Korean Journal of Community Nutrition

Research Article

[English]
Association between dietary intake, body measurements, and urinary bone resorption markers in young adults with osteopenia and osteoporosis: a cross-sectional study: Mi-Hyun Kim, Mi-Kyeong Choi; Korean J Community Nutr 2023;28(4):282-292. Published online August 31, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.4.282

Abstract PDF: Objectives
Bone health in early adulthood, as individuals approach peak bone mass, plays a critical role in preventing osteoporosis later in life. This study aimed to investigate the associations between lifestyle and dietary factors, anthropometric measurements, and urinary bone resorption markers in young adults.
Methods
A cross-sectional study was conducted with 100 healthy Korean adults (50 men and 50 women) in their 20s and early 30s. Bone mineral density (BMD), anthropometric measurements, dietary intake (24-hour recall), and urinary bone resorption indicators (deoxypyridinoline and N-terminal telopeptide of type I collagen) were analyzed. Variables were compared between the osteopenia and osteoporosis groups (OSTEO group: 30% men and 60% women) and the healthy control group.
Results
Men in the OSTEO group were significantly taller than those in the control group (P < 0.05). Women in the OSTEO group had significantly lower body weight and body composition (muscle and body fat) than those in the normal group (P< 0.01). Men in the OSTEO group had a significantly higher intake of animal calcium (Ca) than those in the normal group (P < 0.05). Women in the OSTEO group had significantly higher dietary fiber, vitamin A, Ca, plant Ca, and potassium intake than did those in the normal group (P < 0.05). There were no significant differences in caffeinated beverage consumption, eating habits, or urinary bone resorption indicators between the OSTEO and control groups of either sex.
Conclusions
In our study of young South Korean adults, we observed low bone density levels, with particularly low BMD in taller men and underweight women. We found a higher nutrient intake in the OSTEO group, indicating the possibility of reverse causality, a phenomenon often found in cross-sectional studies. Therefore, there is a need to further elucidate dietary factors related to osteoporosis in young adults through prospective cohort studies involving a larger population.

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Original Articles

[English]
Factors Associated with Bone Mineral Density in Korean Postmenopausal Women Aged 50 Years and Above: Using 2008-2010 Korean National Health and Nutrition Examination Survey: Son Ok Mun, Jihye Kim, Yoon Jung Yang; Korean J Community Nutr 2013;18(2):177-186. Published online April 30, 2013; DOI: https://doi.org/10.5720/kjcn.2013.18.2.177

The purpose of this study was to investigate factors associated with Bone Mineral Density (BMD) in Korean postmenopausal women. The data from 2008-2010 Korean National Health and Nutrition Examination Survey (KNHANES) were used for data analysis. Subjects were 2,701 postmenopausal women aged > or = 50 years. BMDs at whole body, total femur, femoral neck, and lumbar spine were measured by Dual-energy X-ray absorptiometry (DXA). Dietary data from 24-hour dietary recall and a food frequency questionnaire containing 63 food items were used. The proportions of osteopenia at total femur, femoral neck, and lumbar spine were 37.4%, 54.5%, and 45.4%, respectively. The proportions of osteoporosis at total femur, femoral neck, and lumbar spine were 6.2%, 25.6%, and 34.3%, respectively. Age, anthropometric index including height, weight, and Body Mass Index (BMI), parathyroid hormone, and physical activity were related to BMD, but the relationships were site specific. Total femur BMD was explained by age, weight, parathyroid hormone and intakes of carbohydrate and fruits. Femoral neck BMD was related to age, weight, parathyroid hormone and intakes of riboflavin and fruits. Lumbar spine BMD was associated with age, weight, milk and dairy products, calcium intake, and exercise. These results indicated that adequate intakes of milk and dairy products, fruits, carbohydrate, calcium, riboflavin and exercise as well as weight maintenance might play an important role in maintaining optimum bone health in Korean postmenopausal women.

Citations

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[English]
Study of Bone Mineral Density, Body Composition and Dietary Habits of 20~30 Years Women: Jae Ok Koo, Hong Seok Ahn, Sook Young Yoo; Korean J Community Nutr 2008;13(4):489-498. Published online August 31, 2008

