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The Association between Changes in Food and Nutrient Intakes and Changes in Bone Metabolic Indicators in Postmenopausal Women with Osteopenia after a 12-week Intervention of Nutrition Education and Aerobic Exercise


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The Association between Changes in Food and Nutrient Intakes and Changes in Bone Metabolic Indicators in Postmenopausal Women with Osteopenia after a 12-week Intervention of Nutrition Education and Aerobic Exercise

Article information

Korean J Community Nutr. 2013;18(3):213-222
Publication date (electronic) : 2013 June 30
doi : https://doi.org/10.5720/kjcn.2013.18.3.213
Seo-Jin Kim, Suh-Jung Kang1, Yoon Jung Park2, Ji-Yun Hwang3
Department of Foodservice Management and Nutrition, Sangmyung University, Seoul, Korea.
1Department of Sports Science, Sangmyung University, Seoul, Korea.
2Department of Nutrition Science and Food Management, Ewha Womans University, Seoul, Korea.
3Nutrition Education Major, Graduate School of Education, Sangmyung University, Seoul, Korea.
Corresponding author: Ji-Yun Hwang, Nutrition Education Major, Graduate School of Education, Sangmyung University, 7 Hongji-dong, Jongno-gu, Seoul 110-743, Korea. Tel: (02) 781-7521, Fax: (02) 2287-0104, jiyunhk@smu.ac.kr
Received 2013 January 18; Revised 2013 April 11; Accepted 2013 May 20.

Abstract

Few studies investigated the effects of nutrition education and exercises in women with osteopenia. This study examined the relationship between changes in dietary intakes and changes in indicators related to bone health in postmenopausal women with osteopenia (-2.5 ≤ T-score ≤ 1) after a 12-week intervention. Thirty-one postmenopausal women aged > 50 years residing in Seoul were recruited and participated in nutritional education regarding bone health and general nutrition practices and aerobic exercises (three times a week; 60 min per session). Twenty-five subjects completed the study and were eligible for the analysis. Bone mineral density (BMD) at femoral neck was measured by dual energy x-ray absorptiometry. Serum calcium, osteocalcin, and intact parathyroid hormone (PTH) were also measured. Dietary intake was estimated by using a one-day 24 recall by a clinical dietitian. After 12 weeks, meat consumption increased (P = 0.028) but vegetable intake decreased (P = 0.005). Intakes of animal protein (P = 0.024), vitamin B1 (P = 0.012) and vitamin B2 (P = 0.047) increased, and sodium intake decreased (P = 0.033). Intact PTH (P = 0.002) decreased and osteocalcin (P = 0.000) increased, however, BMD decreased (P = 0.000). Changes in mushroom consumption were positively correlated with femoral neck BMD (r = 0.673, P = 0.003). Changes in animal iron intake were negatively correlated with intact PTH (r = -0.488, P = 0.013) but were positively correlated with osteocalcin (r = 0.541, P = 0.005). These results suggested that the association between animal iron intake and biochemical markers of bone turnover may play an important role in bone metabolism. Further studies are needed to shed light on complicated mechanisms of diet, hormonal levels of bone metabolism, and bone density.

Keywords: bone health; intervention; iron intake; nutrition education; hormone

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Copyright © 2013 The Korean Society of Community Nutrition

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Table 1

Nutrition education program for bone health

Table 1

Table 2

Age and anthropometrics, indicators related to bone mineral density (BMD), and dietary behaviors related to bone health from baseline to follow-up in subjects with osteopenia (n = 25)

Table 2

1) Dietary quality was assessed by Mini Dietary Assessment (Oh et al. 2007)

Table 3

Food group intake from baseline to follow-up in subjects with osteopenia (n = 25)

Table 3

Table 4

Nutrient intake from baseline to follow-up in subjects with osteopenia (n = 25)

Table 4

1) The proportion of subject whose intake was less than the Korean estimated energy requirements for females in her age (Korean Nutrition Society 2010).

2) The proportion of subject whose intake of both animal and plant sources was less than the Korean estimated average requirements for females in her age (Korean Nutrition Society 2010).

3) The proportion of subject whose intake was less than the Korean estimated average requirements for females in her age (Korean Nutrition Society 2010).

1),2),3) Statistical tests to examine differences in frequencies before and after intervention were not conducted (expected frequencies < 5)

Table 5

Correlation between food group intakes change and change of indicators related to bone mineral density(BMD) (n = 25)

Table 5

1) Data were available for 21 subjects.

Table 6

Correlation between nutrient intakes change and change of indicators related to bone mineral density(BMD)

Table 6

1) Data were available for 21 subjects.