Ward Kate A, Prentice Ann, Kuh Diana L, Adams Judith E, Ambrosini Gina L
MRC Human Nutrition Research, Cambridge, UK.
MRC Unit for Lifelong Healthy Ageing at University College London, London, UK.
J Bone Miner Res. 2016 Jun;31(6):1167-76. doi: 10.1002/jbmr.2798. Epub 2016 Mar 8.
Evidence for the contribution of individual foods and nutrients to bone health is weak. Few studies have considered hypothesis-based dietary patterns and bone health. We investigated whether a protein-calcium-potassium-rich (PrCaK-rich) dietary pattern over the adult life course, was positively associated with bone outcomes at 60 to 64 years of age. Diet diaries were collected at ages 36, 46, 53, and 60 to 64 years in 1263 participants (661 women) from the MRC National Survey of Health and Development. DXA and pQCT measurements were obtained at age 60 to 64 years, including size-adjusted bone mineral content (SA-BMC) and volumetric bone mineral density (vBMD). A food-based dietary pattern best explaining dietary calcium, potassium, and protein intakes (g/1000 kcal) was identified using reduced rank regression. Dietary pattern Z-scores were calculated for each individual, at each time point. Individual trajectories in dietary pattern Z-scores were modeled to summarize changes in Z-scores over the study period. Regression models examined associations between these trajectories and bone outcomes at age 60 to 64 years, adjusting for baseline dietary pattern Z-score and other confounders. A consistent PrCaK-rich dietary pattern was identified within the population, over time. Mean ± SD dietary pattern Z-scores at age 36 years and age 60 to 64 years were -0.32 ± 0.97 and 2.2 ± 1.5 (women) and -0.35 ± 0.98 and 1.7 ± 1.6 (men), respectively. Mean trajectory in dietary pattern Z-scores ± SD was 0.07 ± 0.02 units/year. Among women, a 0.02-SD unit/year higher trajectory in dietary pattern Z-score over time was associated with higher SA-BMC (spine 1.40% [95% CI, 0.30 to 2.51]; hip 1.35% [95% CI, 0.48 to 2.23]), and vBMD (radius 1.81% [95% CI, 0.13 to 3.50]) at age 60 to 64 years. No statistically significant associations were found in men. During adulthood, an increasing score for a dietary pattern rich in protein, calcium, and potassium was associated with greater SA-BMC at fracture-prone sites in women. This study emphasizes the importance of these nutrients, within the context of the whole diet, to bone health. © 2016 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research (ASBMR).
关于单一食物和营养素对骨骼健康影响的证据尚不充分。很少有研究探讨基于假设的饮食模式与骨骼健康之间的关系。我们调查了在成年期保持富含蛋白质、钙和钾（PrCaK丰富）的饮食模式是否与60至64岁时的骨骼健康状况呈正相关。在医学研究委员会全国健康与发展调查中，对1263名参与者（661名女性）在36岁、46岁、53岁以及60至64岁时收集饮食日记。在60至64岁时进行双能X线吸收法（DXA）和外周定量CT（pQCT）测量，包括经尺寸调整的骨矿物质含量（SA-BMC）和体积骨矿物质密度（vBMD）。使用降秩回归确定了最能解释饮食中钙、钾和蛋白质摄入量（克/1000千卡）的基于食物的饮食模式。在每个时间点为每个个体计算饮食模式Z分数。对饮食模式Z分数的个体轨迹进行建模，以总结研究期间Z分数的变化。回归模型检验了这些轨迹与60至64岁时骨骼健康状况之间的关联，并对基线饮食模式Z分数和其他混杂因素进行了调整。随着时间的推移，在人群中确定了一种一致的富含PrCaK的饮食模式。36岁以及60至64岁时饮食模式Z分数的均值±标准差，女性分别为-0.32±0.97和2.2±1.5，男性分别为-0.35±0.98和1.7±1.6。饮食模式Z分数的平均轨迹±标准差为0.07±0.02单位/年。在女性中，随着时间推移饮食模式Z分数轨迹每年高出0.02标准差单位与60至64岁时更高的SA-BMC（脊柱1.40%[95%CI，0.30至2.51]；髋部1.35%[95%CI，0.48至2.23]）以及vBMD（桡骨1.81%[95%CI，0.13至3.50]）相关。在男性中未发现统计学上的显著关联。在成年期，富含蛋白质、钙和钾的饮食模式得分增加与女性易骨折部位更高的SA-BMC相关。本研究强调了在整体饮食背景下这些营养素对骨骼健康的重要性。©2016作者。《骨与矿物质研究杂志》由威利期刊公司代表美国骨与矿物质研究学会（ASBMR）出版。
