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Mechanisms by which fruit and vegetables influence postmenopausal bone health - a randomised control trial (RCT) in a well-characterised population
Project Code: N05043;
Macdonald HM, Black AJ, Aucott L, Duthie G, Duthie S, Sandison R, Hardcastle AC, Lanham New SA, Fraser WD & Reid DM (2008a) Effect of potassium citrate supplementation or increased fruit and vegetable intake on bone metabolism in healthy postmenopausal women: a randomized controlled trial. Am J Clin Nutr 88, 465-474.
Macdonald HM, McGuigan FE, Lanham-New SA, Fraser WD, Ralston SH & Reid DM (2008c) Vitamin K1 intake is associated with higher bone mineral density and reduced bone resorption in early postmenopausal Scottish women: no evidence of gene-nutrient interaction with apolipoprotein E polymorphisms. Am J Clin Nutr 87, 1513-1520.
University of Aberdeen
Dietary vitamin K intake data was available for 3239 women from the Aberdeen Prospective Osteoporosis Screening Study (APOSS). The mean vitamin K intake was 107µg at study visit 2 (range 8-499µg). Bone mineral density (BMD) was lowest in the lowest quartile of energy adjusted vitamin K intake compared to the highest quartile, however after adjustment for confounders the relationship was only significant at the hip. No relationship was observed between BMD loss and vitamin K intake.
Information on APOE was available for 2731 early postmenopausal women, with no difference in characteristics such as weight, height etc between the different genotypes. Carriers of the APOE-2 allele had less bone loss over the study period than carriers of the APOE-4 allele, with the difference significant at the lumbar spine. Following adjustment for confounders including height, weight, smoking, socio-economic status, baseline BMD, menopausal status and HRT use the relationship was significant for both lumbar spine and hipbone.
No interaction between vitamin K intake, APOE genotype and BMD or BMD change was reported.
In the second part of the study 203 women from APOSS completed the randomised controlled trial, with an additional 24 women who discontinued treatment but attended trial visits included in the intention to treat analysis. Compliance to the tablet intervention was good at 93% and fruit and vegetable compliance assessed by dietary checklists showed that the extra 3 daily portions were met mainly through increasing fruit intake. Results of the trial found no difference between treatment groups for serum bone markers or any change in lumbar spine BMD between the groups. BMD loss at the total hip was slightly greater for the low dose potassium citrate group compared to placebo.
Overall fruit and vegetables had no influence on bone markers or BMD change.
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