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The link between poor diet and poor health is well-known. Nevertheless, 90% of Americans are not meeting current dietary guidelines, avoiding nutrient dense foods like vegetables, and opting for high-calorie foods. One of the reasons for this behavior is that healthy options are often considered less enjoyable, compared with less healthy options. Addressing this issue, the current work tests the effectiveness of a novel approach to encourage consumption of healthier options. We explore the effectiveness of using figurative language (e.g., rhyme, metaphor) in naming food items on preference for these items. Research shows that figurative language induces pleasure and perceived enjoyment. Relying on this research, we propose that naming food figuratively will increase anticipated enjoyment with that food, as well as preference for that food. We tested this prediction in a large-scale field experiment at a university dining hall. We found that giving vegetable dishes figurative names (

BACKGROUND: Vitamin C may benefit bone as an antioxidant. OBJECTIVES: This cross-sectional study evaluated associations between dietary, supplemental, and plasma vitamin C with bone mineral density (BMD) among Puerto Rican adults. METHODS: Diet was assessed by food-frequency questionnaire (n = 902); plasma vitamin C, measured in fasting blood (n = 809), was categorized as sufficient (≥50 μmol/L), insufficient (20–49 μmol/L), or low (

Titanium dioxide (TiO2/E171) is used in foods primarily as a whitening agent. Little is known regarding TiO2 exposure in the United States.To quantify stool TiO2 content among US adults and evaluate its association with estimated intake.Adults participated in phase 1 [three 24-h dietary recalls (DRs) and stool TiO2 measured from 3 matched samples (n = 52)] and/or phase 2 [tailored FFQ and stool TiO2 measured from 3 samples over 3 mo (n = 61)]. TiO2 in foods was estimated from a database, and concentration in 49 additional foods and 339 stool samples were quantified using inductively coupled plasma mass spectrometry. Associations between dietary and stool TiO2 were assessed by log-linear multivariable regression. USDA food groups (n = 49, servings/d) were related to stool TiO2 by stepwise regression.TiO2 food content varied by brand. Mean TiO2 intake from three 24-h DRs [0.19 ± 0.31 mg/(kg body weight · d)] was lower than from the FFQ [0.30 ± 0.21 mg/(kg body weight · d)]. Dietary TiO2 was not predictive of stool TiO2, in phase 1 or phase 2, 10^(β) per 10 times higher dietary TiO2: 1.138 [10^(95% CI): 0.635, 2.037, P = 0.66] and 0.628 [10^(95% CI): 0.206, 1.910, P = 0.41], respectively. Food groups related to stool TiO2 were 1) milk desserts, sauces, and gravies [10^(β) per servings/d: 3.361; 10^(95% CI): 0.312, 36.163; P = 0.002] and 2) yeast breads [10^(β): 1.430; 10^(95% CI): 0.709, 2.884; P = 0.002] in phase 1 and 1) cream and cream substitutes [10^(β) = 10.925; 10^(95% CI): 1.952, 61.137; P = 0.01] and 2) milk and milk drinks [10^(β) = 0.306; 10^(95% CI): 0.086, 1.092, P = 0.07] in phase 2.Intake of certain foods was associated with higher stool TiO2 content. There is a need for valid estimation of TiO2 intakes via the improvement of a dietary assessment method and a TiO2 food composition database. Future research should assess whether high stool TiO2 content is related to adverse health outcomes.

OBJECTIVES: There is evidence to suggest that higher serum concentration of carotenoids is protective of osteoporosis, although studies have shown inconsistent findings. The majority of studies on serum carotenoids and bone have been conducted in predominantly non-Hispanic white populations. This study examined the relationship between serum total carotenoids and bone mineral density (BMD) and odds of osteoporosis among Puerto Rican older adults. METHODS: Data are from the Boston Puerto Rican Osteoporosis Study, a prospective cohort of Puerto Rican adults aged 47 to 79 y (n = 907). Serum total carotene (ug/dL) concentration was measured by fasting blood sample at baseline and 2-year follow-up. A cumulative average of the two measures was calculated. BMD (g/cm2) at the hip and lumbar spine sites were measured using dual x-ray absorptiometry. Multivariable analysis of covariance models tested associations between serum total carotenoids and BMD outcomes and multivariable logistic regression models examined associations with odds of osteoporosis. Models were adjusted for age, height, estrogenic (male, non-menopausal or taking hormone replacements, no estrogen) status, BMI, alcohol use, smoking status, calcium intake, and serum vitamin D and triglycerides. RESULTS: Participants were primarily female (72.1%), mean age: 59 years ± 7.4 and mean serum carotenoids: 93 ug/dL ± 34.2. Serum total carotenoids were not associated with BMD at the trochanter (β = 0.16 ± 0.13), femoral neck (β = 0.09 ± 0.13), total hip (β = −0.46 ± 0.18), or lumbar spine (β = 0.11 ± 0.14) (P = 0.16–0.50). Further, there was no association between serum carotenoids and odds of osteoporosis after adjusting for potential confounding (OR = 1.00, 95%CI: 0.99, 1.01). CONCLUSIONS: These findings suggest that dietary factors other than total carotenoids may be more important for bone health among Puerto Rican adults. Further research is needed to confirm these results. Investigation of individual dietary carotenoids may provide additional insight into the associations with bone in this population. FUNDING SOURCES: NIH (P01 AG023394, P50 HL105185, R01 AG027087). SEN is supported by K01 AR067894.

BACKGROUND: Dairy foods have been shown to improve bone mineral density (BMD) in non-Hispanic whites. Puerto Rican adults have a higher prevalence of osteoporosis and vitamin D deficiency than non-Hispanic whites. However, there is little understanding of lifestyle influences on bone in this population. OBJECTIVE: The aim of this study was to examine associations of dairy intakes with BMD among adults from the Boston Puerto Rican Osteoporosis Study with and without adequate serum vitamin D status. METHODS: A total of 904 participants in this cross-sectional analysis provided dietary intakes with a culturally tailored food-frequency questionnaire. Dairy food groups were calculated [total dairy, modified dairy (without cream or dairy desserts), fluid dairy (milk + yogurt), cheese, yogurt, and cream and desserts]. BMD (grams per centimeter squared) was measured using dual-energy X-ray absorptiometry. Vitamin D status was defined as sufficient (serum 25-hydroxyvitamin D [25(OH)D] ≥20 ng/mL) or insufficient (

Research shows that higher dietary protein of up to 1.2 g/kgbodyweight/day may help prevent sarcopenia and maintain musculoskeletal health in older individuals. Achieving higher daily dietary protein levels is challenging, particularly for older adults with declining appetites and underlying health conditions. The negative impact of these limitations on aging muscle may be circumvented through the consumption of high-quality sources of protein and/or supplementation. Currently, there is a debate regarding whether source of protein differentially affects musculoskeletal health in older adults. Whey and soy protein have been used as the most common high-quality proteins in recent literature. However, there is growing consumer demand for additional plant-sourced dietary protein options. For example, pea protein is rapidly gaining popularity among consumers, despite little to no research regarding its long-term impact on muscle health. Therefore, the objectives of this review are to: (1) review current literature from the past decade evaluating whether specific source(s) of dietary protein provide maximum benefit to muscle health in older adults; and (2) highlight the need for future research specific to underrepresented plant protein sources, such as pea protein, to then provide clearer messaging surrounding plant-sourced versus animal-sourced protein and their effects on the aging musculoskeletal system.

