Adequate intakes of fruit and vegetables are recommended for optimum health in children.
The objective of this study was to determine whether consuming fruit and vegetables >3 times per day is beneficial to bone mass in children.
Fifty-six white females (Tanner stage 2) recorded dietary intake on 3 independent days. The numbers of servings of fruit and vegetables were recorded for each day and tallied, and the subjects were divided into 2 consumption groups for analysis (low consumption: <3 servings/d, n = 22; high consumption: > or = 3 servings/d, n = 34). Bone area and the bone mineral content of the whole body and radius were assessed by using dual-energy X-ray absorptiometry. Radioimmunoassays measured serum parathyroid hormone and 25-hydroxyvitamin D. Twenty-four-hour urine samples were assessed for calcium, sodium, and creatinine.
After adjustment for age, body mass index, and physical activity, those children who reported consuming > or = 3 servings fruit and vegetables/d had more bone area of the whole body (6.0%; P = 0.03) and radius (8.3%; P = 0.03), lower urinary calcium excretion (2.6 +/- 0.2 compared with 1.8 +/- 0.3 mg/kg; P = 0.04), and lower parathyroid hormone (19.6 +/- 1.9 compared with 25.0 +/- 1.6 pg/mL; P = 0.01) than did those children who reported consuming <3 servings fruit and vegetables/d.
High fruit and vegetable intakes have beneficial effects on the bone area of the radius and whole body in early pubertal girls. The lower urinary calcium output associated with higher fruit and vegetable intakes may be a modulating factor.
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... Similarly, another systematic review reported that the regular consumption of dairy products was associated with increased bone mineral content (BMC) in children [7]. Other studies have examined the relationships between fruit and vegetable [8,9], mineral [10] and vitamin [11] intake and bone status in pediatric populations. ...
Early bone accrual significantly influences adult bone health and osteoporosis incidence. We aimed to investigate the relationship between dietary patterns (DPs), bone mineral content (BMC) and bone mineral density (BMD) in school-age children in China. Children aged six–nine years (n = 465) were enrolled in this cross-sectional study. DPs were identified by principal component factor analysis. Total body (TB) and total body less head (TBLH) BMC and BMD were measured using dual-energy X-ray absorptiometry. Five DPs were identified. After adjustment for covariates, multiple linear regression analysis showed that the “fruit-milk-eggs” dietary pattern was positively associated with TB (β = 10.480; 95% CI: 2.190, 18.770) and TBLH (β = 5.577; 95% CI: 0.214, 10.941) BMC, the “animal organs-refined cereals” pattern was associated with low TB BMC (β = −10.305; 95% CI: −18.433, −2.176), TBLH BMC (β = −6.346; 95% CI: −11.596, −1.096), TB BMD (β = −0.006; 95% CI: −0.011, −0.001) and TBLH BMD (β = −0.004; 95% CI: −0.007, −0.001). In conclusion, our study recommends home or school meals should be rich in fruit, milk, eggs with a moderate amount of vegetables, coarse grains and meat to promote bone development for school-age children.
... In addition to calcium intake, dietary protein intake may also be important. Several studies of the diet of children and adolescents have examined the effects of foods such as milk products and fruit and vegetables on bone growth (New et al. 2000;McGartland et al. 2004;Tylavsky et al. 2004). PBMAS results suggest that in addition to adequate dietary calcium intake, appropriate intakes of vegetables and fruit have a beneficial effect on total body BMC in boys but not girls. ...
Context:
Girls' and boys' growth patterns differ in timing and tempo, and they have different lifestyles with regards to diet and physical activity. These factors have all been linked with bone mineral accrual.
Objective:
To identify the associations of boys' and girls' growth, maturation, and lifestyle choices relating to parameters of bone geometry and mineral accrual.
Methods:
Between 1991 and 1993, 251 children aged 8-15 years were recruited into a mixed-longitudinal cohort study (The Paediatric Bone Mineral Accrual Study (PBMAS)) and followed repeatedly over 26 years.
