Inverse association of carotenoid intakes with 4-year change in bone mineral density in elderly men and women: the Framingham Osteoporosis Study

Authors: SAHNI, SHIVANI - JM USDA HNRCA @ TUFTS; HANNAN, MARIAN - HEB SENLIFE: INST AGING; Blumberg, Jeffrey; CUPPLES, L ADRIENNE - BU SCH OF PUB HEALTH; KIEL, DOUGLAS - HEB SENLIFE: INST AGING; Tucker, Katherine

Submitted to: The American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/28/2008
Publication Date: 1/1/2009
Citation: Sahni, S., Hannan, M.T., Blumberg, J., Cupples, L., Kiel, D.P., Tucker, K. 2009. Inverse association of carotenoid intakes with 4-year change in bone mineral density in elderly men and women: the Framingham Osteoporosis Study. American Journal of Clinical Nutrition. 89:416-424.

Interpretive Summary: It has been estimated that almost 10 million Americans have osteoporosis, and low bone mass is a major public health threat for almost 44 million people in the US population aged 50 y and older. Studies have consistently shown that higher fruit and vegetable intake has positive effects on bone mineral status, and that fruit and vegetable specific antioxidants, such as carotenoids, may decrease oxidative stress arising from reactive oxygen intermediates that may be involved in the bone-resorptive process. Therefore, carotenoids might help in preventing osteoporosis. The aim of this study was to evaluate associations between intake of total carotenoids as well as individual carotenoids and changes in bone mineral density (BMD) at the hip, spine and radial shaft, in men and women participants in the Framingham Osteoporosis Study. Furthermore, we examined these associations for effect modification by smoking status as a previous study identified this as an important interaction. Although we observed few cross-sectional associations between carotenoid intakes and BMD, we observed several inverse associations between carotenoids and 4-y loss in BMD in men and of lycopene and bone loss at the lumbar spine in women. These results suggest a possible protective effect of carotenoids, particularly of lycopene against bone loss in older adults. It is therefore possible that carotenoids explain part of the previously observed protective effects of fruit and vegetable intake on BMD. More studies are needed to examine these associations in other populations.

Technical Abstract: In vitro and in vivo studies suggest that carotenoids may inhibit bone resorption and stimulate proliferation and differentiation of osteoblasts. Few studies have examined the association between carotenoid intake (other than beta-carotene) and bone mineral density (BMD). We evaluated associations between total and individual carotenoid intake (alpha-carotene, beta-carotene, beta-cryptoxanthin, lycopene, lutein+zeaxanthin) with BMD at the hip, spine and radial shaft, and 4-y change in BMD. Both cross-sectional and longitudinal analyses were conducted, in 334 men and 540 women (mean age, 75 +/- 5 y) in the Framingham Osteoporosis Study. Energy adjusted carotenoid intakes were estimated from the Willett food frequency questionnaire. Mean BMD and mean 4-y BMD changes were estimated, for men and women separately, by quartile of carotenoid intake adjusting for appropriate confounders. Few cross-sectional associations were observed with carotenoid intake. Associations between lycopene intake and 4-y change in lumbar spine BMD were significant for women (P trend= 0.03), and with intakes of total carotenoids, beta-carotene, lycopene and lutein+zeaxanthin at the trochanter in men (P trend=0.0005, 0.02, 0.009 and 0.008 respectively). Longitudinally, carotenoids showed protective associations against 4-y loss in trochanter BMD in men and in lumbar spine in women. No significant associations were observed at other bone sites among men or women. These results support a protective role of carotenoids for BMD in older men and women.