Dietary Folate Is Significantly Associated with the Risk of Osteoporosis

by | Oct 8, 2024 | 2024, Bone Health, Folic Acid & Folate, Women's Health - Bone Health

Written by Chrystal Moulton, Science Writer. Individuals in the high folate group had a significantly lower risk of osteoporosis after adjusting for all confounding factors (OR= 0.30, P= 0.001). 

bone healthOsteoporosis is a systemic skeletal disorder that is influenced by lifestyle and dietary factors1. Research has shown that not only calcium, phosphorus, and vitamin D are essential to bone health2 but folate is also essential to bone health3. Homocysteine, an amino acid which enhances osteoclast differentiation and activity, at high levels in the bloodstream can ultimately lead to brittle fractures and poor iliac health (iliac or ilium is the largest bone in the hip region)4,5. A deficiency in folate can lead to an increase in homocysteine levels and therefore increase the risk of osteoporosis6. In the current trial, researchers investigated the association of dietary folate and the risk of osteoporosis using data from the National Health and Nutritional Examination Survey [NHANES]7.

This study was a cross-sectional trial utilizing data from the NHANES study between 2017 and 2020. Participants in the NHANES study underwent 2 interviews to assess dietary intake (two 24h dietary recall assessments); completed DXA scan of the femur, trochanter, intertrochanter, and femoral neck; and completed questionnaires relating to sociodemographic data and disease status. Dietary folate was calculated via 24h dietary recall assessments and the average was used for analysis. Participants were divided into three groups based on folate intake: low (≤264mcg/d), medium (264-390mcg/d), and high (>390mcg/d). Participants missing any dietary, demographic, disease, or DXA scan data were excluded from this analysis. Logistical regression analysis was used to assess possible relationship between dietary folate intake and the risk of developing osteoporosis (odds ratio, OR).

Initially, 24,264 individuals were recruited for the analysis. After applying exclusion criteria, data from 2,297 participants was used for this analysis.  The average age of participants was roughly 63 years old and 49.92% were females.  Total number of participants with osteoporosis was 159 with a prevalence of 6.92%. Individuals with osteoporosis were more likely to be older non-Hispanic White females who were either widowed/ divorced/ or separated. They were also more likely to be non-drinkers with low dietary folate intake.  Logistical regression analysis showed that compared to individuals in the lowest tertile of folate intake, individuals in the high folate group had a significantly lower risk of osteoporosis after adjusting for all confounding factors (OR= 0.30, P= 0.001). Furthermore, women in the high folate intake group (OR= 0.18, P= 0.007) and women in the high folate intake group over 60yrs old (OR= 0.30, P< 0.001) had a significantly lower risk of osteoporosis compared to the lowest and medium folate intake groups. No significant association between folate intake and osteoporosis was observed for men. Dose- response analysis showed a non-linear decrease in the risk of osteoporosis with increasing intakes of folate (P= 0.015).

Data from this analysis showed that folate intake was significantly associated with osteoporosis in women especially those over 60yrs of age. Furthermore, a negative association was observed between folate intake and risk of osteoporosis. However, the data showed no significant associations in male participants.  Additional research will be needed to verify these results.

Source: Zhou, Li, Weinmin Deng, Qingrong Wu, Yandong Pan, and Hongxing Huang. “Association between dietary folate intake and the risk of osteoporosis in adults: a cross-sectional study.” BMC Musculoskeletal Disorders 25, no. 1 (2024): 1-9.

© The Author(s) 2024. Open Access 

Click here to read the full text study.

Posted October 8, 2024.

Chrystal Moulton BA, PMP, is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Indianapolis, IN.

References:

  1. Wang Q, Yu H, Kong Y. Association of vitamins with bone mineral density and osteoporosis measured by dual-energy x-ray absorptiometry: a cross-sectional study. BMC Musculoskelet Disord. Jan 17 2024;25(1):69. doi:10.1186/s12891-024-07173-y
  2. Kanis JA, Cooper C, Rizzoli R, Reginster JY. European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. Jan 2019;30(1):3-44. doi:10.1007/s00198-018-4704-5
  3. Li X, Liu X. Associations of serum vitamins levels with bone mineral density in the different race-ethnicities US adults. BMC Musculoskelet Disord. Feb 4 2021;22(1):137. doi:10.1186/s12891-021-03997-0
  4. Herrmann M, Widmann T, Colaianni G, Colucci S, Zallone A, Herrmann W. Increased osteoclast activity in the presence of increased homocysteine concentrations. Clin Chem. Dec 2005;51(12):2348-53. doi:10.1373/clinchem.2005.053363
  5. Liu G, Nellaiappan K, Kagan HM. Irreversible inhibition of lysyl oxidase by homocysteine thiolactone and its selenium and oxygen analogues. Implications for homocystinuria. The Journal of biological chemistry. Dec 19 1997;272(51):32370-7. doi:10.1074/jbc.272.51.32370
  6. Martínez-Ramírez MJ, Palma Pérez S, Delgado-Martínez AD, Martínez-González MA, De la Fuente Arrillaga C, Delgado-Rodríguez M. Vitamin C, vitamin B12, folate and the risk of osteoporotic fractures. A case-control study. International journal for vitamin and nutrition research Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung Journal international de vitaminologie et de nutrition. Nov 2007;77(6):359-68. doi:10.1024/0300-9831.77.6.359
  7. Zhou L, Deng W, Wu Q, Pan Y, Huang H. Association between dietary folate intake and the risk of osteoporosis in adults: a cross-sectional study. BMC Musculoskelet Disord. Jun 22 2024;25(1):487. doi:10.1186/s12891-024-07605-9

 

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