Association Between Dietary Fiber Intake and Bone Loss in the Framingham Offspring Study

Abstract

Dietary fiber may increase calcium absorption, but its role in bone mineralization is unclear. Furthermore, the health effect of dietary fiber may be different between genders. We examined the association between dietary fiber (total fiber and fiber from cereal, fruits, vegetables, nuts and legumes) and bone loss at the femoral neck, trochanter and lumbar spine (L2–4) in older men and women. In the Framingham Offspring Study, at baseline (1996–2001), diet was assessed using the Willett food frequency questionnaire and bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry. Follow-up BMD was measured in 2001–2005 and 2005–2008 among 792 men (mean age, 58.1yr; BMI, 28.6kg/m2) and 1,065 women (57.3yr; 27.2kg/m2). We used sex-specific generalized estimating equations in multivariable regressions to estimate the difference (β) of annualized BMD change in percent (%ΔBMD) at each skeletal site per 5 g/d increase in dietary fiber. We further estimated the adjusted mean for bone loss (annualized %ΔBMD) among participants in each higher quartile (Q2, Q3 or Q4) compared with those in the lowest quartile (Q1) of fiber intake. Higher dietary total fiber (β=0.06, p=0.003) and fruit fiber (β=0.04, p=0.008) was protective against bone loss at the femoral neck in men but not in women. When examined in quartiles, men in Q2–Q4 of total fiber had significantly less bone loss at the femoral neck versus those in Q1 (all p<0.04). Fiber from vegetables appeared to be protective against spine bone loss in women but not men. There were no associations with cereal fiber or nut and legume fiber and bone loss in men or women. Our findings suggest that higher dietary fiber may modestly reduce bone loss in men at the hip.

Associations between Dietary Fiber Intake and Bone Mineral Density in Adult Korean Population: Analysis of National Health and Nutrition Examination Survey in 2011

“…A recently published 8-year of follow-up longitudinal cohort study using the Framingham offspring cohort demonstrated the higher the amount of daily dietary fiber the male participants consumed, the less bone loss of femur neck they experienced. [23] The positive relationship between fiber intake and bone health in younger male group in our cross-sectional study was in line with the study outcome of the Framingham offspring cohort study; higher fiber intake increased BMD of femur neck only in males. Notably, sex difference in the association of dietary fiber and BMD was evident in both studies regardless of types of dietary fiber that study participants consumed; most of the study participants in the Framingham offspring cohort study were Caucasians whose sources of fiber may be different than those of most Koreans.…”

Bone Response to Dietary Co-Enrichment with Powdered Whole Grape and Probiotics

“…Another possibility is that a positive effect of grape oligosaccharides and fiber on bone architecture was inhibited by co-ingestion of probiotics. Higher dietary and specifically fruit fiber intake has been shown to protect against femoral neck bone loss in men [ 88 ]. Mechanisms include improved mineral solubility and absorption resulting from growth of gut bacteria that ferment oligosaccharides and fiber to short-chain fatty acids [ 89 , 90 , 91 ].…”

Whole Fruits and Fruit Fiber Emerging Health Effects

“…No significant associations were found for young women or older men. A 2018 Framingham Offspring Study (792 men, mean age 58 years; 1065 women; mean age 57 years; 8 years follow-up) observed significantly reduced annualized loss of femoral neck bone mineral density (predictive of hip fracture risk) per 5 g/day total fiber by 0.06% or fruit fiber by 0.04% [344]. A 2017 Chinese cross-sectional study (3089 participants; age range 40 to 75 years; 66% women) observed that high fruit intake had dose-dependent associations with greater bone mineral density and a lower risk of osteoporosis; but this was not shown for vegetables [345].…”