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ARS Home » Northeast Area » Beltsville, Maryland (BHNRC) » Beltsville Human Nutrition Research Center » Food Surveys Research Group » Research » Publications at this Location » Publication #353809
Title: Dietary mineral intake ratios and bone health in adults

Author
item LOBENE, ANDREA - Purdue University
item MCCABE, LINDA - Purdue University
item STONE, MICHAEL - Purdue University
item KINDLER, JOSEPH - Purdue University
item BAILEY, REGAN - Purdue University
item Moshfegh, Alanna
item Rhodes, Donna
item Goldman, Joseph
item MCCABE, GEORGE - Purdue University
item WEAVER, CONNIE - Purdue University

Submitted to: Nutrional Aspects of Osteoporosis
Publication Type: Book / Chapter
Publication Acceptance Date: 6/25/2018
Publication Date: 10/25/2018
Citation: Lobene, A.J., McCabe, L.D., Stone, M.S., Kindler, J.M., Bailey, R.L., Moshfegh, A.J., Rhodes, D.G., Goldman, J.D., McCabe, G.P., Weaver, C.M. 2018. Dietary mineral intake ratios and bone health in adults. In: Weaver C., Bischoff-Ferrari H., Daly R., Wong MS., editors. Nutritional Influences on Bone Health. Cham, Switzerland: Springer, Cham. p. 53-67. https://doi.org/10.1007/978-3-319-98464-3_6.
DOI: https://doi.org/10.1007/978-3-319-98464-3_6

Interpretive Summary: Fruit and vegetable consumption has consistently been identified as a favorable dietary strategy for bone health. Diets high in fruits and vegetables tend to be high in several minerals that are advantageous for bone health, including potassium, calcium, and magnesium, and low in sodium. The role of calcium in bone health has been well-characterized. However, there are few studies examining the link between potassium, magnesium, and sodium and bone. The aim of this study was to characterize the relationships between sodium, potassium, calcium and magnesium intake and fracture incidence in a representative sample of U.S. adults 40 years of age and over (n=2,617) from the National Health and Nutrition Examination Survey (NHANES) 2013-2014. A model for predicting bone outcomes was developed using the following explanatory variables: age, race, height, weight, and smoking status (yes/no). Body weight explained the largest proportion of the variance in assessed bone mineral density (BMD) and race explained the largest proportion of the variance in fracture incidence in both women (3%) and men (2%). Intake of sodium, potassium, calcium, and magnesium individually were positive predictors of assessed BMD in men, but not in women. In addition, mineral intake ratios were not predictive of assessed BMD, which may suggest that the minerals assessed have an effect on bone that is independent of their interaction with other minerals. In the future, controlled feeding studies should be conducted to determine the effect of consuming these minerals from food as well as the ratio of their intakes on bone outcomes. Such findings would have important implications for making dietary recommendations and designing dietary interventions for reducing fracture risk.

Technical Abstract: Fruit and vegetable consumption has consistently been identified as a favorable dietary strategy for bone health. Diets high in fruits and vegetables tend to be high in several minerals that are advantageous for bone health, including potassium, calcium, and magnesium, and low in sodium. The role of calcium in bone health has been well-characterized. However, there are few studies examining the link between potassium, magnesium, and sodium and bone. Moreover, characterizing the relationships between individual mineral intakes as well as their ratios and health outcomes is important due to their interactive effect of these minerals. Therefore, the aim of this study was to characterize the relationships between sodium, potassium, calcium and magnesium intake and their ratios and bone mineral density and fracture incidence in a representative sample of U.S. adults. We used data from The National Health and Nutrition Examination Survey (NHANES) 2013-2014 for these analyses. We included adult men and women >=40 years of age, who were not pregnant or lactating, with complete and plausible data (n=2,617). Diet was assessed using two 24-hour dietary recalls. Total femur and femoral neck areal bone mineral density (aBMD) was assessed using DXA, and fracture incidence after age 20 y was determined by self-report. A model for predicting bone outcomes was developed using the following explanatory variables: age, race, height, weight, and smoking status (yes/no). Relationships between individual mineral intakes and mineral intake ratios and bone outcomes were assessed by adding each of these terms to the basic regression model separately. Body weight explained the largest proportion of the variance in total femur aBMD (29% in women, 21% in men) and femoral neck aBMD (22% in women, 15% in men), and race explained the largest proportion of the variance in fracture incidence in both women (3%) and men (2%). Sodium, potassium, calcium, and magnesium intake were positive predictors of aBMD in men (all p < 0.05), but not in women. Mineral intake ratios were not predictive of aBMD, and individual minerals nor intake ratios were predictive of fracture incidence (all p > 0.05). Randomized, controlled, full-feeding studies are required to determine the effect of mineral consumption from food as well as the ratio of their intakes on bone outcomes. Such findings would have important implications for making dietary recommendations and designing dietary interventions for reducing fracture risk.