Background Puerto Rican adults residing in the US mainland experience a high prevalence of metabolic syndrome (MetS). A diet containing healthy protein-rich sources may help control risk factors for MetS. Objective This study aimed to evaluate 2-year longitudinal associations between intake of various protein-rich foods and changes in the six MetS components. Design This is a secondary analysis of a longitudinal cohort study using data from the baseline (2004–2007) and 2-year follow-up visits (2006–2011) in the Boston Puerto Rican Health Study. Participants/setting Participants were self-identified Puerto Ricans, aged 45 to 75 years, residing in Boston, Massachusetts, or the surrounding area (n = 1,126). Main outcome measures MetS components were fasting glucose, high-density lipoprotein (HDL) cholesterol, triglycerides, systolic and diastolic blood pressures, and waist circumference. Statistical analysis Baseline intake of foods reported in a semiquantitative food frequency questionnaire were expressed as servings/day, and protein-rich foods were categorized as unprocessed white meat, unprocessed red meat, processed meat, milk and yogurt, cheese, fish and seafood, beans, nuts, and eggs. Associations between each continuous protein food group and continuous 2-year change in MetS components were assessed using linear mixed models adjusted for socioeconomic and behavioral factors, and other dietary sources. Results The top contributors to total protein intake were unprocessed red meat (13.3%) and unprocessed poultry (13.0%), and the lowest were eggs (2.92%) and nuts (0.91%). Higher intake of processed meats was associated with an increase in waist circumference over 2 years (β = 1.28; standard error [SE] = 0.63), whereas higher intake of fish and seafood was associated with a decrease in waist circumference (β = −3.47; SE = 1.39). Intake of unprocessed poultry was associated with a decrease in triglycerides (β = −24.5; SE = 9.13). No other significant associations were observed between protein sources and 2-year changes in MetS components. Conclusions Consuming less processed meat and more fish and seafood and unprocessed poultry was associated with decreases in waist circumference and triglycerides among US mainland Puerto Ricans. Other dietary protein sources were not related to cardiometabolic health.

OBJECTIVES: To investigate the prospective associations of DASH and MeDS with self-reported arthritis across three time points [baseline, 2y and 6y follow-up] among Puerto Rican older adults. METHODS: Data are from the Boston Puerto Rican Health Study, a prospective cohort of Puerto Rican adults aged 45 to 75 y. Individuals were included if they presented with diet and arthritis data at minimum 2/3 visits (n = 1210). Dietary quality indices (DASH and MeDS) were derived from dietary data assessed by FFQ. Participants self-reported arthritis. Generalized linear mixed modeling was used to estimate multivariable hierarchical logistic regression models, accounting for multiple time points (baseline, 2y and 6y). Models were adjusted for smoking, alcohol, physical activity, sex, estrogen, education, diabetes (y/n), BMI, and age. RESULTS: Among participants with data at all timepoints (n = 958), the mean time from baseline to last follow-up was 6.2 ± 0.97y. Mean age was 63 ± 7y (range 49–81y at follow-up), 72% were women, mean BMI was 31 ± 6 kg/m2, DASH score 24.0 ± 4.3 (10–37), and MeDS 5.0 ± 1.2 (0–9). MeDS was not predictive of arthritis at follow-up in crude (fixed effects estimate: −0.016, P = 0.70) nor adjusted (−0.016, P = 0.73) models. DASH score was inversely associated with arthritis in crude models (0.032, P = 0.01); but was no longer significantly associated after controlling for confounders, including age (0.013, P = 0.39). Age was significantly associated with DASH score in final models (fixed effects estimate: 0.08, P

Objective: Colleges should aim to cultivate healthy behaviors among students by addressing alterations in wellness students view as important. The purpose of this study was to determine the self-pe...

The purpose of this study was to investigate whether a treadmill endurance exercise program would reduce serum testosterone and leptin in male rats and assess the impact of increased dietary cholesterol on serum hormones. Male Sprague-Dawley Rats (n = 20) were randomly assigned to a control group (C) or an exercise training group (EX) that performed treadmill running 40 min/day, 6 days/week for 12 weeks. At study midpoint (week 6), rats were randomized to a high-cholesterol (HC) diet (n = 10) or remain on standard semi-purified (LC) diet (n = 10). Results are presented as median [IQR]. At end of week 6, EX + LC had significantly lower body weight (508 [460–527] vs 570 [516–606] g; p = 0.01), mean daily energy intake (76.3 [74.9–82.2] vs 90.9 [86.9–94.5] kcal; p

Historically, osteoporosis has not been considered a public health priority for the Hispanic population. However, recent data indicate that Mexican Americans are at increased risk for this chronic condition. Although it is well established that there is heterogeneity in social, lifestyle, and health-related factors among Hispanic subgroups, there are currently few studies on bone health among Hispanic subgroups other than Mexican Americans. The current study aimed to determine the prevalence of osteoporosis and low bone mass (LBM) among 953 Puerto Rican adults, aged 47 to 79 years and living on the US mainland, using data from one of the largest cohorts on bone health in this population: The Boston Puerto Rican Osteoporosis Study (BPROS). Participants completed an interview to assess demographic and lifestyle characteristics and bone mineral density measures. To facilitate comparisons with national data, we calculated age-adjusted estimates for osteoporosis and LBM for Mexican American, non-Hispanic white, and non-Hispanic black adults, aged ≥50 years, from the National Health and Nutrition Examination Survey (NHANES). The overall prevalence of osteoporosis and LBM were 10.5% and 43.3% for participants in the BPROS, respectively. For men, the highest prevalence of osteoporosis was among those aged 50 to 59 years (11%) and lowest for men ≥70 years (3.7%). The age-adjusted prevalence of osteoporosis for Puerto Rican men was 8.6%, compared with 2.3% for non-Hispanic white, and 3.9% for Mexican American men. There were no statistically significant differences between age-adjusted estimates for Puerto Rican women (10.7%), non-Hispanic white women (10.1%), or Mexican American women (16%). There is a need to understand specific factors contributing to osteoporosis in Puerto Rican adults, particularly younger men. This will provide important information to guide the development of culturally and linguistically tailored interventions to improve bone health in this understudied and high-risk population. © 2017 American Society for Bone and Mineral Research.

