A Mediterranean-like dietary pattern with vitamin D3 (10 µg/d) supplements reduced the rate of bone loss in older Europeans with osteoporosis at baseline: results of a 1-y randomized controlled trial

Amy Jennings, Kevin D Cashman, Rachel Gillings, Aedin Cassidy, Jonathan Tang, William Fraser, Kirsten G Dowling, George L J Hull, Agnes A M Berendsen, Lisette C P G M de Groot, Barbara Pietruszka, Elzbieta Wierzbicka, Rita Ostan, Alberto Bazzocchi, Giuseppe Battista, Elodie Caumon, Nathalie Meunier, Corinne Malpuech-Brugère, Claudio Franceschi, Aurelia Santoro, Susan J Fairweather-Tait, Amy Jennings, Kevin D Cashman, Rachel Gillings, Aedin Cassidy, Jonathan Tang, William Fraser, Kirsten G Dowling, George L J Hull, Agnes A M Berendsen, Lisette C P G M de Groot, Barbara Pietruszka, Elzbieta Wierzbicka, Rita Ostan, Alberto Bazzocchi, Giuseppe Battista, Elodie Caumon, Nathalie Meunier, Corinne Malpuech-Brugère, Claudio Franceschi, Aurelia Santoro, Susan J Fairweather-Tait

Abstract

Background: The Mediterranean diet (MD) is widely recommended for the prevention of chronic disease, but evidence for a beneficial effect on bone health is lacking.

Objective: The aim of this study was to examine the effect of a Mediterranean-like dietary pattern [NU-AGE (New Dietary Strategies Addressing the Specific Needs of the Elderly Population for Healthy Aging in Europe)] on indexes of inflammation with a number of secondary endpoints, including bone mineral density (BMD) and biomarkers of bone and collagen degradation in a 1-y multicenter randomized controlled trial (RCT; NU-AGE) in elderly Europeans.

Design: An RCT was undertaken across 5 European centers. Subjects in the intervention group consumed the NU-AGE diet for 1 y by receiving individually tailored dietary advice, coupled with supplies of foods including whole-grain pasta, olive oil, and a vitamin D3 supplement (10 µg/d). Participants in the control group were provided with leaflets on healthy eating available in their country.

Results: A total of 1294 participants (mean ± SD age: 70.9 ±4.0 y; 44% male) were recruited to the study and 1142 completed the 1-y trial. The Mediterranean-like dietary pattern had no effect on BMD (site-specific or whole-body); the inclusion of compliance to the intervention in the statistical model did not change the findings. There was also no effect of the intervention on the urinary biomarkers free pyridinoline or free deoxypyridinoline. Serum 25-hydroxyvitamin D significantly increased and parathyroid hormone decreased (P < 0.001) in the MD compared with the control group. Subgroup analysis of individuals with osteoporosis at baseline (site-specific BMD T-score ≤ -2.5 SDs) showed that the MD attenuated the expected decline in femoral neck BMD (n = 24 and 30 in MD and control groups, respectively; P = 0.04) but had no effect on lumbar spine or whole-body BMD.

Conclusions: A 1-y intervention of the Mediterranean-like diet together with vitamin D3 supplements (10 µg/d) had no effect on BMD in the normal age-related range, but it significantly reduced the rate of loss of bone at the femoral neck in individuals with osteoporosis. The NU-AGE trial is registered at clinicaltrials.gov as NCT01754012.

Figures

FIGURE 1
FIGURE 1
Mean difference in intake of dietary components associated with bone health after 1 y of follow-up in the intervention and control diet groups assessed by using 7-d food diaries. *P < 0.05, ANCOVA adjusted for site; **plotted on a secondary axis.

