Bone Mineral Density in Premenopausal Women Is Associated with the Dietary Intake of α-Tocopherol: A Cross-Sectional Study

Abstract

This study aimed to investigate the relationship between the consumption of various nutrients and bone mineral density (BMD) in middle-aged women. This cross-sectional survey was conducted based on the clinical records of 157 women aged 38–76. Their lumbar spine BMD was measured with dual-energy X-ray absorptiometry and dietary habits were assessed with the brief-type self-administered diet history questionnaire. Participants were divided into premenopausal (n = 46) and postmenopausal (n = 111) groups and the correlation between the BMD Z-score (Z-score) and the intakes of 43 nutrients was investigated separately for each group. In premenopausal women, the daily intake of ash, calcium, and α-tocopherol was positively correlated with the Z-score (Pearson’s correlation coefficient, R = 0.31, 0.34, 0.33, p = 0.037, 0.020, 0.027, respectively). When dividing the consumption of ash, calcium, and α-tocopherol into low, middle, and high tertiles, the Z-score significantly differed only between the α-tocopherol tertiles. After adjustment for age, body mass index, and lifestyle factors, daily intake of α-tocopherol remained significantly associated with the Z-score (regression coefficient = 0.452, p = 0.022). No nutrient was found to be significantly correlated with the Z-score in postmenopausal women. Increase in the intake of α-tocopherol could help maintain bone mass in premenopausal women.

Osteoclast Multinucleation: Review of Current Literature

“…Zhang et al identified a negative association between serum α-tocopherol concentration and bone mineral density in an elderly US population [ 200 ], and Ilesanmi-Oyelere et al reported that a diet rich in vitamin E and fats was associated with lower bone mineral density in postmenopausal women [ 201 ]. On the other hand, Odai et al’s cross-sectional study showed that dietary intake of vitamin E was associated with higher bone mineral density in premenopausal women but had no effect in postmenopausal women [ 202 ]. Yang et al found no effect of vitamin E on bone turnover markers or bone mineral density in peri- or postmenopausal women in the UK [ 203 ].…”

Positive Associations of Dietary Intake and Plasma Concentrations of Vitamin E with Skeletal Muscle Mass, Heel Bone Ultrasound Attenuation and Fracture Risk in the EPIC-Norfolk Cohort

“…Limited research exists, mainly in older adults, which suggests that vitamin E, a lipid-soluble, anti-oxidant vitamin, may also be protective with respect to muscle mass and frailty [ 21 , 22 , 23 , 24 , 25 , 26 ], as skeletal muscle is the organ with the highest consumption of oxygen in the body. Positive associations of vitamin E intake with bone mineral density (BMD) and fracture risk have also been reported in both men and women [ 27 , 28 , 29 , 30 ]. The major forms of vitamin E in food are the α- and γ-tocopherols, and thus these are found in greater abundance than other tocopherols and tocotrienols in tissues.…”

Association of Dietary Total Antioxidant Capacity with Bone Mass and Osteoporosis Risk in Korean Women: Analysis of the Korea National Health and Nutrition Examination Survey 2008–2011

“…Furthermore, Li et al [ 37 ] reported that the intake of fruits and vegetables was significantly associated with whole-body BMC, but not with the BMC and BMD of specific sites in premenopausal women. In premenopausal women, vitamin C intake was positively associated with femur BMD [ 42 ], vitamin E intake was positively correlated with lumbar BMD [ 9 ], and carotenoid intake was positively linked to the BMD of the total hip [ 6 ]. These findings suggest that the effect of a single antioxidant on BMD could be site-specific in premenopausal women.…”

“…The beneficial association between antioxidant intake, bone mass, and the risk of osteoporosis has been studied in many countries, including the Republic of Korea [ 6 , 8 , 12 , 14 , 15 ], China [ 10 , 13 ], and Japan [ 9 ]. However, these studies primarily focused on the effects of single antioxidant intake, which might not fully explain the effects of all antioxidants in the diet.…”

“…A recent study demonstrated that the intake of fruits and vegetables containing abundant antioxidants was associated with reduced bone mass loss and a reduced risk of osteoporosis in postmenopausal women [ 5 ]. Although epidemiological studies have reported a positive association between bone mineral density (BMD) and the intake of single antioxidants, such as vitamin C, vitamin E, carotenoids, and flavonoids in both premenopausal and postmenopausal women [ 6 , 7 , 8 , 9 , 10 , 11 ], the beneficial effects of antioxidant intake on bone health have been controversial. In fact, the consumption of vitamin C has been found to be positively correlated with the risk of osteoporosis in several studies [ 12 , 13 , 14 ], but not in others [ 15 , 16 ].…”