Results:
It was found that girls matured approximately two years earlier than boys (11.8 vs. 13.4 years) but on average were shorter, had less lean mass and had greater fat mass (p < 0.05). There was a dissociation between the growth of bone and its mineralisation in both sexes. Boys had greater bone mass and bone geometry (p < 0.05). Both a healthy childhood diet and high levels of physical activity were associated with improved bone parameters.
Conclusions:
Most, but not all, of the sex differences observed, were explained by height and lean mass differences. The importance of diet and physical activity on obtaining optimal bone mass during adolescence in both sexes was also paramount.
... Observational studies show a consistent bone benefit with increased dietary potassium associated with higher fruit and vegetable intakes across gender and life stage [10][11][12][13][14][15]38,39]. While clinical interventions assessing the effect of increased dietary potassium on Ca balance are lacking, evidence from clinical supplementation trials suggest that potassium intake decreases urinary Ca excretion [15][16][17], and may increase Ca retention [18,19]. ...
Potassium supplementation has been associated with reduced urinary calcium (Ca) excretion and increased Ca balance. Dietary interventions assessing the impact of potassium on bone are lacking. In this secondary analysis of a study designed primarily to determine blood pressure effects, we assessed the effects of potassium intake from potato sources and a potassium supplement on urinary Ca, urine pH, and Ca balance. Thirty men (n = 15) and women (n = 15) with a mean ± SD age and BMI of 48.2 ± 15 years and 31.4 ± 6.1 kg/m2, respectively, were enrolled in a cross-over, randomized control feeding trial. Participants were assigned to a random order of four 16-day dietary potassium interventions including a basal diet (control) of 2300 mg/day (~60 mmol/day) of potassium, and three phases of an additional 1000 mg/day (3300 mg/day(~85 mmol/day) total) of potassium in the form of potatoes (baked, boiled, or pan-heated), French fries (FF), or a potassium (K)-gluconate supplement. Calcium intake for all diets was approximately 700–800 mg/day. Using a mixed model ANOVA there was a significantly lower urinary Ca excretion in the K-gluconate phase (96 ± 10 mg/day) compared to the control (115 ± 10 mg/day; p = 0.027) and potato (114 ± 10 mg/day; p = 0.033). In addition, there was a significant difference in urinary pH between the supplement and control phases (6.54 ± 0.16 vs. 6.08 ± 0.18; p = 0.0036). There were no significant differences in Ca retention. An increased potassium intake via K-gluconate supplementation may favorably influence urinary Ca excretion and urine pH. This trial was registered at ClinicalTrials.gov as NCT02697708.
... Thus, also macronutrients could modulate PTH secretion in adolescence. For example, lower PTH concentrations and beneficial effects on bone size were observed in early pubertal children who have high fruit and vegetable intakes (106). This strongly suggests that nutrient supplementation influences PTH release in children and consequently bone homeostasis. ...
There is growing recognition of the role of diet and physical activity in modulating bone mineral density, bone mineral content, and remodeling, which in turn can impact bone health later in life. Adequate nutrient composition could influence bone health and help to maximize peak bone mass. Therefore, children’s nutrition may have lifelong consequences. Also, physical activity, adequate in volume or intensity, may have positive consequences on bone mineral content and density and may preserve bone loss in adulthood. Most of the literature that exists for children, about diet and physical activity on bone health, has been translated from studies conducted in adults. Thus, there are still many unanswered questions about what type of diet and physical activity may positively influence skeletal development. This review focuses on bone requirements in terms of nutrients and physical activity in childhood and adolescence to promote bone health. It explores the contemporary scientific literature that analyzes the impact of diet together with the typology and timing of physical activity that could be more appropriate depending on whether they are children and adolescents to assure an optimal skeleton formation. A description of the role of parathyroid hormone (PTH) and gut hormones (gastric inhibitory peptide (GIP), glucagon-like peptide (GLP)-1, and GLP-2) as potential candidates in this interaction to promote bone health is also presented.
Healthcare professionals are consistently bombarded with conflicting messages about the role of diet in bone health. Yet, few resources are available that compile the broad scope of dietary factors that influence bone health. This article evaluates the evidence on the association of diet and exercise with bone health, with the aim to provide a resource for healthcare professionals and researchers in the field. This review also highlights gaps in knowledge, provides dialogue around why some studies exhibit conflicting outcomes, and showcases why many remaining questions likely cannot be answered with the current evidence to date. The best evidence to date supports obtaining recommended dairy and calcium intakes for building bone in early life and mitigating bone loss with age. However, nutrients do not solely work in isolation, and there is growing evidence that many other nutrients and dietary bioactives play a synergistic role in supporting bone health. Large randomized controlled trials, particularly in traditionally underserved subpopulations (eg, people of color, transgender individuals, older adults, etc), are needed to fully elucidate the effects of diet and exercise on bone health across the lifespan.
Bone health is the result of a tightly regulated balance between bone modeling and bone remodeling, and alterations of these processes have been observed in several diseases both in adult and pediatric populations. The imbalance in bone remodeling can ultimately lead to osteoporosis, which is most often associated with aging, but contributing factors can already act during the developmental age, when over a third of bone mass is accumulated. The maintenance of an adequate bone mass is influenced by genetic and environmental factors, such as physical activity and diet, and particularly by an adequate intake of calcium and vitamin D. In addition, it has been claimed that the integration of specific nutraceuticals such as resveratrol, anthocyanins, isoflavones, lycopene, curcumin, lutein, and β-carotene and the intake of bioactive compounds from the diet such as honey, tea, dried plums, blueberry, and olive oil can be efficient strategies for bone loss prevention. Nutraceuticals and functional foods are largely used to provide medical or health benefits, but there is an urge to determine which products have adequate clinical evidence and a strong safety profile. The aim of this review is to explore the scientific and clinical evidence of the positive role of nutraceuticals and functional food in bone health, focusing both on molecular mechanisms and on real-world studies.
Osteoporosis is a significant public health concern, particularly in aging populations, leading to fractures, decreased mobility, and reduced quality of life. While calcium and vitamin D have long been recognized as essential for bone health, emerging research suggests that potassium may play a crucial role in maintaining bone density and preventing osteoporosis. This manuscript explores the relationship between potassium and osteoporosis, delving into the mechanisms, epidemiological evidence, and potential therapeutic implications of potassium in bone health. Furthermore, the manuscript discusses the sources of dietary potassium, its impact on bone metabolism, and the future directions in research and clinical practice regarding potassium’s role in osteoporosis management.
Osteoporosis commonly affects postmenopausal women and accounts for 300,000 hip fractures in the United States each year. More women are deferring or discontinuing pharmacologic treatment because of intolerable adverse reactions or fear of long-term safety. Supplementing dietary intake of certain vitamins and minerals can have positive effects on bone parameters. Calcium is frequently recommended for osteoporotic patients but many not confer much benefit toward bone density. Certain forms of vitamins A and K have been shown to increase bone density. Isoflavones and phytates are phytochemicals found in soy foods that are comparable to bisphosphonates when consumed at certain levels. Lastly, increasing certain daily fruit and vegetable servings can improve bone health. Nutritional interventions are typically safe alternatives that should be considered for postmenopausal women who are seeking nonpharmacologic treatment options for osteoporosis.
Abstract: Calciotropic hormones, parathyroid hormone (PTH) and calcitonin are involved in the regulation of bone mineral metabolism and maintenance of calcium and phosphate homeostasis in the body. Therefore, an understanding of environmental and genetic factors influencing PTH and calcitonin levels is crucial. Genetic factors are estimated to account for 60% of variations in PTH levels, while the genetic background of interindividual calcitonin variations has not yet been studied. In this review, we analyzed the literature discussing the influence of environmental factors
(lifestyle factors and pollutants) on PTH and calcitonin levels. Among lifestyle factors, smoking, body mass index (BMI), diet, alcohol, and exercise were analyzed; among pollutants, heavy metals and chemicals were analyzed. Lifestyle factors that showed the clearest association with PTH levels were smoking, BMI, exercise, and micronutrients taken from the diet (vitamin D and calcium). Smoking, vitamin D, and calcium intake led to a decrease in PTH levels, while higher BMI and exercise led to an increase in PTH levels. In terms of pollutants, exposure to cadmium led to a decrease in PTH levels, while exposure to lead increased PTH levels. Several studies have
investigated the effect of chemicals on PTH levels in humans. Compared to PTH studies, a smaller number of studies analyzed the influence of environmental factors on calcitonin levels, which gives
great variability in results. Only a few studies have analyzed the influence of pollutants on calcitonin levels in humans. The lifestyle factor with the clearest relationship with calcitonin was smoking (smokers had increased calcitonin levels). Given the importance of PTH and calcitonin in maintaining calcium and phosphate homeostasis and bone mineral metabolism, additional studies
on the influence of environmental factors that could affect PTH and calcitonin levels are crucial.
