Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
Cork Center for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences.
Am J Clin Nutr. 2018 Sep 1;108(3):633-640. doi: 10.1093/ajcn/nqy122.
The Mediterranean diet (MD) is widely recommended for the prevention of chronic disease, but evidence for a beneficial effect on bone health is lacking.
The aim of this study was to examine the effect of a Mediterranean-like dietary pattern [NU-AGE (New Dietary Strategies Addressing the Specific Needs of the Elderly Population for Healthy Aging in Europe)] on indexes of inflammation with a number of secondary endpoints, including bone mineral density (BMD) and biomarkers of bone and collagen degradation in a 1-y multicenter randomized controlled trial (RCT; NU-AGE) in elderly Europeans.
An RCT was undertaken across 5 European centers. Subjects in the intervention group consumed the NU-AGE diet for 1 y by receiving individually tailored dietary advice, coupled with supplies of foods including whole-grain pasta, olive oil, and a vitamin D3 supplement (10 µg/d). Participants in the control group were provided with leaflets on healthy eating available in their country.
A total of 1294 participants (mean ± SD age: 70.9 ±4.0 y; 44% male) were recruited to the study and 1142 completed the 1-y trial. The Mediterranean-like dietary pattern had no effect on BMD (site-specific or whole-body); the inclusion of compliance to the intervention in the statistical model did not change the findings. There was also no effect of the intervention on the urinary biomarkers free pyridinoline or free deoxypyridinoline. Serum 25-hydroxyvitamin D significantly increased and parathyroid hormone decreased (P < 0.001) in the MD compared with the control group. Subgroup analysis of individuals with osteoporosis at baseline (site-specific BMD T-score ≤ -2.5 SDs) showed that the MD attenuated the expected decline in femoral neck BMD (n = 24 and 30 in MD and control groups, respectively; P = 0.04) but had no effect on lumbar spine or whole-body BMD.
A 1-y intervention of the Mediterranean-like diet together with vitamin D3 supplements (10 µg/d) had no effect on BMD in the normal age-related range, but it significantly reduced the rate of loss of bone at the femoral neck in individuals with osteoporosis. The NU-AGE trial is registered at clinicaltrials.gov as NCT01754012.
地中海饮食（MD）被广泛推荐用于预防慢性病，但关于其对骨骼健康有益的证据尚缺乏。
本研究旨在通过一项为期 1 年的多中心随机对照试验（RCT；NU-AGE），观察类似地中海饮食模式（NU-AGE[新的饮食策略应对欧洲老年人健康老龄化的特殊需求]）对炎症指标的影响，并探讨其多个次要终点，包括骨密度（BMD）和骨与胶原降解的生物标志物，以此研究欧洲老年人的骨骼健康。
在欧洲的 5 个中心开展了一项 RCT。干预组通过接受个性化的饮食建议以及提供包括全麦意大利面、橄榄油和 10μg/d 维生素 D3 补充剂在内的食物，食用 NU-AGE 饮食 1 年。对照组则提供本国的健康饮食小册子。
共有 1294 名（平均年龄±标准差：70.9±4.0 岁；44%为男性）参与者被招募到研究中，1142 名完成了 1 年的试验。类似地中海的饮食模式对 BMD（特定部位或全身）没有影响；将对干预的依从性纳入统计模型并没有改变研究结果。该干预措施也没有影响尿游离吡啶啉或游离脱氧吡啶啉的生物标志物。与对照组相比，MD 组的血清 25-羟维生素 D 显著增加，甲状旁腺激素降低（P<0.001）。对基线时患有骨质疏松症的个体（特定部位 BMD T 评分≤-2.5 个标准差）进行亚组分析显示，MD 可减轻股骨颈 BMD 的预期下降（MD 组 n=24，对照组 n=30；P=0.04），但对腰椎或全身 BMD 没有影响。
为期 1 年的类似地中海饮食与维生素 D3 补充剂（10μg/d）联合干预对正常年龄相关范围内的 BMD 没有影响，但可显著降低骨质疏松症患者股骨颈骨丢失的速度。NU-AGE 试验在 clinicaltrials.gov 注册为 NCT01754012。