OBJECTIVES: Dietary calcium and magnesium have been shown to be beneficial for bone health primarily in non-Hispanic white populations. There are no studies of calcium and magnesium intake among Hispanics of Caribbean origin. A calcium to magnesium ratio (Ca: Mg) may be important due to their competitive nature during absorption. This study examined associations between dietary calcium and magnesium and osteoporosis, accounting for calcium to magnesium ratio among Puerto Rican adults METHODS: Data from the Boston Puerto Rican Osteoporosis Study were used. Puerto Ricans aged 47–79 y with complete data on bone and diet were included (n = 955). Bone measures were assessed using dual-energy X-ray absorptiometry. A food frequency questionnaire adapted for this population was used. Dietary calcium and magnesium were energy adjusted using the residual method. Tertiles of Ca : Mg were calculate. Multivariable logistic regressions modeled associations between calcium, magnesium and tertiles of Ca : Mg. Model 1 included Ca : Mg tertiles and dietary magnesium; Model 2 Ca : Mg tertiles and dietary calcium; Model 3 Ca : Mg tertiles and dietary calcium and magnesium. All models were adjusted for age, estrogenic status (male, non-menopausal or taking estrogen, postmenopausal not taking estrogen), height, BMI, calcium (0, 0–300 mg, ≥300 mg) and magnesium (0, 0–100 mg) supplement use, serum vitamin D, alcohol use, smoking status, and bone medication use. RESULTS: Mean age was 59.9 y ± 7.6 and 71.3% were female. In model 1, the highest tertile of Ca : Mg was associated with higher likelihood (OR: 1.3; 95%CI: 0.77, 2.4) and the middle tertile with lower likelihood (OR: 0.51; 95%CI: 0.26,0.99) of osteoporosis compared with the lowest Ca: Mg tertile. Dietary magnesium was also associated with lower odds of osteoporosis (OR: 0.99; 95%CI: 0.98, 0.99). In model 2, dietary calcium (OR: 0.99, 95%CI: 0.99, 1.0) was associated with lower of odds osteoporosis, but Ca: Mg was not. In model 3, dietary calcium and magnesium and tertiles of Ca : Mg were not associated with osteoporosis. CONCLUSIONS: Dietary calcium and magnesium are important nutrients for bone health in Puerto Rican older adults. The Ca : Mg ratio appears optimal within a range of 2.6–3.1 suggesting that a balance of these two nutrients is most important. FUNDING SOURCES: National Institutes of Health P01 AG023394, P50 HL105185, R01 AG027087 K01 AR067894

OBJECTIVES: Engineered nanomaterials, such as titanium dioxide (TiO(2)/E171) are used in food primarily as a whitening agent. Over 99% ingested TiO(2) passes to the gastrointestinal (GI) tract while 1% is absorbed and shown to bioaccumulate in organs and may cause adverse outcomes. At present, dietary exposure of TiO(2) in the US is unknown. The objective is to estimate dietary TiO(2) and measure TiO(2) output in matched stool samples as a biological marker of intake. METHODS: Participants (n = 51), aged 18–30 y, were recruited in Lowell, MA and were eligible if they had not taken laxatives/antibiotics in the past 6 mo, free of GI disease and no history of GI alterations. Recent dietary intake was assessed by 3, 24-h recalls (NDSR2019) and estimated TiO(2) intake is presented as the average of the 3 days. A published database of TiO(2) content in foods (Netherlands), with extrapolations for similar US foods, was used to estimate TiO(2) exposure. To capture TiO(2) excretion, stool samples (n = 3) were collected the same day of diet recall. TiO(2) was measured in reported foods suspected to contain TiO(2) to improve the database. Concentrations of TiO(2) in food and stool samples were measured using inductively coupled plasma mass spectrometry following acid digestion. RESULTS: Mean age was 23 ± 3 y; BMI 27 ± 5 kg/m(2); 52.9% female. Mean estimated TiO(2) intake was 0.13 ± 0.28 mg/kg(bw)/d (median: 0.03; range: 0.01–1.63 mg/kg(bw)/d). Mean measured TiO(2) concentration in stool samples was 0.107 ± 0.134 mg/mg (median: 0.043; range: 0.005–0.536 ug/mg). Food analysis showed TiO(2) content varies widely and is dependent on brand. The top 5 contributors to TiO(2) intake in this sample were frostings (62.2%), sauces (8.7%), grains (5.3%), chewing gum (4.43%), and commercial desserts – miscellaneous (3.3%). No association was observed between reported TiO(2) intake and measured stool concentration. CONCLUSIONS: To our knowledge, this is the first study to assess dietary TiO(2) in the US using a validated dietary method and stool excretion. Estimated TiO(2) intakes were similar to those in the Netherlands (0.17 mg/kg(bw)/d), but lower than previous estimates for the US, via Monte Carlo simulation (0.7 mg/kg(bw)/d). Improvement in the food database is needed to study the effects of chronic TiO(2) intake on health outcomes, such as gut health and the microbiome. FUNDING SOURCES: None.

Background: Previous studies showed beneficial effects of specific dairy foods on bone health in middle-aged adults.Objective: We examined the association of milk, yogurt, cheese, cream, fluid dairy (milk + yogurt), and milk + yogurt + cheese intakes with bone mineral density (BMD) and 4-y percentage of change in BMD [▵%BMD; femoral neck, trochanter, and lumbar spine (LS)]. We further assessed whether these associations were modified by vitamin D supplement use in this cohort of older adults.Methods: Food-frequency questionnaire responses, baseline BMD (hip and spine, n = 862 in 1988-1989), and follow-up BMD (n = 628 in 1992-1993) were measured in the Framingham study, a prospective cohort study of older Caucasian men and women aged 67-93 y. Outcomes included baseline BMD and ▵%BMD. Dairy-food intakes (servings per week) were converted to energy-adjusted residuals, and linear regression was used, adjusting for covariates. These associations were further examined by vitamin D supplement use.Results: The mean age of the participants was 75 y. In the full sample, dairy-food items were not associated with BMD (P = 0.11-0.99) or with ▵%BMD (P = 0.29-0.96). Among vitamin D supplement users, but not among nonusers, higher milk, fluid dairy, and milk + yogurt + cheese intakes were associated with higher LS BMD (P = 0.011-0.009). Among vitamin D supplement users, but not among nonusers, higher milk + yogurt + cheese intakes were protective against trochanter BMD loss (P = 0.009).Conclusions: In this population of older adults, higher intakes of milk, fluid dairy, and milk + yogurt + cheese were associated with higher LS BMD, and a higher intake of milk + yogurt + cheese was protective against trochanter BMD loss among vitamin D supplement users but not among nonusers. These findings underscore that the benefits of dairy intake on the skeleton may be dependent on vitamin D intake.

Background: Above-average dietary protein, as a single nutrient, improves musculoskeletal health. Evaluating the link between dietary protein and musculoskeletal health from a whole-diet perspective is important, as dietary guidelines focus on dietary patterns. Objective: We examined the prospective association of novel dietary protein food clusters (derived from established dietary pattern techniques) with appendicular lean mass (ALM), quadriceps strength (QS), and bone mineral density (BMD) in 2986 men and women, aged 19–72 y, from the Framingham Third Generation Study. Design: Total protein intake was estimated by food-frequency questionnaire in 2002–2005. A cluster analysis was used to classify participants into mutually exclusive groups, which were determined by using the percentage of contribution of food intake to overall protein intake. General linear modeling was used to 1) estimate the association between protein intake (grams per day) and BMD, ALM, appendicular lean mass normalized for height (ALM/ht2), and QS (2008–2011) and to 2) calculate adjusted least-squares mean outcomes across quartiles of protein (grams per day) and protein food clusters. Results: The mean ± SD age of subjects was 40 ± 9 y; 82% of participants met the Recommended Daily Allowance (0.8 g · kg body weight–1 · d–1). The following 6 dietary protein food clusters were identified: fast food and full-fat dairy, fish, red meat, chicken, low-fat milk, and legumes. BMD was not different across quartiles of protein intake (P-trend range = 0.32–0.82); but significant positive trends were observed for ALM, ALM/ht2 (P < 0.001), and QS (P = 0.0028). Individuals in the lowest quartile of total protein intake (quartile 1) had significantly lower ALM, ALM/ht2, and QS than did those in the higher quartiles of intake (quartiles 2–4; (P ranges = 0.0001–0.003, 0.0007–0.003, and 0.009–0.05, respectively). However, there were no associations between protein clusters and any musculoskeletal outcome in adjusted models. Conclusions: In a protein-replete cohort of adults, dietary protein is associated with ALM and QS but not with BMD. In this study, dietary protein food patterns do not provide further insight into beneficial protein effects on muscle outcomes.

