenopausal and postmenopausal women. European Journal of Clinical Nutrition 1997; 51: 394–9.
133Devine, A, Criddle, RA, Dick, IM, Kerr, RA, Prince, RL. A longitudinal study of the effect of sodium and calcium intakes on regional bone density in postmenopausal women. American Journal of Clinical Nutrition 1995; 62: 740–5.
134Ginty, F, Flynn, A, Cashman, KD. The effect of sodium intake on biochemical markers of bone metabolism in young women. British Journal of Nutrition 1998; 79: 343–50.
135Tucker, KL, Hannan, MT, Chen, H, Cupples, LA, Wilson, PW, Kiel, DP. Potassium, magnesium, and fruit and vegetable intakes are associated with greater bone mineral density in elderly men and women. American Journal of Clinical Nutrition 1999; 69: 727–36.
136Remer, T, Manz, F. Potential renal acid load of foods and its influence on urine pH. Journal of the American Dietetic Association 1995; 95: 791–2.
137Reid, DM, New, SA. Nutritional influences on bone mass. British Journal of Nutrition 1997; 56: 977–87.
138Wood, RJ. Potassium bicarbonate supplementation and calcium metabolism in postmenopausal women: are we barking up the wrong tree?. Nutrition Reviews 1994; 52: 278–80.
139Sebastian, A, Harris, ST, Ottaway, JH, Todd, KM, Morris, RC. Improved mineral balance and skeletal metabolism in postmenopausal women treated with potassium bicarbonate. New England Journal of Medicine 1994; 330: 1776–81.
140Bingham, SA, Atkinson, C, Liggins, J, Bluck, L, Coward, A. Phyto-oestrogens: where are we now?. British Journal of Nutrition 1998; 79: 393406.
141Kardinaal, AF, Morton, MS, Bruggemann-Rotgans, IE, van-Beresteijn, EC. Phyto-oestrogen excretion and rate of bone loss in postmenopausal women. European Journal of Clinical Nutrition 1998; 52: 850–5.
142Ho, SC, Chan, SG, Yi, Q, Wong, E, Leung, PC. Soy intake and the maintenance of peak bone mass in Hong Kong Chinese women. Journal of Bone and Mineral Research 2001; 16: 1363–9.
143Grainge, MJ, Coupland, CA, Cliffe, SJ, Chilvers, CE, Hosking, DJ. Cigarette smoking, alcohol and caffeine consumtpion and bone mineral density in postmenopausal women. The Nottingham EPIC Study Group. Osteoporosis International 1998; 8: 355–63.
144Lloyd, T, Johnson-Rollongs, N, Eggli, DF, Kieselhorst, K, Mauger, EA, Cusatis, DC. Bone status among postmenopausal women with different habitual caffeine intakes: a longitudinal investigation. Journal of the American College of Nutrition 2000; 19: 256–61.
145Conlisk, AJ, Galuska, DA. Is caffeine associated with bone mineral density in young adult women?. Preventative Medicine 2000; 31: 562–8.
146Rapuri, PB, Gallagher, JC, Kinyamu, HK, Ryschon, KL. Caffeine intake increases the rate of bone loss in elderly women and interacts with vitamin D receptor genotypes. American Journal of Clinical Nutrition 2001; 74: 694700.
147Parsons, TJ, Prentice, A, Smith, EA, Cole, TJ, Compston, JE. Bone mineral mass consolidation in young British adults. Journal of Bone and Mineral Research 1996; 11: 264–74.
148Baumgartner, RN, Stauber, PM, Koehler, KM, Romero, L, Garry, PJ. Associations of fat and muscle masses with bone mineral in elderly men and women. American Journal of Clinical Nutrition 1996; 63: 365–72.
149Honkanen, R, Kroger, H, Alhava, E, Turpeinen, P, Tuppurainen, M, Saarikoski, S. Lactose intolerance associated with fractures of weight-bearing bones in Finnish women aged 38–57 years. Bone 1997; 21: 473–7.
150Harma, M, Alhava, E. Is lactose malabsorption a risk factor for fractures of the elderly?. Annales Chirurgiae et Gynaecologiae 1988; 77: 180–3.
151Goulding, A, Taylor, RW, Keil, D, Gold, E, Lewis-Barned, NJ, Williams, SM. Lactose malabsorption and rate of bone loss in older women. Age and Ageing 1999; 28: 175–80.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed