Dietary intake of Brazilian black and white men and its relationship to the bone mineral density of the femoral neck
Heliópolis Hospital and Faculdade de Saúde Pública da Universidade de São Paulo, São Paulo, Brazil
INTRODUCTIONOsteoporosis is an important public health problem because of the significant morbidity and mortality associated with bone fractures and the high cost of treatment.
1Osteoporosis and fragility fractures in men constitute a considerable health care burden. The risk of fracture is directly associated with bone mineral density (BMD).3 Bone loss is expected with age, 4,5 and it dramatically increases the incidence of hip and vertebral fractures in both men and women. 6 The frequency of occurrence of bone fractures in South America is lower than in other regions of the world; however, it is possible that this problem is becoming intensifi ed due to the increasing life expectancy of the population on this continent.
7Although bone loss occurs with age for everybody, the incidence of bone loss fractures varies greatly between racial groups. 8 Higher bone mass has been observed in black individuals than in white individuals. 9,10 Calcium intake is a signifi cant determinant of BMD. In countries with high osteoporotic fracture incidence, low calcium intake among older men and women is associated with increased fracture risk.11 On the other hand, inadequate protein intake, when too high or too low, increases the risk of osteoporotic fractures. 6,11 Low body weight is related to bone mass decline and to increased risk of osteoporotic fractures. 12 It should be noted that the majority of studies on dietary intake, bone mass and osteoporosis have been carried out in developed countries, where the population's lifestyle and food consumption are very different from those of developing nations. Moreover, although it is known that there are important differences in bone mineral density between black and non-black individuals, the study of dietary intake differences in racial groups has received little attention.
OBJECTIVEThe aim of the present study was to determine the relationship between calcium, protein and energy intake and the bone mineral density of the femoral neck (FNBMD) in Brazilian men aged 50 years and older, comparing black and white individuals.
METHODS
Population PopulationThis was a cross-sectional study involving volunteer men. From February to August 1997, we recruited 307 healthy male subjects aged 50 years or older, all resident in the city of São Paulo (southeastern Brazil). They were men whose wives had been referred by their primary care physicians for a bone densitometry scan, or who had responded to a newspaper advertisement.We excluded from the study men using any kind of medication or having medical conditions that could affect bone metabolism: there was one individual with cancer of the colon, one with multiple myeloma, one with hyperthyroidism and one with rheumatoid arthritis. Twenty-two individuals were excluded due to the lack of bone densitometry data and 25 individuals w...