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Impact of fruit and vegetables on bone health: potential mechanisms at the whole body and cellular level.

Project Code: N05044

01/10/2010

MRC-National Survey of Health and Development, University College London
Prynne, C ; Mishra, G;
MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge
O'Connell, M; Muniz, G; Laskey, A; Yan, L; Prentice, A; Ginty, F

Subjects participating in this study were reasonably affluent and had a good educational background. In the older age groups only 50% of subjects had intakes equal to or greater than the recommended 400 g/d of fruit and vegetables, whereas this figure fell to 25% of adolescents and 38% of young women.
Key results are as follows:
• There was a significant positive association between size adjusted bone mineral content and fruit and vegetable intake, vitamin C intake and carotenoid and vitamin E status in adolescents and older women. The relationship between bone measurements, fruit and vegetable intake and carotenoids were strongest in boys possibly because they were still growing and thus more susceptible to variations within the diet, whereas girls are more skeletally mature. In the older women rapid bone loss had probably subsided, however the significant positive associations suggest that a diet higher in fruit and vegetable may positively influence bone mineral status at this life-stage.
• Significant inverse associations were observed between bone markers (osteocalcin, procollagen type I intact N terminal propeptide (P1NP), C-terminal peptide and osteoprotegerin) and carotenoids and a-tocopherol suggestive of a modulatory effect of fruit and vegetable intake on bone turnover.
• Fewest relationships were found in the young women and older men. This does not suggest that fruit and vegetable intake is less important for bone health in these groups, but may indicate that other dietary or lifestyle factors may be more important.
• To investigate the effect of fruit and vegetables on net renal acid load, two approaches based on dietary data were used: (a) calculation of net acid excretion by the Remer method and (b) calculation of net endogenous acid production by the Frasetto method which is the ratio of dietary protein to dietary K. Estimates of net acid excretion or net endogenous acid production were not a significant inverse predictor of size-adjusted bone mineral content in any of the age or sex groups, however estimates of net acid excretion were a positive predictor in older men and women
Further studies are required to define the lower limit of fruit and vegetable intake where there is increased risk of osteoporosis, and to identify the underlying mechanisms.

Final report (paper)

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