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- Title
Dietary vitamin A intake and bone health in the elderly: the Rotterdam Study.
- Authors
de Jonge, E A L; Kiefte-de Jong, J C; Campos-Obando, N; Booij, L; Franco, O H; Hofman, A; Uitterlinden, A G; Rivadeneira, F; Zillikens, M C
- Abstract
<bold>Background/objectives: </bold>High vitamin A intake may be associated with a decreased bone mineral density (BMD) and increased risk of fractures. Our objectives were to study whether dietary intake of vitamin A (total, retinol or beta-carotene) is associated with BMD and fracture risk and if associations are modified by body mass index (BMI) and vitamin D.<bold>Subjects/methods: </bold>Participants were aged 55 years and older (n=5288) from the Rotterdam Study, a population-based prospective cohort. Baseline vitamin A and D intake was measured by a food frequency questionnaire. BMD was measured by dual-energy X-ray absorptiometry at four visits between baseline (1989-1993) and 2004. Serum vitamin D was assessed in a subgroup (n=3161). Fracture incidence data were derived from medical records with a mean follow-up time of 13.9 years.<bold>Results: </bold>Median intake of vitamin A ranged from 684 retinol equivalents (REs)/day (quintile 1) to 2000 REs/day (quintile 5). After adjustment for confounders related to lifestyle and socioeconomic status, BMD was significantly higher in subjects in the highest quintile of total vitamin A (mean difference in BMD (95% confidence interval (CI))=11.53 (0.37-22.7) mg/cm(2)) and retinol intake (mean difference in BMD (95% CI)=12.57 (1.10-24.05) mg/cm(2)) than in the middle quintile. Additional adjustment for BMI diluted these associations. Fracture risk was reduced in these subjects. Significant interaction was present between intake of retinol and overweight (BMI >25 kg/m(2)) in relation to fractures (P for interaction =0.05), but not BMD. Stratified analysis showed that these favourable associations with fracture risk were only present in overweight subjects (BMI >25 kg/m(2)). No effect modification by vitamin D intake or serum levels was observed.<bold>Conclusions: </bold>Our results suggest a plausible favourable relation between high vitamin A intake from the diet and fracture risk in overweight subjects, whereas the association between vitamin A and BMD is mainly explained by BMI.
- Subjects
BONE metabolism; BONES; DIET; DOSE-effect relationship in pharmacology; BONE fractures; LONGITUDINAL method; NUTRITIONAL assessment; QUESTIONNAIRES; VITAMIN A; VITAMIN D; SOCIOECONOMIC factors; BONE density; BODY mass index; LIFESTYLES; DISEASE incidence; NUTRITIONAL status; PHOTON absorptiometry
- Publication
European Journal of Clinical Nutrition, 2015, Vol 69, Issue 12, p1360
- ISSN
0954-3007
- Publication type
journal article
- DOI
10.1038/ejcn.2015.154