Fruit and vegetable intake and bone health in women aged 45 years and over: a systematic review

Hamidi, Maryam; Boucher, Beatrice A.; Cheung, Angela M.; Beyene, Joseph; Shah, Parita

doi:10.1007/s00198-010-1510-0

Cited by 54 publications

(39 citation statements)

References 52 publications

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“…We found associations between BMD of the hip and spine and several flavonoid subclasses that were of greater magnitude than have been found previously in studies of fruits and vegetables and their components. (2) These data support a role for flavonoids present in plant-based foods on bone health. Our study therefore provides an important evidence base to further investigate the relative impact of flavonoid subclasses, specifically the anthocyanins and flavonols, on bone health.…”

Section: Discussionmentioning

confidence: 66%

“…(2,(35)(36)(37)(38)(39)(40) Of those which did find a positive association, the magnitude of effect ranged between 0.3% per serving of fruit and vegetables to 2.2% per 100 g fruit and vegetables…”

Section: Discussionmentioning

confidence: 99%

“…(1) Dietary intake plays a key role in the maintenance of bone health throughout life, and there are data illustrating the importance of plant-based foods, particularly in relation to fruit and vegetable intake, although the results from published studies have been inconsistent. (2) However, the key constituents that may impact on bone mineral density (BMD) are unclear and limited research to date has focused on flavonoids. These occur naturally in plant-based foods and are present in measurable amounts in many commonly consumed fruits, vegetables, grains, herbs, and drinks (including tea, wine, and juices).…”

Section: Introductionmentioning

confidence: 99%

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Habitual flavonoid intakes are positively associated with bone mineral density in women

Welch

Macgregor

Jennings

et al. 2012

Journal of Bone and Mineral Research

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Dietary flavonoids exert bone-protective effects in animal models, but there is limited information on the effect of different flavonoid subclasses on bone health in humans. The aim of this observational study was to examine the association between habitual intake of flavonoid subclasses with bone mineral density (BMD) in a cohort of female twins. A total of 3160 women from the TwinsUK adult twin registry participated in the study. Habitual intakes of flavonoids and subclasses (flavanones, anthocyanins, flavan-3-ols, polymers, flavonols, and flavones) were calculated from semiquantitative food frequency questionnaires using an updated and extended U.S. Department of Agriculture (USDA) database. Bone density was measured using dual-energy X-ray absorptiometry. In multivariate analyses, total flavonoid intake was positively associated with higher BMD at the spine but not at the hip. For the subclasses, the magnitude of effect was greatest for anthocyanins, with a 0.034 g/cm 2 (3.4%) and 0.029 g/cm 2 (3.1%) higher BMD at the spine and hip, respectively, for women in the highest intake quintile compared to those in the lowest. Participants in the top quintile of flavone intake had a higher BMD at both sites; 0.021 g/cm 2 (spine) and 0.026 g/cm 2 (hip). At the spine, a greater intake of flavonols and polymers was associated with a higher BMD (0.021 and 0.024 g/cm 2 , respectively), whereas a higher flavanone intake was positively associated with hip BMD (0.008 g/cm 2 ). In conclusion, total flavonoid intake was positively associated with BMD, with effects observed for anthocyanins and flavones at both the hip and spine, supporting a role for flavonoids present in plant-based foods on bone health. ß

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Habitual flavonoid intakes are positively associated with bone mineral density in women

Welch

Macgregor

Jennings

et al. 2012

Journal of Bone and Mineral Research

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“…The association between fruit intake and risk of fractures has scarcely been assessed 269 independently of that of vegetables, which were not associated with the risk of fractures in the present 270 study [27]. A higher fruit consumption was not associated with a significant reduced risk of hip 271 fractures, in the overall sample, in analyses mutually adjusted for the food groups composing the 272 MeDi score in different reports from the EPIC cohort [16] [28], suggesting that the relationship 273 between fruit intake and risk of hip fracture remains questionable.…”

mentioning

confidence: 71%

“…A higher fruit consumption was not associated with a significant reduced risk of hip 271 fractures, in the overall sample, in analyses mutually adjusted for the food groups composing the 272 MeDi score in different reports from the EPIC cohort [16] [28], suggesting that the relationship 273 between fruit intake and risk of hip fracture remains questionable. The potential benefit of fruits and 274 vegetables is based on their ability to emphasize alkaline status, therefore counterbalancing the acidic 275 load that might lead to osteoporosis [27,29]; however, conflicting results have also been reported [30].…”

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confidence: 99%

Adherence to a Mediterranean diet and risk of fractures in French older persons

et al. 2013

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Plant Foods and Health

Buttriss

2012

Phytonutrients

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Table 1.2 Categorisation of plant derived foods and drinks Group Examples Fruits Tree Fruits Apples, pears, plums, apricots, peaches, cherries, citrus fruit, dates, pineapple, mango, papaya, fig, olive Soft fruits Strawberries, raspberries, blackberries, cranberries, currants Other Melons, grapes, kiwi, bananas Vegetables Root crops* Potatoes, sweet potatoes, yam, cassava Carrots, turnips, swedes, parsnips Cabbage family Cabbage, broccoli, Brussels sprouts Onion family Onions, leeks, garlic Salad vegetables Lettuce, celery, cucumbers Tomato family Tomatoes, sweet peppers, chilli peppers, aubergine Mushrooms and fungi Mushroom varieties, Quorn™ Other Squashes, sprouted seeds, sea vegetables Cereals (grains) Wheat, barley, maize (corn), millet, oats, rice, rye Tree nuts and seeds Walnuts, cashews, almonds, chestnuts, pecans, brazils, hazelnuts, pistachio, pine kernels, sesame seeds, pumpkin seeds Pulses (legumes) Soya beans and products e.g. tofu, red kidney beans, butter beans, chick peas, lentils, peanuts (groundnuts) Beverages Tea, coffee, cocoa, wine, spirits, beer Oils Seed oils e.g. sunflower oil, corn oil, rapeseed oil, linseed oil; olive oil, soya oil, peanut oil; evening primrose oil, borage oil Other Chocolate Herbs, spices, condiments Sage, rosemary, thyme, ginger, pepper, cumin, mustard, tomato-based sauces *Potato, sweet potato and yam are classified as starchy foods, rather than vegetables, in many food guidance models. From Buttriss 2003.

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Fruit and vegetable intake and bone health in women aged 45 years and over: a systematic review

Abstract: Based on limited evidence, the benefits of F&V on bone health remain unclear for women aged ≥ 45 years. Further studies with low risk of bias are needed.

Cited by 54 publications

References 52 publications

Habitual flavonoid intakes are positively associated with bone mineral density in women

Habitual flavonoid intakes are positively associated with bone mineral density in women

Adherence to a Mediterranean diet and risk of fractures in French older persons

Plant Foods and Health

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