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12-05-2011 | Bone health | Article

Healthy Eating Index 2005 not a good measure of bone health


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MedWire News: The Healthy Eating Index 2005 (HEI-2005) does not correlate with bone turnover markers (BTMs), and is therefore not a good measure of healthy eating for optimal bone health, Canadian research shows.

Angela Cheung (University Health Network, Toronto) and colleagues used the HEI-2005 - a diet quality-assessment tool developed by the US Department of Agriculture - to examine the association between overall diet quality and BTMs in 827 postmenopausal women aged 45 years and older.

They explain that previous studies that report that overall diet quality affects bone status in postmenopausal women are inconsistent, and "it is unclear whether diet as a whole or as individual dietary components is a better predictor of bone metabolism in aging women."

Using data from the National Health and Nutrition Examination Survey 1999-2002, the researchers found no association between the total HEI-2005 score and serum bone-specific alkaline phosphatase (BAP), a marker of bone formation, or urinary N-terminal cross-linked telopeptide of type I collagen/creatinine (uNTx/Cr), a marker of bone resorption.

The team then looked for associations between the BTMs and specific food groups.

They report that the "milk group" (ie, dairy products) component of HEI-2005 was significantly negatively associated with uNTx/Cr. Indeed, women in the lowest tertile for milk group intake had significantly higher serum uNTx/Cr levels than those in the highest tertile, at 49.23 versus 44.50 nmol bone collagen equivalents/l per mmol Cr/l.

In addition, a high intake of added sugar per 1000 kcal was associated with increased BAP. More specifically, women in the highest tertile of energy-adjusted added sugar intake had significantly higher BAP concentrations than did those in the lowest tertile, at 17.27 versus 15.18 µg/l.

"Our results confirm the role of well-established dietary risk factors for bone loss and support the ability of a healthy diet with adequate dairy intake to promote bone health in aging women," write Cheung and co-authors in the American Journal of Clinical Nutrition.

They suggest that the lack of association between the HEI-2005 score and BTMs could be due to several reasons, including the fact that a high dairy intake can result in a lower HEI-2005 score due to high fat or sodium intake.

"Further research is needed to develop an overall dietary assessment tool in relation to bone health for postmenopausal women," the team concludes.

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Laura Dean

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