BACKGROUND: Conflicting results on associations between dietary quality and bone have been noted across populations, and this has been understudied in Puerto Ricans, a population at higher risk of osteoporosis than previously appreciated. OBJECTIVE: To compare cross-sectional associations between 3 dietary quality indices [Dietary Approaches to Stop Hypertension (DASH), Alternative Health Eating Index (AHEI-2010), and Mediterranean Diet Score (MeDS)] with bone outcomes. METHOD: Participants (n = 865–896) from the Boston Puerto Rican Osteoporosis Study (BPROS) with complete bone and dietary data were included. Indices were calculated from validated food frequency data. Bone mineral density (BMD) was measured using DXA. Associations between dietary indices (z-scores) and their individual components with BMD and osteoporosis were tested with ANCOVA and logistic regression, respectively, at the lumbar spine and femoral neck, stratified by male, premenopausal women, and postmenopausal women. RESULTS: Participants were 59.9 y ± 7.6 y and mostly female (71%). Among postmenopausal women not taking estrogen, DASH (score: 11–38) was associated with higher trochanter (0.026 ± 0.006 g/cm(2), P

The impact of nutrition on the metabolic profile of osteoporosis is incompletely characterized. The objective of this cross-sectional study was to detangle the association of fruit and vegetable (FV) intakes with osteoporosis prevalence. Dietary, anthropometric and blood plasma metabolite data were examined from the Boston Puerto Rican Osteoporosis Study, a cohort of 600 individuals (age 46-79yr). High FV intake was protective against osteoporosis prevalence. Associations of 525 plasma metabolites were assessed with fruit and vegetable intake, and separately with osteoporosis status. Several biological processes affiliated with the FV-associating metabolites, including caffeine metabolism, carnitines and fatty acids, and glycerophospholipids. For osteoporosis-associated metabolites, important processes were steroid hormone biosynthesis in women, and branched-chain amino acid metabolism in men. In all instances, the metabolite patterns differed greatly between sexes, arguing for a stratified nutrition approach in recommending FV intakes to improve bone health. Factors derived from principal components analysis of the FV intakes were correlated with the osteoporosis-associated metabolites, with high intake of dark leafy greens and berries/melons appearing protective in both sexes. These data warrant investigation into whether increasing intakes of dark leafy greens, berries and melons causally affect bone turnover and BMD among adults at risk for osteoporosis via sex-specific metabolic pathways, and how gene-diet interactions alter these sex-specific metabolomic-osteoporosis links.

Background Caribbean Latino adults have disproportionately high prevalence of chronic disease; however, underlying mechanisms are unknown. Unique gut microbiome profiles and relation to dietary quality may underlie health disparities. Objectives To examine the dietary quality of an underrepresented group of Caribbean Latino older adults with high prevalence of chronic disease; characterize gut microbiome profiles in this cohort; determine associations between dietary quality, gut microbiome composition, and short-chain fatty acid (SCFA) production; examine associations of clinical factors (body mass index, type 2 diabetes [T2D] status, and laxative use) with gut microbiome composition. Design The study design was cross-sectional. Participants/setting Recruitment and interviews occurred at the Senior Center in Lawrence, MA, from September 2016-September 2017. A total of 20 adults aged ≥50 years, self-identified of Caribbean Latino origin, without use of antibiotics in 6 months or intestinal surgery were included in the study. Exposure and outcome measures Diet was assessed by two, 24-hour recalls and dietary quality was calculated using the Healthy Eating Index 2015 and the Mediterranean Diet Score. The gut microbiome was assessed by 16S rRNA sequencing and fecal SCFA content. Anthropometrics (ie, weight and height) were measured by a trained interviewer, and self-reported laxative use, and other self-report health outcomes (ie, T2D status) were assessed by questionnaire. Statistical analyses Faith Phylogenetic Diversity (alpha diversity) and unique fraction metric, or UniFrac (beta diversity) and nonphylogenetic metrics, including Shannon diversity index (alpha diversity) were calculated. Spearman correlations and group comparisons using Kruskal-Wallis test between alpha diversity indexes and nutrient intakes were calculated. Patterns in the microbiome were estimated using a partitioning around medoids with estimation of number of clusters, with optimum average silhouette width. Log odds were calculated to compare predefined nutrients and diet score components between microbiome clusters using multivariable logistic regression, controlling for age and sex. Pearson correlation was used to relate SCFA fecal content to individual nutrients and diet indexes. Final models were additionally adjusted for laxative use. Differences in lifestyle factors by gut microbiome cluster were tested by Fisher's exact test. Results Generally, there was poor alignment of participant's diets to either the Mediterranean Diet score or Healthy Eating Index 2015. Range in the Healthy Eating Index 2015 was 36 to 90, where only 5% (n=1) of the sample showed high adherence to the Dietary Guidelines for Americans. Mediterranean Diet scores suggested low conformance with a Mediterranean eating pattern (score range=2 to 8, where 45% scored ≤3 [poor adherence]). The gut microbiome separated into two clusters by difference in a single bacterial taxon: Prevotella copri (P copri) (permutational multivariate analysis of variance [PERMANOVA] R2=0.576, ADONIS function P=0.001). Significantly lower P copri abundance was observed in cluster 1 compared with cluster 2 (Mann-Whitney P Conclusions Two unique microbiome profiles, identified by abundance of P copri, were identified among Caribbean Latino adults. Microbiome profiles and SCFA content were associated with diet, T2D, and lifestyle. Further research is needed to determine the role of P copri and SCFA production in the risk for chronic disease and associated lifestyle predictors.

