Effects of Lemon Beverages on Bone Metabolism and Bone Mineral Density in Postmenopausal Women: A Double-Blind, Controlled Intervention Study with Ca-Supplemented and Unsupplemented Lemon Beverages

Abstract

The aim of the present study was to elucidate how bone metabolism and bone mineral density are affected by the consumption of a lemon juice-containing calcium (Ca)-enriched beverage. The efficacy of this investigational product was evaluated in postmenopausal women during five months of continuous intake (intervention). This was a randomized, controlled trial. Eighty-three subjects were assigned to three groups. Using a double-blind format, the first two groups received a Ca-supplemented lemon-juice (lemon) beverage (LECA) or a Ca-unsupplemented lemon-juice (lemon) beverage (LE). The third group (control) received no intervention. Each subject in the LECA and LE groups consumed one bottle (290 mL) of their assigned investigational product every day for five consecutive months. After five months of intervention, the gain in bone mineral density at the lumbar spine was significantly larger in the LECA and LE groups than in the control group. In the femur, subjects in the LECA group gained significantly more bone mineral density than the control subjects. The largest gain in bone mineral density at the lumbar spine was observed in the LECA group. As for the concentrations of the bone resorption marker tartrate-resistant acid phosphatase 5b (TRACP-5b), subjects in the LECA group had significantly lower values than those in the control group.

Effects of Lemon Beverage Containing Citric Acid with Calcium Supplementation on Bone Metabolism and Mineral Density in Postmenopausal Women: Double-Blind 11-Month Intervention Study

“…e sample size was determined according to the 6-month difference regarding bone mineral density in the lumbar spine using G-power. Based on the results of a prior study conducted by Ikeda et al [9] on the relationship between an LECA group and control group and after considering M1 � 0.021 (mean BMD of 6 months, difference in the control group), SD 1 � 0.020, M2 � -0.027 (mean BMD of 6 months difference in the LECA group), SD2 � 0.041, two-sided α � 0.05, and power � 95%, the minimum number of subjects per group was determined to be 15, which was increased to 23 (minimum sample size of the control group) to take account for potential attrition, making the total sample size 79. us, 79 individuals who participated in all medical examinations conducted at the start of the trial prior to consuming a test beverage, as well as 5 and 11 months after starting consumption ingestion, were subjected to analysis. e subjects included those who had not been diagnosed with osteoporosis but were at a level indicating such a diagnosis.…”

“…Informed written consent was obtained from 100 volunteers. e present study was conducted as a randomized control trial using methods previously reported by Hua et al in 2018 [7,9]. e subjects were given individual ID numbers to assure anonymity.…”

“…We previously conducted a 5-month interventional trial using lemon beverages containing approximately 1.5 g of citric acid in each bottle (290 mL), with that consumed by the experimental group supplemented with 350 mg Ca, which were consumed by postmenopausal women under a double-blind protocol [9].…”

Effect of a Calcium-Enriched Lemon Beverage on Bone Metabolism and Bone Mineral Density in Postmenopausal Women: A Double-Blind, 11-Month, Intervention Study

“…Previously, our group examined the effectiveness of a Ca-supplemented lemon beverage for the prevention of osteoporosis in postmenopausal women who had regularly consumed the beverage for five months [18].…”

“…Despite these limitations, unprecedented results were obtained from this clinical research, which was conducted with subjects who consumed a Ca-supplemented investigational product, while otherwise leading their normal lives. In our previous study [18], in which the effects of the same investigational products were assessed after five months of intervention, we proposed a hypothesis that citric acid in lemons increases the absorption of 4 bone alkaline phosphatase 5 standard deviation 6 They received an unsupplemented lemon beverage. 7 They received a lemon beverage supplemented with Ca.…”