Unbalanced Diet to Lower Serum Cholesterol Level is a Risk Factor for Postmenopausal Osteoporosis and Distal Forearm Fracture

Abstract

The purpose of this study was to assess whether dietary changes aimed at reducing serum cholesterol can increase the risk of osteoporosis (OP) and fracture. The study group consisted of 311 postmenopausal women with high serum cholesterol levels and following a diet low in dairy products (calcium intake estimated at less than 300 mg/day) for 27.3 +/- 29.1 months. This sample was compared with a case-control group of 622 healthy postmenopausal women paired for age and age at menopause and with a calcium intake estimated at more than 1 g/day. Bone mineral density was measured at the lumbar spine by dual-energy X-ray absorptiometry. Prevalence of OP was significantly higher in women with a low dairy calcium intake (42.1% vs 22.3%; p < 0.0001), as was the number of Colles' fractures occurring after menopause (4.5% vs 1.6%; p = 0.008). Multiple logistic regression analyses demonstrated that a diet low in dairy calcium was a risk factor for OP (OR = 2.52, 95% CI 1.84-3.45) and Colles' fracture (OR = 2.72, 95% CI 1.18-6.26). In the low dairy calcium group, diet duration significantly influenced the risk of OP (OR = 1.13, 95% CI 1.01-1.25 for 1 year of diet). No differences in further risk factors for coronary heart disease were found between the groups, but the proportion of women physically active was lower in the women with high serum cholesterol levels. A diet that severely limits calcium intake from dairy products in an attempt to correct raised serum cholesterol levels is a risk factor for postmenopausal OP and Colles' fracture. Dietary intervention methods to lower serum cholesterol in postmenopausal women should maintain an adequate calcium intake by providing calcium from low-fat dairy products or calcium supplements.

The utility of lumbar spine trabecular bone score and femoral neck bone mineral density for identifying asymptomatic vertebral fractures in well-compensated type 2 diabetic patients

“…In all subjects, a detailed personal and familial history and a previously validated questionnaire regarding the propensity to fall and the calcium daily intake were collected [24].…”

Atherogenic lipid profile and elevated lipoprotein (a) are associated with lower bone mineral density in early postmenopausal overweight women

“…Calcium intake was lower in the hypercholesterolemia group, but not in the high-Lp(a) group, probably due to the decrease in dairy foods secondary to low-fat diet [7,21,22] and it is suggested that the restriction in calcium intake due to low-fat diet may be responsible for low bone mass [21]. In a casecontrol study comparing 311 postmenopausal women with hypercholesterolemia following a low-fat diet with low dairy calcium intake (<214 mg/day) with 622 healthy postmenopausal women with high dairy calcium intake (>857 mg/day), the prevalence of lumbar osteoporosis was higher in the, hypercholesterolemia group (42.1% vs. 22.3%) suggesting the authors that the restriction in calcium intake due to the low-fat diet may have been responsible for low bone mass [21].…”

Prevalence of subclinical contributors to low bone mineral density and/or fragility fracture

“…In all patients, the presence of previous fragility fractures was ascertained by self-report and no additional validation of this information was conducted. Calcium intake, expressed as milligrams per day, was assessed using a validated questionnaire (26). In particular, usual calcium intake coming from some selected calcium-rich foods (milk and dairy products) was estimated by a 7-day food frequency questionnaire.…”

“…To standardize the slice weight, three cardboard samples of different sizes were used (about 100, 50 and 25 g). The number of standardized servings was assessed, each containing w300 mg of calcium (a 250 ml cup of milk or yoghurt, a portion of about 100 g of cottage cheese, a 50 g slice of soft cheese and a 25 g slice of aged cheese) (26). In all patients height and weight were measured and BMI was calculated.…”