Bone density, biomarkers and nutrient intake of postmenopausal women : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics at Massey University, Albany, New Zealand
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2024
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Massey University
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Background: Osteoporosis is associated with an increased risk of bone fractures and carry a significant burden on the individual and the health care system. Of these individuals, postmenopausal women have a high risk for developing osteoporosis due to decreased oestrogen production. Objectives: This study explored the relationship between nutrient intake and bone health in postmenopausal women. Specifically, C-terminal of telopeptide of type 1 collagen (CTx-1), an indicator of bone turnover, and bone mineral density (BMD) were analysed in relation to the identified nutrient patterns. Correlations with additional markers associated with bone metabolism, parathyroid hormone (PTH), BMD, and vitamin D, were also examined. Method: The present study was an analysis using baseline data from the COPES 4 Bones project. Eighty seven postmenopausal women participated (aged 48-77). Questionnaires were used to obtain participant demographics and physical activity levels. A three-day food record was self-reported by the participants. BMD was measured using dual x-ray absorptiometry. Weight, height and BMI were measured using standard techniques. Fasted venous blood samples were collected to measure CTx-1, 25-hydroxyvitamin D3, and PTH. Nutrient patterns were derived from 3-day food records using principal component analysis. Linear regression was used to explore the association between BMD and the nutrient patterns. Age, weight, serum vitamin D, and physical activity were confounders in the model. Results: Four nutrient patterns were identified from the data. Nutrient pattern 1 (NP1) was characterised by high amounts of phosphorus, protein, zinc, and niacin equivalents. Nutrient pattern 2 (NP2) was characterised by high amounts of dietary fibre, magnesium, potassium and a low amount of saturated fat. Nutrient pattern 3 (NP3) was characterised by high amounts of monounsaturated fat, vitamin E, polyunsaturated fat and a low amount of carbohydrates. Nutrient pattern 4 (NP4) was characterised by high amounts of alpha carotene and beta carotene. One significant negative correlation was identified between NP2 and hip BMD without consideration of confounders. Conclusion: The current study identified NP2 as a potential factor contributing to bone health in a model exclusive of confounders such as weight and age. The research found weight to be positively associated with BMD. While dietary patterns were not explicitly studied, a diet consisting of high fruit and vegetable intake may be inferred from the characteristics of NP2. A negative relationship between a diet of this form and BMD challenges previously reported findings in postmenopausal women. Therefore, this work prompts future research to better characterise the role of nutrient intake in modulating bone health.