Abstract PDF: This study was carried out to identify bone mineral density (BMD), body composition, lifestyle and dietary habits of young women by physical measurement and questionnaires. The study subjects, 190 young women living in Seoul, were divided into three age groups: 20 ~ 24 years (93), 25 ~ 29 years (44) and 30 ~ 39 years (53). There was no significant difference in mean body muscle mass, protein, mineral, body fat and BMI among the three age groups. The rate of low weight (18%) in 20 years group was higher that of the 30 years (11.3%). The mean BMD and T-score were 0.44 g/cm2 and -0.66. BMD and T-score of the forearm bone were significantly higher in the 30 ~ 39 years group. But BMD and T-score of calcanues were not significantly different among the three age groups. The rate of normal, osteopenia and osteoporosis subjects by BMD were 60.5%, 38.4%, 1.1%, respectively. The rate of osteopenia in 20 ~ 24 years group was significantly higher than the other age groups. The rate of meal irregularity was significantly higher in 20 ~ 24 years group. The rate of women who walk and are exposed to sunlight more than 1hr per day were significantly higher in 20~24 years group than the others. However, the score of food behaviors is significantly higher (bad) in 20 ~ 24 years group than the others. The relationship between BMD and frequency of food intake showed significant differences in beans, broom, seaweed and rice wine. In conclusion, the risk rate of BMD was very high, 40% of the subjects, and the risk rate of BMD was higher in 20 years group than 30 years group, and the rate of low weight in 20 years group was higher than in 30 years group. The food habits and behaviors were not healthy enough. Therefore, nutrition education is needed for bone health.

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[English]
The Association of Dietary Patterns with Bone Mineral Density in Middle-aged Women: A Cohort of Korean Genome Epidemiology Study: Seon Joo Park, Younjhin Ahn, Hyo Mi Kim, Seong Eun Joo, Kyung Soo Oh, Chan Park; Korean J Community Nutr 2007;12(3):352-360. Published online June 30, 2007

Abstract PDF: Several nutrients are known to affect bone mineral density (BMD). However, these nutrients are combined with food intake and dietary patterns and little is known about the association of dietary patterns and BMD. The objective of this study was to investigate the association of dietary patterns with BMD in Korea Genome Epidemiology Study subjects. Among 2,884 women (40-69 yr) recruited at baseline study (2001), 861 subjects with BMD measurements at baseline and a 4-year follow up study (2005) completed the semi-quantitative food frequency questionnaire. BMD was measured by the Quantitative Ultrasound method. One hundred three food items were combined into 17 food groups and 4 dietary patterns were identified by factor analysis. Cluster analysis using factor score classified each subject into one of three dietary pattern groups named 'Rice and kimchi eating' (n = 617), 'Contented eating' (n = 124), and 'Healthy and light eating' (n = 120). The 'Healthy and light eating' group, characterized by higher intake of fruit, vegetables, fish, milk and dairy products, and younger age, more exercise, higher education, and higher income than other groups. The tibia BMD of the 'Healthy and light eating' group was higher than the other groups after adjusting for the age. After the adjustment for the age BMI and exercise, the 'Healthy and light eating' group showed significantly lower odds of tibia osteopenia/osteoporosis risk compared to the 'Rice and kimchi eating' group both at the baseline [OR(95% CI) : 0.50(0.30-0.84)] and follow-up [OR(95% CI) : 0.59(0.36-0.97)] examinations. The dietary pattern with low calorie and high intakes of fruit, vegetables, fish, milk and dairy products may have beneficial effects on BMD in middle-aged women.

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[English]
A Study of Nutrient Intake and Serum Levels of Osteocalcin, Ca, P, and Mg and Their Correlation to Bone Mineral Density in Korean Postmenopausal Women Residing in Rural Areas: Chung Ja Sung, Yun Hee Choi, Mi Hyun Kim, Sun Hae Choi, Kyung Ok Cho; Korean J Community Nutr 2002;7(1):111-120. Published online February 28, 2002

Abstract PDF: Postmenopausal women lose more bone mass than men as a result of estrogen deprivation. The resultant low bone mineral density (BMD) is a major risk factor in the development of osteoporosis. Calcium, phosphorus and magnesium are main components of bone. The purpose of this study is to investigate nutrient intake and serum osteocalcin, Ca, P and Mg and their correlation to bone mineral density in Korean postmenopausal women residing in rural areas. We conducted 24 hour dietary recalls, anthropometric measurements and blood analysis on 60 postmenopausal women. The BMD of the lumbar spine (L2-->L4) and the femoral neck were measured by dual energy X-ray absorptiometry (DEXA). Subjects were assigned to one of three groups:normal (T-score> -1, n=20), osteopenia (-2.5> T-score< or = -1, n=23), and osteoporosis ( T-score< or = -2.5, n=17). The mean age, height, weight and BMI were 62.37 yr, 154.36 cm, 55.28 kg and 23.18 kg/m2 respectively. The mean daily energy and protein intakes were 76.35% and 87.41% of RDA for Koreans. The mean intakes of calcium, phosphorus, and magnesium were 463.62 mg (66.23% of RDA), 955.32 mg (136.47% of RDA), 345.87 mg respectively. The mean serum levels of calcium, phosphorus and magnesium were 8.76 mg/dl, 3.80 mg/dl, and 2.10 mg/dl, respectively, and there were no significant differences among the three groups. However, the BMD of the femoral neck showed a significantly negative correlation with serum magnesium (p<0.05). To summarize the results, most nutrient intakes (especially calcium) in postmenopausal women did not reach the RDA values for Koreans. Also, increase of serum magnesium levels may be related to bone loss.

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