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Comparison between Dietary Assessment Methods for Determining Associations between Nutrient Intakes and Bone Mineral Density in Postmenopausal Women

https://doi.org/10.1016/j.jada.2009.02.008Get rights and content

Abstract

It is important to identify the role of nutrition in the treatment and prevention of osteoporosis. The goal of this study was to compare the equivalency of nutrient intakes assessed by diet records and the Arizona Food Frequency Questionnaire and the associations of these nutrients with bone mineral density (BMD). This is a secondary analysis of cross-sectional data that was analyzed from six cohorts (fall 1995 to fall 1997) of postmenopausal women (n=244; 55.7±4.6 years) participating in a 12-month, block-randomized, clinical trial. One-year dietary intakes were assessed using 8 days of diet records and the Arizona Food Frequency Questionnaire. Participants' BMD was measured at the lumbar spine (L2-L4), femur trochanter, femur neck, Ward's triangle, and total body using dual-energy x-ray absorptiometry. Linear regression analyses (P≤0.05) were adjusted for the effects of exercise, hormone therapy use, body weight at 1 year, years post menopause, and total energy intake. Significant correlations (r=0.30 to 0.70, P≤0.05) between dietary assessment methods were found with all dietary intake variables. Iron and magnesium were consistently and significantly positively associated with BMD at all bone sites regardless of the dietary assessment method. Zinc, dietary calcium, phosphorous, potassium, total calcium, and fiber intakes were positively associated with BMD at three or more of the same bone sites regardless of the dietary assessment method. Protein, alcohol, caffeine, sodium, and vitamin E did not have any similar BMD associations. Diet records and the Arizona Food Frequency Questionnaire are acceptable dietary tools used to determine the associations of particular nutrients and BMD sites in healthy postmenopausal women.

Section snippets

Study Design and Anthropometry

This is a secondary analysis of cross-sectional data that was collected from the first year of the Bone Estrogen Strength Training study, a blocked, randomized clinical trial. The Bone Estrogen Strength Training study investigated the effect of exercise on BMD in healthy postmenopausal women. Participants were categorized by hormone therapy and then randomized to exercise or control conditions. They were provided with and requested to consume 800 mg calcium in supplemental form each day during

Statistical Methods

All data analyses were performed using the Statistical Package for the Social Sciences (version 11.5, 2002, SPSS Inc, Chicago, IL). Year 1 average nutrient intake values were calculated from estimates of dietary intake alone except for total calcium. Average total calcium intake was calculated as the sum of the mean calcium intakes obtained from the diet records or AFFQs plus mean intakes from the calcium supplements calculated through tablet count compliance.

Dietary intake distributions were

Results and Discussion

Three hundred twenty-one women were enrolled in the primary study. The current investigation excluded participants who had less than 5 days of diet records (n=28), and missing or incomplete AFFQs (n=20). Five participants were excluded for having AFFQ mean energy intake twice that of the diet records. Twenty-four were excluded because they did not have valid dual-energy x-ray absorptiometry measurements. Two hundred forty-four women were included in these analyses.

Mean age of subjects was

Conclusions

This study suggests that both diet records and AFFQs, assessing the same year of dietary intake, provided equivalent estimates of particular nutrient intakes when determining the associations of dietary nutrient intakes with BMD in healthy, postmenopausal women. This analysis showed iron and magnesium were consistently and significantly associated with BMD at all bone sites and zinc, fiber, phosphorous, potassium, calcium, and total calcium were significantly associated with BMD at three or

V. A. Farrell is a senior research specialist, University of Arizona, Tucson

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    V. A. Farrell is a senior research specialist, University of Arizona, Tucson

    S. B. Going is a professor, University of Arizona, Tucson

    C. Thomson is an associate professor, Department of Nutritional Sciences, University of Arizona, Tucson

    T. G. Lohman is a professor, Department of Physiology, University of Arizona, Tucson

    L. B. Houtkooper is Cooperative Extension associate director, programs, University of Arizona, Tucson

    M. Harris is an assistant professor-health specialist, Division of Agriculture Cooperative Extension Service, Family and Consumer Sciences, University of Arkansas, Little Rock

    J. L. Weber is an associate professor, Department of Pediatrics, College of Medicine, University of Arkansas, Little Rock

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