References

    1. Willett WC, Sacks F, Tricholpoulou A, Drescher G, Ferro-Luzzi A, Helsing E, Tricholpoulos D. Mediterranean diet pyramid: a cultural model for healthy eating. Am J Clin Nutr 1995;61:1402–6.
    1. Trichopoulou A, Costacou T, Barnia C, Trichopoulos D. Adherence to a Mediterranean diet and survival in a Greek population. New Engl J Med 2003;348:2599–608.
    1. Sofi F, Cesari F, Abbate R, Gensini GF, Casini A. Adherence to Mediterranean diet and health status: meta-analysis. BMJ 2008;337:a1344.
    1. Liyanage T, Ninomiya T, Wang A, Neal B, Jun M, Wong MG, Jardine M, Hillis GS, Perkvic V. Effects of the Mediterranean diet on cardiovascular outcomes—a systematic review and meta-analysis. PloS One 2016;11(8):e0159252.
    1. Perez AR, Velasco AR. Adherence to Mediterranean diet and bone health. Nutr Hosp 2014;29:989–96.
    1. Cauley JA. Osteoporosis: fracture epidemiology update 2016. Curr Opin Rheumatol 2017;29:150–6.
    1. Haring B, Crandall CJ, Wu C, LeBlanc ES, Shikany JM, Carbone L, Orchard T, Thomas F, Wactawski-Wende J, Li W et al. .. Dietary patterns and fractures in postmenopausal women. Results from the Women's Health Initiative. JAMA Intern Med 2016;176:645–52.
    1. Santoro A, Pini E, Scurti M, Palmas G, Berendsen A, Brzozowska A, Pietruszka B, Szczecinska A, Cano N, Meunier N et al. .. Combating inflammaging through a Mediterranean whole diet approach: the NU-AGE project's conceptual framework and design. Mech Ageing Dev 2014;136–137:3–13.
    1. Berendsen A, Santoro A, Pini E, Cevenini E, Ostan R, Pietruszka B, Rolf K, Cano N, Caille A, Lyon-Belgy N et al. .. A parallel randomized trial on the effect of a healthful diet on inflammageing and its consequences in European elderly people: design of the NU-AGE dietary intervention study. Mech Ageing Dev 2014;136–137:14–21.
    1. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G et al. .. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56:M146–56.
    1. Kanis JA, Melton LJ III, Christiansen C, Johnston CC, Khaltaev N. The diagnosis of osteoporosis. J Bone Miner Res 1994;9:1137–41.
    1. Tang J, Dutton J, Piec I, Green D, Fisher E, Washbourne C, Fraser WD. LC–MS/MS application for urine free pyridinoline and free deoxypyridinoline: urine markers of collagen and bone degradation. Clin Mass Spectrom 2016;1:11–8.
    1. Cashman KD, Kiely M, Kinsella M, Durazo-Arvizu RA, Tian L, Zhang Y, Lucey A, Flynn A, Gibney MJ, Vesper HW et al. .. Evaluation of vitamin D standardization program protocols for standardizing serum 25-hydroxyvitamin D data: a case study of the program's potential for national nutrition and health surveys. Am J Clin Nutr 2013;97:1235–42.
    1. CDC CDC's Vitamin D Standardization Certification Program (VDSCP). [cited 2018 Feb 9]. Available from: .
    1. Moschonis G, Manios Y. Skeletal site-dependent response of bone mineral density and quantitative ultrasound parameters following a 12-month dietary intervention using dairy products fortified with calcium and vitamin D: the Postmenopausal Health Study. Br J Nutr 2006;96:1140–8
    1. Chen G, Dong X, Zhu Y, Tian H, He J, Chen Y. Adherence to the Mediterranean diet is associated with a higher BMD in middle-aged and elderly Chinese. Sci Rep 2016;6:srep25662.
    1. Erkkila A, Sadeghi H, Isanejad M, Mursu J, Tuppurainen M, Kroger H. Associations of Baltic Sea and Mediterranean dietary patterns with bone mineral density in elderly women. Pub Health Nutr 2017;20:2735–43.
    1. Kontogianni MD, Melistas L, Yannakoulia M, Malagris I, Panagiotakos DB, Yiannakouris N. Association between dietary patterns and indices of bone mass in a sample of Mediterranean women. Nutrition 2009;25:165–71.
    1. Rivas A, Romero A, Mariscal-Arcas M, Monteagudo C, Feriche B, Lorenzo ML, Olea F. Mediterranean diet and bone mineral density in two age groups of women. Int J Food Sci Nutr 2013;64:155–61.
    1. Vuolo L, Barrea L, Savanelli MC, Savastano S, Rubino M, Scarano E, Soprano M, Illario M, Colao A, Di Somma C. Nutrition and osteoporosis: preliminary data of Campania region of European PERsonalised ICT Supported Service for Independent Living and Active Ageing. Trans Med 2016;13:13–18.
    1. Garcia-Gavilan JF, Bullo M, Canudas S, Martinez-Gonzales MA, Estruch R, Giardina S, Firo M, Corella D, Ros E, Salas-Salvado J. Extra virgin olive oil consumption reduces the risk of osteoporotic fractures in the PREDIMED trial. Clin Nutr. 2018;37(1):329–35.
    1. Fernandez-Real JM, Bullo M, Moreno-Navarrete JM, Ricart W, Ros E, Estruch R, Salas-Salvado J. A Mediterranean diet enriched with olive oil is associated with higher serum total osteocalcin levels in elderly men at high cardiovascular risk. J Clin Endocrinol Metab 2012;97:3792–8.
    1. Lin PH, Ginty F, Appel LJ, Aickin M, Bohannon A, Garnero P, Barclay D, Svetkey LP. The DASH diet and sodium reduction improve markers of bone turnover and calcium metabolism in adults. J Nutr 2003;133(10):3130–6.
    1. Doyle L, Cashman KD. The DASH diet may have beneficial effects on bone health. Nutr Rev 2004;62(5):215–20.
    1. Feart C, Lorrain S, Coupez VG, Samieri C, Letenneur L, Paineau D, Barberger-Gateau P. Adherence to a Mediterranean diet and risk of fractures in French older persons. Osteoporos Int 2013;24(12):3031–41.
    1. Benetou V, Orfanos P, Pettersson-Kymmer U, Bergstrom U, Svensson O, Johansson I, Berrino F, Tumino R, Borch KB, Lund E et al. .. Mediterranean diet and incidence of hip fractures in a European cohort. Osteoporosis Int 2013;24:1587–98.
    1. MacDonald HM, Wood AD, Aucott LS, Black AJ, Fraser WD, Mavroeidi A, Reid DM, Secombes KR, Simpson WG, Thies F. Hip bone loss is attenuated with 1000 IU but not 400 IU daily vitamin D3: a 1-year double-blind RCT in postmenopausal women. J Bone Miner Res 2013;28:2202–13.
    1. Bischoff‐Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson‐Hughes B. Fracture prevention with vitamin D supplementation: a meta‐analysis of randomized controlled trials. JAMA 2005;293:2257–64.
    1. Institute of Medicine Food and Nutrition Board Dietary Reference Intakes for calcium and vitamin D. Washington (DC): National Academies Press; 2011.
    1. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM; Endocrine Society Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011;96:1911–30.

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