Diets High in Fiber and Vegetable Protein Are Associated with Low Lumbar Bone Mineral Density in Young Athletes with Oligoamenorrhea

Abstract

Background Associations of bone mineral density (BMD) with specific food components, including dietary fiber and isoflavones (that have a negative association with serum estrogen), are unclear and need to be determined, particularly in a population more likely to consume large amounts of these nutrients (such as young athletes). Objective To determine dietary intake of specific food components in oligo-amenorrheic athletes (OA) compared to eumenorrheic athletes (EA) and non-athletes (NA), and associations of the dietary intake of these nutrients with lumbar spine BMD. Design and Subjects This cross-sectional study evaluated 68 OA, 24 EA, and 26 NA 14–23 years old. Measurements included four-day food records (assessed using Nutrient Data System for Research software), a DXA scan evaluating lumbar spine BMD and body composition, and hormone levels. Multivariate analysis was used to estimate associations of nutrients with lumbar spine BMD. Results Compared with EA and NA, OA had higher intake of fiber, phytic acid, and vegetable protein (p<0.0001 for all). Intake of isoflavones, genistein and daidzein, was higher in OA than NA (p=0.003 and 0.0002 respectively). OA had lower consumption of energy from saturated fatty acids (%SFA) than NA (p=0.002). After controlling for confounders such as body weight, menstrual status (indicative of estrogen status), calcium intake, and serum vitamin D (known BMD determinants), lumbar spine BMD Z-scores were inversely associated with dietary fiber [β coefficient (β)= −0.30; p=0.01], vegetable protein (β = −0.28, p=0.02), phytic acid (β = −0.27, p=0.02), genistein (β = −0.25, p=0.01), and daidzein (β = −0.24, p=0.01), and positively with %SFA (β =0.32, p=0.0006)]. Conclusions Compared to EA and NA, OA had a higher dietary intake of fiber, vegetable protein and phytic acid, which were inversely associated with lumbar spine BMD Z-scores. Further studies are needed to assess dietary recommendations for OA to optimize bone accrual.

Bone microarchitecture in adolescent boys with autism spectrum disorder

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Evidence of a cumulative effect for risk factors predicting low bone mass among male adolescent athletes

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Peripheral skeleton bone strength is positively correlated with total and dairy protein intakes in healthy postmenopausal women

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