OBJECTIVES: To examine risk factors for bone mineral density (BMD) and osteoporosis at the femoral neck (FN) and lumbar spine (LS) in a cross-sectional study among Puerto Rican adults, 47- 77 y. METHODS: The Boston Puerto Rican Osteoporosis Study (BPROS) is an ancillary study to the Boston Puerto Rican Health Study, a cohort of 1504 Puerto Rican adults from the Greater Boston area. A total of 973 participants participated in the BPROS, where data on sociodemographics, health and health behaviors, and medication use were collected through questionnaire, and anthropometrics measured. Dietary intake and supplement use were assessed using a food frequency questionnaire. Fasting blood samples were collected for biochemical analysis. BMD (g/cm(2)) at the FN and LS (L2-L4) was measured using dual-energy X-ray absorptiometry. Linear regression models estimated associations between risk factors and FN and LS BMD and logistic regression for osteoporosis (T-score ≤ −2.5 g/cm(2)) at the FN and/or LS. A total of 680 participants had complete data on risk factors and bone measures. RESULTS: Average age of participants was 59.9 y ± 7.6 y and 71.3% were women. The prevalence of osteoporosis was 10.6%. Age was inversely associated with FN BMD (Table 1). BMI and height were positively associated with BMD. Neither calcium intake from food sources nor plasma 25-OH vitamin D were associated with BMD (P > 0.36). Bone medication and calcium supplement use were inversely associated with BMD, likely due to reverse causation. Magnesium intake from supplements was positively associated with LS and FN BMD (β = 0.07, P = 0.006 and β = 0.05, P = 0.008). Moderate alcohol consumption was associated with lower odds of osteoporosis, compared to no intake (OR: 0.40, P = 0.02; Table 2). Current smoking (vs. never smokers) was associated with increased odds of osteoporosis (OR: 2.5, P = 0.02). Magnesium from supplements was associated with lower odds of osteoporosis (OR: 0.41, P = 0.04). CONCLUSIONS: In contrast to expectation, dietary calcium and plasma 25-OH vitamin D were not associated with bone. Interestingly, magnesium intake from supplements was associated with higher BMD and lower odds of osteoporosis. This requires further investigation, as this may serve as a feasible intervention to improve BMD and decrease risk of osteoporosis in this high-risk population. FUNDING SOURCES: NIH/NIAMS K01 AR067894, NIH P50 HL105185, P01 AG023394, and R01 AG027087. SUPPORTING TABLES, IMAGES AND/OR GRAPHS

SUMMARY: Few studies have examined knowledge and perceptions of osteoporosis among Caribbean Latino adults. Confusion regarding the term osteoporosis was noted. Doctors were viewed as trusted sources of health information, although descriptions of a paradoxical relationship emerged. This study can be used to inform culturally tailored interventions for osteoporosis prevention. PURPOSE: The overall goal of this study was to assess knowledge, attitudes, and beliefs of bone health and osteoporosis among Caribbean Latino adults aged ≥ 50 years. METHODS: This triangulated mixed methods study included completion of a quantitative questionnaire and participation in one of four focus groups to obtain information on (1) general health, (2) knowledge about bone health and osteoporosis, (3) sources of information about bone health, and (4) prevention knowledge and personal responsibility. Quantitative data were analyzed using SAS, and qualitative data were analyzed using descriptive and structural coding by two independent research members. RESULTS: The majority of participants were female (73%), Dominican (84%), and low income (82% < $20,000) with a mean age of 68.4 (± 8.5) years. Most participants had heard of osteoporosis (90%); however, the majority were not able to accurately describe this chronic condition. Health care providers were viewed as most trusted sources of health information, despite feelings of being rushed during their visits, with limited communication about preventative care. Most participants felt that nutrition and exercise were important for overall health. CONCLUSIONS: Caribbean Hispanic adults in this study reported knowledge of osteoporosis and nutritional factors associated with prevention of this chronic condition. However, qualitatively, there was confusion between osteoporosis and other bone and joint conditions. Culturally specific interventions to promote prevention of osteoporosis are urgently needed for this underserved, high-risk population.

Background The impact of nutrition on the metabolic profile of osteoporosis (OS) is unknown. Objective Identify biochemical factors driving the association of fruit and vegetable (FV) intakes with OS prevalence using an untargeted metabolomics approach. Design Cross-sectional dietary, anthropometric and plasma metabolite data were examined from the Boston Puerto Rican Osteoporosis Study, n = 600 (46–79 yr). Methods Bone mineral density was assessed by DXA. OS was defined by clinical standards. A culturally adapted FFQ assessed usual dietary intake. Principal components analysis (PCA) of 42 FV items created 6 factors. Metabolomic profiles derived from plasma samples were assessed on a commercial platform. Differences in levels of 525 plasma metabolites between disease groups (OS vs no-OS) were compared using logistic regression; and associations with FV intakes by multivariable linear regression, adjusted for covariates. Metabolites significantly associated with OS status or with total FV intake were analyzed for enrichment in various biological pathways using Mbrole 2.0, MetaboAnalyst, and Reactome, using FDR correction of P-values. Correlation coefficients were calculated as Spearman's rho rank correlations, followed by hierarchical clustering of the resulting correlation coefficients using PCA FV factors and sex-specific sets of OS-associated metabolites. Results High FV intake was inversely related to OS prevalence (Odds Ratio = 0.73; 95% CI = 0.57, 0.94; P = 0.01). Several biological processes affiliated with the FV-associating metabolites, including caffeine metabolism, carnitines and fatty acids, and glycerophospholipids. Important processes identified with OS-associated metabolites were steroid hormone biosynthesis in women and branched-chain amino acid metabolism in men. Factors derived from PCA were correlated with the OS-associated metabolites, with high intake of dark leafy greens and berries/melons appearing protective in both sexes. Conclusions These data warrant investigation into whether increasing intakes of dark leafy greens, berries and melons causally affect bone turnover and BMD among middle-aged and older adults at risk for osteoporosis via sex-specific metabolic pathways, and how gene-diet interactions alter these sex-specific metabolomic-osteoporosis links. ClinicalTrials.gov Identifier: NCT01231958 .

Malnutrition is a significant risk factor for poor functional recovery following hip fracture. General undernutrition can be assessed using nutrition assessment screening tools. Identification of nutritionally at risk individuals may prevent complications and poor recovery following a fracture. Simple nutritional supplementation has not resulted in meaningful changes in health outcomes following fracture. However, newer multidisciplinary approaches to improving nutritional status are showing improved health care outcomes. Data on the effectiveness of individual nutrients on hip fracture recovery are limited. Therefore, future studies on combined nutrition interventions (calories, protein, and individual nutrients) are warranted, using a multidisciplinary team approach, both acutely and at home following fracture.

Osteoporosis is characterized by systemic impairment of bone mass, strength, and microarchitecture, resulting in increased risk for fragility fracture, disability, loss of independence and even death. Adequate nutrition is important in achieving and maintaining optimal bone mass, as well as preventing this debilitating disease. It is widely accepted that adequate calcium and vitamin D intake are necessary for good bone health; however, nutritional benefits to bone go beyond these two nutrients. This review article will provide updated information on all nutrients and foods now understood to alter bone health. Specifically, this paper will focus on related research from the Framingham Osteoporosis Study, an ancillary study of the Framingham Heart Study, with data on more than five thousand adult men and women.

