Depletion and repletion of fruit and vegetable intake alters serum bone turnover markers: a 28-week single-arm experimental feeding intervention

Authors: Cao, Jay; WHIGHAM, LEAH - The Paso Del Norte Institute For Healthy Living; Jahns, Lisa

Submitted to: British Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/29/2018
Publication Date: 7/19/2018
Citation: Cao, J.J., Whigham, L., Jahns, L.A. 2018. Depletion and repletion of fruit and vegetable intake alters serum bone turnover markers: A 28-week single-arm experimental feeding intervention. British Journal of Nutrition. https://doi.org/10.1017/S0007114518001642.
DOI: https://doi.org/10.1017/S0007114518001642

Interpretive Summary: The Dietary Guidelines for Americans recommend a daily intake of fruits and vegetables of at least 5 servings per day. Fruits and vegetables are rich in many nutrients and other bioactive ingredients. Evidence supports that diets rich in fruits and vegetables are beneficial in preventing many chronic diseases. We tested whether high fruit and vegetable intake would be helpful to bone health. Twenty-nine subjects were recruited to participate in a 28-wk experimental feeding trial and to consume low fruit and vegetable diets for 6 weeks, an experimental high fruit and vegetable diet based upon the Dietary Guidelines for Americans for 8 wks (about 6-cup), low fruit and vegetable diets for 6 weeks, and then usual diet for 8 wks. We found that low intake of fruits and vegetables resulted in an increase the bone resorption marker, C-terminal telopeptide of type 1 collagen and decreases the bone formation marker, bone specific alkaline phosphatase. High intake of fruits and vegetables reversed these changes through decreased bone resorption marker CTX and increased bone formation marker BAP. Our data support that increased consumption of fruits and vegetables at or above federal dietary guidance improves bone health.

Technical Abstract: Data from controlled intervention trials are lacking that support a positive association between the intake of fruits and vegetables and bone health. The objective of this study was to test the hypothesis that elevated fruit and vegetable intake improves serum markers of bone turnover. Twenty-nine subjects participated in a 28-week single-arm experimental feeding intervention trial and consumed a prescribed low fruit and vegetable diet for 6 weeks (depletion-1), a provided high fruit and vegetable diet based upon the Dietary Guidelines for Americans for 8 weeks (6-cup equivalents/d), another prescribed low fruit and vegetable diet for 6 weeks (depletion-2), and then their usual diets for 8 weeks (repletion). At the baseline, depletion-1, high fruit and vegetable, depletion-2, and repletion phases, intakes of total carotenoids, the most commonly used biomarker of fruit and vegetables intake, were 11.5 ± 1.2, 1.4 ± 0.2, 62.3 ± 0.9, 1.5 ± 0.4, and 9.0 ± 1.0 mg/d (mean ± SE), respectively. Compared to the baseline, reduced fruit and vegetable intake (depletion-1) resulted in an increase (p < 0.05) in the bone resorption marker C-terminal telopeptide of type 1 collagen (CTX, 0.68 ± 0.05 vs 0.97 ± 0.08 ng/ml for the baseline and the depletion-1, respectively) and a decrease in the bone formation marker bone specific alkaline phosphatase (BAP, 10.7 ±0.7 vs 9.5 ± 0.8 µg/L for the baseline and the depletion-1, respectively). High intake of fruits and vegetables decreased serum CTX (p < 0.05) to 0.60 ± 0.04 ng/ml and increased serum BAP to 11.3 ± 0.7µg/L (p < 0.05), compared to the depletion-1 phase. Serum concentrations of CTX were inversely and BAP were positively correlated with blood lycopene. These data demonstrate that increased fruit and vegetable consumption at or above federal dietary guidance is beneficial to bone health.