Effect of Mediterranean Diet Plus Vitamin D3 on Bone Density in Osteoporosis

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Participants in the intervention group received foods such as whole-grain pasta; olive oil; low-fat, low-salt cheese; and vitamin D3 supplements.
Participants in the intervention group received foods such as whole-grain pasta; olive oil; low-fat, low-salt cheese; and vitamin D3 supplements.

Consumption of a Mediterranean-style diet along with vitamin D3 supplementation (10 µg/d) had no effect on bone mass density (BMD) in individuals with a BMD within the normal age-related range but did significantly reduce the rate of bone loss in the femoral neck in patients with osteoporosis, according to new findings published in the American Journal of Clinical Nutrition.

The Mediterranean diet has been recommended for helping to prevent the onset of chronic diseases, but there is limited evidence regarding its effect on bone health. The primary goal of the multicenter randomized New Dietary Strategies Addressing the Specific Needs of the Elderly Population for Healthy Aging in Europe study was to examine the effect of consuming a Mediterranean diet on inflammatory response at 1 year in elderly Europeans. There were also 15 prespecified secondary outcomes, one of which was the diet's effect on BMD and biomarkers of bone and collagen degradation.

A total of 1142 participants (mean±SD age: 70.9±4.0; 44% men) completed the 1-year study. Participants in the intervention group received individually tailored dietary advice coupled with supplies of food and vitamin D3 supplements. The individuals in the control group were provided with leaflets on healthy eating based on food options available in their specific country of residence.

Consuming a Mediterranean diet showed no effect on either site-specific or whole-body BMD and no effect on the urinary biomarkers free pyridinoline or free deoxypyridinoline was observed. Levels of serum 25hydroxyvitamin D significantly increased and parathyroid hormone decreased (P <.001) in the intervention vs the control group. In a subgroup analysis of participants with osteoporosis at baseline, the dietary intervention attenuated the decline of femoral neck BMD (P =.04) but had no effect on lumbar spine or whole-body BMD.

“To our knowledge, no previous dietary intervention studies in elderly people have reported the effect of the Mediterranean diet on BMD,” wrote the investigators, adding that this study “provides an important opportunity to clarify the relation[ship].”

Reference

Jennings A, Cashman KD, Gillings R, et al. 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 [published online July 11, 2018]. Am J Clin Nutr. doi:10.1093/ajcn/nqy122

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