Context:It has been assumed that the increase in urine calcium (Ca) that accompanies an increase in dietary protein was due to increased bone resorption. However, studies using stable Ca isotopes have found that dietary protein increases Ca absorption without increasing bone resorption.Objective:The objective of the study was to investigate the impact of a moderately high protein diet on bone mineral density (BMD).Design:This was a randomized, double-blind, placebo-controlled trial of protein supplementation daily for 18 months.Setting:The study was conducted at two institutional research centers.Participants:Two hundred eight older women and men with a body mass index between 19 and 32 kg/m2 and a self-reported protein intake between 0.6 and 1.0 g/kg participated in the study.Intervention:Subjects were asked to incorporate either a 45-g whey protein or isocaloric maltodextrin supplement into their usual diet for 18 months.Main Outcome Measure:BMD by dual-energy x-ray absorptiometry, body composition, and markers of skeletal and mineral metabolism were measured at baseline and at 9 and 18 months.Results:There were no significant differences between groups for changes in L-spine BMD (primary outcome) or the other skeletal sites of interest. Truncal lean mass was significantly higher in the protein group at 18 months (P = .048). C-terminal telopeptide (P = .0414), IGF-1 (P = .0054), and urinary urea (P < .001) were also higher in the protein group at the end of the study period. There was no difference in estimated glomerular filtration rate at 18 months.Conclusion:Our data suggest that protein supplementation above the recommended dietary allowance (0.8 g/kg) may preserve fat-free mass without adversely affecting skeletal health or renal function in healthy older adults.

Osteoporosis, or low bone mass, currently affects 48 million adults in the United States. Vegans may be at increased risk for developing low bone mass due to lack of adequate consumption of specific bone-benefiting nutrients found largely in animal products, such as calcium, vitamin D, protein, vitamin B12, zinc, and n-3 fatty acids. Educating the vegan community on food alternatives and proper dietary management of these at-risk nutrients is important to prevent risk of fracture in this vulnerable population. There are also many nutrients consumed in high amounts from fruit and vegetable intake that may promote bone health among vegans. Therefore, knowledge of dietary habits that will benefit bone health among vegans is of utmost importance in preventing bone loss in this at-risk population.

Dairy foods are rich in bone-beneficial nutrients, yet the role of dairy foods in hip fracture prevention remains controversial. Our objective was to evaluate the association of milk, yogurt, cheese, cream, and milk + yogurt intakes with incident hip fracture in the Framingham Original Cohort. A total of 830 men and women from the Framingham Original Cohort, a prospective cohort study, completed a food-frequency questionnaire (1988 to 1989) and were followed for hip fracture until 2008. In this population-based study, Cox-proportional hazards regression was used to estimate hazard ratios (HR) by categories of energy-adjusted dairy intake (servings/wk), adjusting for standard confounders and covariates. The exposure was energy-adjusted intakes of milk, yogurt, cheese, cream, and milk + yogurt (servings/wk). Risk of hip fracture over the follow-up was the primary outcome; the hypothesis being tested was formulated after data collection. The mean age at baseline was 77 years (SD 4.9, range 68 to 96). Ninety-seven hip fractures occurred over the mean follow-up time of 11.6 years (range 0.04 to 21.9 years). The mean ± SD (servings/wk) of dairy intakes at baseline were: milk = 6.0 ± 6.4; yogurt = 0.4 ± 1.3; cheese = 2.6 ± 3.1; and cream = 3.4 ± 5.5. Participants with medium (>1 and

High dietary acid load (DAL) may be detrimental to bone mineral density (BMD). The objectives of the study were to: (1) evaluate the cross-sectional relation between DAL and BMD; and (2) determine whether calcium intake modifies this association. Men (n = 1218) and women (n = 907) aged ≥60 years were included from the National Health and Nutrition Examination Survey 2005–2008. Nutrient intake from 2, 24-hour recalls was used to calculate net endogenous acid production (NEAP) and potential renal acid load (PRAL) (mEq/d). PRAL was calculated from dietary calcium (PRALdiet) and diet + supplemental calcium (PRALtotal). Tests for linear trend in adjusted mean BMD of the hip and lumbar spine were performed across energy-adjusted NEAP and PRAL quartiles. Modification by calcium intake (dietary or total) above or below 800 mg/d was assessed by interaction terms. Overall, mean age was 69 ± 0.3 years. Among women, there was no association between NEAP and BMD. PRALdiet was positively associated with proximal femur BMD (p trend = 0.04). No associations were observed with PRALtotal at any BMD site (p range, 0.38–0.82). Among men, no significant associations were observed between BMD and NEAP or PRAL. However, an interaction between PRALdiet and calcium intake was observed with proximal femur BMD (p = 0.08). An inverse association between PRALdiet and proximal femur BMD was detected among men with

OBJECTIVES: To analyze the impact of different sources of protein (pea, whey or casein) on functional muscle performance in C57BL/6 mice. METHODS: A total of 21 mice were randomized to protein intervention groups. Mice were individually caged in a temperature controlled and 12-h light-dark cycle room. Subjects were randomly assigned to casein, whey, and pea protein sourced diets, matched by sex. Total energy (3.77 ± 0.04 kcal/g) and macronutrient composition (% of total energy: carbohydrate 66%, protein 18% and fat 16%) were matched across diets. Body weight and amount of food consumed was measured weekly. Functional muscle performance was measured by forelimb grip strength test using an Accuforce Cadet Force Gage and hanging test using Kondziela's inverted screen test capped at 600 seconds (at intervention week 9). The recorded strength and hang time measurements were corrected for body-mass. Data processing and analyses were performed in IBM SPSS Statistics 25. RESULTS: Excluding 2 mice due to outliers, the total number of mice per group were: casein (n = 9), whey (n = 6), and pea (n = 5). No baseline differences in body weight or average amount of food consumed per week were observed between groups. However, mice on the pea protein diet gained significantly more weight (8 ± 2g) compared to whey (4 ± 2g) and casein (2 ± 2g) diet groups (P

Food is always a good topic of conversation and inquiry. Humans require it, the variety of eating patterns spark personal debate, scientific measurement of dietary intakes are fraught with methodical issues, and the often changing (and inconsistent) nutrition messages in the media make for good discussion. The devil is in the detail when it comes to nutrients and the inferences to health beyond food intakes. Indeed, food is often the example when nuances of scientific inference are examined across time periods: “Is dairy good or bad for you?”, “should we consume more or less protein in our diet?” “how much fruit & vegetable is needed?”, or “should salt intake be limited”? Macronutrients (carbohydrates, proteins and fats) as well as micronutrients (minerals and vitamins) are essential for the human body. Intakes of these nutrients have been the topic of bone investigations and patient questions for many years, especially as related to the occurrence of fractures. In this issue of Journal of Bone & Mineral Research, two exciting articles present their findings on first, serum sodium levels, and then, fruit and vegetable intakes, in relation to fracture risk. These topics are highly relevant to clinicians and researchers interested in bone outcomes. Patients are keenly interested in nutrition-related influences upon bone health, both those with positive as well as negative aspects. Examining nutrient intakes in relation to health outcomes is complicated, but can lead to significant risk factor modification as well as influence in food and health decisions, especially in older adults. Defining dietary intakes precisely is a major challenge in both clinical patients and participants of population-based studies as the scientific community continues to search for the long-term effects of dietary intakes. Nutrition studies are common in outcomes of cancer and heart disease, and less so with bone outcomes (with the exception of calcium and vitamin D). Prior to inference of causality, especially for dietary intakes, it is important to first document a significant association with outcomes and across populations.