Background There continues to be considerable debate about the role of acid vs. basic components of the diet on the long-term status
of bone mineral density.
Aim In a set of two analyses, we examined the effect of components in the diet thought to have basic effects (magnesium, potassium,
fruit, vegetables) and acid effects (protein) on bone mineral density in an elderly cohort.
Methods Bone mineral density of participants in the Framingham Osteoporosis Study was measured at three hip sites and one forearm
site at two points in time, four years apart. At the time of baseline measurement, participants ranged in age from 69–97 years.
Dietary intake was assessed at baseline by food frequency questionnaire.
Results As hypothesized, magnesium, potassium, fruit and vegetable intakes were significantly associated with bone mineral density
at baseline and among men, with lower bone loss over four years. In contrast to the hypothesis, higher rather than lower protein
intakes were associated with lower bone loss.
Conclusion Together these results support the role of base forming foods and nutrients in bone maintenance. The role of protein appears
to be complex and is probably dependent on the presence of other nutrients available in a mixed diet. A balanced diet with
ample fruit and vegetables and adequate protein appears to be important to bone mineral density.
The influence of nutritional factors on bone health still remains largely undefined. Reasons that may explain this phenomena are linked to several factors, including the sole concentration of most studies on the role of calcium (Ca) without reference to other nutrients, the use of weak methods for dietary assessment, low reported energy intakes (EI:BMR <1.2), and the lack of appropriate adjustment for important confounding factors. Furthermore, there is little documentation on the influence of dietary intake on bone metabolism.
Low bone mass and related fractures are a major public health threat. It is of great importance to identify modifiable risk factors: bone structure and turnover, genetic factors, environmental influences (calcium and vitamin D, other macro- or micronutrients, specific food groups). Nutrition intervention in people who are already at risk for or with diagnosed osteoporosis plays a major role in the prevention and treatment of osteoporosis.
Phylogenetic and experimental data on the inorganic content of bone have led to a postulate which delineates the functioning of bone mineral as a buffer base. Bone dissolution is considered as a possible mechanism to buffer the fixed acid load imposed by the ingestion of an "acid ash" diet in man.
The role of nutritional influences on bone health remains largely undefined because most studies have focused attention on calcium intake.
We reported previously that intakes of nutrients found in abundance in fruit and vegetables are positively associated with bone health. We examined this finding further by considering axial and peripheral bone mass and markers of bone metabolism.
This was a cross-sectional study of 62 healthy women aged 45-55 y. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry at the lumbar spine and femoral neck and by peripheral quantitative computed tomography at the ultradistal radial total, trabecular, and cortical sites. Bone resorption was calculated by measuring urinary excretion of pyridinoline and deoxypyridinoline and bone formation by measuring serum osteocalcin. Nutrient intakes were assessed by using a validated food-frequency questionnaire; other lifestyle factors were assessed by additional questions.
After present energy intake was controlled for, higher intakes of magnesium, potassium, and alcohol were associated with higher total bone mass by Pearson correlation (P < 0.05 to P < 0.005). Femoral neck BMD was higher in women who had consumed high amounts of fruit in their childhood than in women who had consumed medium or low amounts (P < 0.01). In a regression analysis with age, weight, height, menstrual status, and dietary intake entered into the model, magnesium intake accounted for 12.3% of the variation in pyridinoline excretion and 12% of the variation in deoxypyridinoline excretion. Alcohol and potassium intakes accounted for 18.1% of the variation in total forearm bone mass.
The BMD results confirm our previous work (but at peripheral bone mass sites), and our findings associating bone resorption with dietary factors provide further evidence of a positive link between fruit and vegetable consumption and bone health.