Sarcopenia, the involuntary loss of skeletal muscle with age, affects up to one-quarter of older adults. Evidence indicates a positive association between dietary protein intake and lean muscle mass and strength among older persons, but information on dietary protein's effect on physical performance in older adults has received less attention.Cross-sectional observational analysis of the relationship of dietary protein on body composition and physical performance.Clinical research center.387 healthy women aged 60 - 90 years (mean 72.7 ± 7.0 y).Measures included body composition (fat-free mass, appendicular skeletal mass and fat mass) via dual x-ray absorptiometry (DXA), physical performance (Physical Performance Test [PPT] and Short Physical Performance Battery [SPPB]), handgrip strength, Physical Activity Scale in the Elderly (PASE), quality of life measure (SF-8), falls, fractures, nutrient and macromolecule intake (four-day food record). Independent samples t-tests determined mean differences between the above or below RDA protein groups.Analysis of covariance was used to control for body mass index (BMI) between groups when assessing physical performance, physical activity and health-related quality of life.The subjects consumed an average of 72.2 g protein/day representing 1.1 g protein/kg body weight/day. Subjects were categorized as below the recommended daily allowance (RDA) for protein (defined as less than 0.8 g protein/kg) or at or above the RDA (equal to or higher than 0.8 g protein/kg). Ninety-seven subjects (25%) were in the low protein group, and 290 (75%) were in the higher protein group. Women in the higher protein group had lower body mass, including fat and lean mass, and fat-to-lean ratio than those in the lower-protein group (p0.001). Composite scores of upper and lower extremity strength were impaired in the group with low protein intake; SPPB score was 9.9±1.9 compared to 10.6±1.6 in those with higher protein intake and PPT was 19.8± 2.9 compared to 20.9± 2.1 in the low and higher protein groups, respectively. The results were attenuated by correction for BMI, but remained significant. The physical component of the SF-8 was also lower in the low protein group but did not remain significant when controlling for BMI. No significant differences were found in hand grip strength or reported physical activity.Healthy, older postmenopausal women consumed, on average, 1.1 g/kg/d protein, although 25% consumed less than the RDA. Those in the low protein group had higher body fat and fat-to-lean ratio than those who consumed the higher protein diet. Upper and lower extremity function was impaired in those who consumed a low protein diet compared to those with a higher protein intake. Protein intake should be considered when evaluating the multi-factorial loss of physical function in older women.

This chapter will provide an overview regarding bone, osteoporosis, musculoskeletal health and dietary protein intakes in adult men and women. A background on evolving thoughts and tested hypotheses on the Acid-base theory will be presented, followed by an overview of the major scientific findings of the effect of dietary protein intake upon bone and muscle health. This review will not cover dietary patterns, although this topic is of keen interest and population-based future studies are encouraged in this area of interest. It would appear that higher levels of dietary protein intake, within the range commonly consumed by U.S. adults, do not result in bone loss in older adults. These positive outcomes may be due to increased calcium absorption, circulating levels of IGF-1 and suppression of PTH. The link between dietary protein intakes and bone health is certainly more complex than simple association studies can tease apart and more in-depth work is still necessary to give insights that are helpful to populations interested in maximizing their bone health. Protein appears to make more of an impact on bone with adequate calcium intake.

Background: Soy foods contain several components (isoflavones and amino acids) that potentially affect bone. Few long-term, large clinical trials of soy as a means of improving bone mineral density (BMD) in late postmenopausal women have been conducted. Objective: Our goal was to evaluate the long-term effect of dietary soy protein and/or soy isoflavone consumption on skeletal health in late postmenopausal women. Design: We conducted a randomized, double-blind, placebo-controlled clinical trial in 131 healthy ambulatory women aged >60 y. Ninety-seven women completed the trial. After a 1-mo baseline period, subjects were randomly assigned into 1 of 4 intervention groups: soy protein (18 g) + isoflavone tablets (105 mg isoflavone aglycone equivalents), soy protein + placebo tablets, control protein + isoflavone tablets, and control protein + placebo tablets. Results: Consumption of protein powder and isoflavone pills did not differ between groups, and compliance with the study powder and pills was 80–90%. No significant differences in BMD were observed between groups from baseline to 1 y after the intervention or in BMD change between equol and non-equol producers. However, there were significant negative correlations between total dietary protein (per kg) and markers of bone turnover (P < 0.05). Conclusions: Because soy protein and isoflavones (either alone or together) did not affect BMD, they should not be considered as effective interventions for preserving skeletal health in older women. The negative correlation between dietary protein and bone turnover suggests that increasing protein intakes may suppress skeletal turnover. This trial was registered at clinicaltrials.gov as {"type":"clinical-trial","attrs":{"text":"NCT00668447","term_id":"NCT00668447"}}NCT00668447.

BACKGROUND Age-related decline in muscle strength is an important public health issue for older adults. Dietary protein has been associated with maintenance of muscle mass, yet its relation to muscle strength remains unclear. METHODS We determined the association of dietary protein (total, animal, and plant) intake, measured by food frequency questionnaire, with change in grip strength over 6 years in 1,746 men and women from the Framingham Offspring cohort. RESULTS Mean age at baseline was 58.7 years (range: 29-85), and mean total, animal, and plant protein intakes were 79, 57, and 22 g/d, respectively. Adjusted baseline mean grip strength did not differ across quartiles of energy-adjusted total, animal or protein intake. Greater protein intake, regardless of source, was associated with less decrease in grip strength (all p for trend ≤.05): participants in the lowest quartiles lost 0.17% to 0.27% per year while those in the highest quartiles gained 0.52% to 0.60% per year. In analyses stratified by age, participants aged 60 years or older (n = 646) had similar linear trends on loss of grip strength for total and animal (all p for trend

Background: The impact of dietary protein intake on lower extremity lean mass and strength in community-dwelling adult Americans is not fully understood. Objectives: The objective was to determine the associations between total protein (TP), animal protein (AP), and plant protein (PP) intakes and lean mass of the legs and quadriceps muscle strength. We further examined whether the associations with quadriceps strength may be explained by lean mass of the legs. Methods: This cross-sectional study included men (n = 1166) and women (n = 1509) from the Framingham Offspring Cohort in Massachusetts. Protein intake in grams per day was measured in either 1995–1998 or 1998–2001. Leg lean mass and isometric quadriceps strength, both in kilograms, were measured in 1996–2001. Multilinear regression models estimated adjusted least squares means of each of the muscle measures by quartile categories of protein intake, adjusting for relevant confounders and covariates. Results: Mean age was 59 ± 9 y (range: 29–86 y) and TP intake was 80 ± 27 g/d in men and 76 ± 26 g/d in women. In men and women, leg lean mass was higher in participants in the highest quartiles of TP and AP intake compared with those in the lowest quartiles of intake [least squares means (kg): TP—17.6 vs. 17.1 in men, P-trend: 0.005, and 11.7 vs. 11.4 in women, P-trend: 0.006; AP—17.6 vs. 17.1 in men, P-trend: 0.002, and 11.7 vs. 11.4 in women, P-trend: 0.003]. PP intake was not associated with lean mass in either sex. In men and women, quadriceps strength was higher in participants in the highest quartile of PP intake compared with those in the lowest quartile [least squares means (kg): 22.9 vs. 21.7 in men, P-trend: 0.01, and 19.0 vs. 18.2 in women, P-trend: 0.01]; this association was no longer significant after adjustment for fruit and vegetable intake (P-trend: 0.06 in men and 0.10 in women). Although no significant association was observed for AP intake in either sex, nonsignificant protective trends were observed for TP intake (P-trend: 0.08 in men and 0.10 in women). Conclusions: Our findings suggest that maintaining adequate protein intake with age may help preserve muscle mass and strength in adult men and women. Dietary protein types may differentially affect muscle mass and strength. Whether PP is a marker of dietary quality or has a direct effect on muscle strength (independent of lean mass) needs to be further clarified.

Objective: To examine the cross-sectional relation of dietary protein food sources with BMD among 2,758 Framingham Offspring Study participants (mean age 60y). Methods: BMD was measured by Lunar DP...

The relation of omega 3 fatty acids (n-3 FA) with bone mineral density (BMD) was assessed among adults60 years; NHANES data (2005-2008). The association of dietary n-3 FA with measures of hip BMD was equivocal, but n-3 FA supplement use was significantly associated with higher spine BMD - a finding that deserves further study.Associations between polyunsaturated fatty acids and bone mineral density are not well understood.To evaluate the cross-sectional relation between dietary omega 3 fatty acid intake (specifically docosahexaenoic acid, eicosapentaenoic acid, and octadecatetraenoic) and BMD at the hip and spine among older adults.Omega 3 FA intake (g/day) was assessed from two 24-h recalls using the National Health and Nutrition Examination Survey (NHANES, in 2005-2008); and omega 3 FA supplement use (yes/no) via questionnaire. Multivariable regression models were developed to explain variance in femoral neck, total femur, and lumbar spine BMD among 2,125 men and women over 60 years.Mean age was 70 years. In adjusted models, dietary omega 3 FA were marginally associated with greater femoral neck BMD (p = 0.0505), but not with total femur BMD (p = 0.95) or lumbar spine BMD (p = 0.74). Omega 3 supplement use was significantly positively associated with lumbar spine BMD (p = 0.005) but not with femoral neck or total femur BMD.Dietary intakes of omega 3 FA were marginally associated with femoral neck BMD; however, omega 3 supplement use was significantly associated with higher lumbar spine BMD in older adults. These results emphasize the need for assessment of total omega 3 intakes (diet and supplements) to provide a greater range of intake and a more accurate picture of the relation between omega 3 FA and BMD.

Dairy foods are rich in bone-beneficial nutrients, yet the role of dairy foods in hip fracture prevention remains controversial. Our objective was to evaluate the association of milk, yogurt, cheese, cream, and milk + yogurt intakes with incident hip fracture in the Framingham Original Cohort. A total of 830 men and women from the Framingham Original Cohort, a prospective cohort study, completed a food-frequency questionnaire (1988 to 1989) and were followed for hip fracture until 2008. In this population-based study, Cox-proportional hazards regression was used to estimate hazard ratios (HR) by categories of energy-adjusted dairy intake (servings/wk), adjusting for standard confounders and covariates. The exposure was energy-adjusted intakes of milk, yogurt, cheese, cream, and milk + yogurt (servings/wk). Risk of hip fracture over the follow-up was the primary outcome; the hypothesis being tested was formulated after data collection. The mean age at baseline was 77 years (SD 4.9, range 68 to 96). Ninety-seven hip fractures occurred over the mean follow-up time of 11.6 years (range 0.04 to 21.9 years). The mean ± SD (servings/wk) of dairy intakes at baseline were: milk = 6.0 ± 6.4; yogurt = 0.4 ± 1.3; cheese = 2.6 ± 3.1; and cream = 3.4 ± 5.5. Participants with medium (1 and7 servings/wk) or higher (≥7 servings/wk) milk intake tended to have lower hip fracture risk than those with low (≤1 serving/wk) intake (high versus low intake HR 0.58, 95% confidence interval [CI] 0.31-1.06, p = 0.078; medium versus low intake HR 0.61, 95% CI 0.36-1.08, p = 0.071; p trend = 0.178]. There appeared to be a threshold for milk, with 40% lower risk of hip fracture among those with medium/high milk intake compared with those with low intake (p = 0.061). A similar threshold was observed for milk + yogurt intake (p = 0.104). These associations were further attenuated after adjustment for femoral neck bone mineral density. No significant associations were seen for other dairy foods (p range = 0.117 to 0.746). These results suggest that greater intakes of milk and milk + yogurt may lower risk for hip fracture in older adults through mechanisms that are partially, but not entirely, attributable to effects on bone mineral density.

Soy foods contain several components, notably, isoflavones and amino acids, that may improve cardiovascular health. We evaluated the long-term effect of soy protein and/or soy isoflavones supplementation on serum lipids and inflammatory markers using a 1-year randomized, double-blind, placebo-control, clinical trial in 131 healthy ambulatory women older than 60 years. We hypothesized that soy protein, in combination with isoflavones, would have the largest positive effect on coronary heart disease risk factors (serum lipids and inflammatory markers) compared with either intervention alone and that, within groups receiving isoflavones, equol producers would have more positive effects on coronary heart disease risk factors than nonequol producers. After a 1-month baseline period, participants were randomized into 1 of 4 intervention groups: soy protein (18 g/d) and isoflavone tablets (105 mg/d isoflavone aglycone equivalents), soy protein and placebo tablets, control protein and isoflavone tablets, or control protein and placebo tablets. T Tests were used to assess differences between equol and nonequol producers. Ninety-seven women completed the trial. Consumption of protein powder and isoflavone tablets did not differ among groups, and compliance with study powder and tablets was 79% and 90%, respectively. After 1 year, in the entire population, there were either no or little effects on serum lipids and inflammatory markers, regardless of treatment group. Equol producers, when analyzed separately, had significant improvements in total cholesterol/high-density lipoprotein and low-density lipoprotein/high-density lipoprotein ratios (−5.9%, P = .02; −7.2%, P = .04 respectively). Soy protein and isoflavone (either alone or together) did not impact serum lipids or inflammatory markers. Therefore, they should not be considered an effective intervention to prevent cardiovascular disease because of lipid modification in healthy late postmenopausal women lacking the ability to produce equol.

Age-related bone and muscle loss are major public health problems. Investigational therapies to reduce these losses include anti-inflammatory dietary supplementations, such as polyunsaturated fatty acids (PUFA). Surprisingly, this topic has received little attention in the osteoporosis community. Recent research highlights the role of PUFA in inflammatory regulation of bone remodeling via cellular pathways. Emerging research suggests significant roles for PUFA in reducing bone and muscle loss with aging; however, findings are conflicted for PUFA and fracture risk. Limited studies suggest a relation between higher omega-3 FA and better muscle/bone in older adults. This review highlights new research since 2008 and synthesizes our current understanding of PUFA in relation to bone and muscle. Across study designs, evidence indicates that PUFA has positive effects upon bone. As data are sparse, future clinical trials and prospective studies are important to determine the long term benefits of PUFA supplementation upon bone and muscle outcomes.