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Vitamin A intake, serum vitamin D and bone mineral density: analysis of the Korea National Health and Nutrition Examination Survey (KNHANES, 2008-2011).

Joo NS, Yang SW, Song BC, Yeum KJ - Nutrients (2015)

Bottom Line: Mean dietary vitamin A intakes were 737 and 600 μg RE (Retinol Equivalents) in men and women, respectively.Total hip and femoral neck BMD in men and lumbar spine BMD in women were both positively correlated with dietary vitamin A intake in subjects with serum 25(OH)D >75 nmol/L.This cross-sectional study indicates that vitamin A intake does not affect bone mineral density as long as the serum 25(OH)D concentration is maintained in the moderate level of 50-75 nmol/L.

View Article: PubMed Central - PubMed

Affiliation: Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon 443-781, Korea. jchcmc@daum.net.

ABSTRACT
The association of high vitamin A intake and low bone mineral density (BMD) is still controversial. To determine the association of dietary vitamin A intake and serum 25-hydroxyvitamin D (25(OH)D) concentration with BMD, a total of 6481 subjects (2907 men and 3574 women) aged ≥50 years from the Korean National Health and Nutrition Examination Survey (2008-2011) were divided into groups according to dietary vitamin A intake (tertiles) and serum 25(OH)D (<50, 50-75, >75 nmol/L), and evaluated for BMD after adjusting for relevant variables. Mean dietary vitamin A intakes were 737 and 600 μg RE (Retinol Equivalents) in men and women, respectively. Total hip and femoral neck BMD in men and lumbar spine BMD in women were both positively correlated with dietary vitamin A intake in subjects with serum 25(OH)D >75 nmol/L. Among men with serum 25(OH)D <50 nmol/L, both the top (mean 1353 μg RE) and bottom (mean 218 μg RE) tertiles of dietary vitamin A intake had lower BMD than the middle group (mean 577 μg RE). In this population, BMD was the highest among men and women with serum 25(OH)D = 50-75 nmol/L and that there were no differences in BMD by vitamin A intake in these vitamin D adequate groups. This cross-sectional study indicates that vitamin A intake does not affect bone mineral density as long as the serum 25(OH)D concentration is maintained in the moderate level of 50-75 nmol/L.

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The bone mineral density of total hip and femur neck by serum 25-hydroxyvitamin D concentration and dietary vitamin A intake. Three bars represent tertiles of vitamin A intakes (A1, mean 217.8; A2, mean 577.4; A3, mean 1353.4 μg RE) for men and (A1, mean 156.4; A2, mean 449.6; A3, mean 1163.6 μg RE) for women. BMD, bone mineral density; serum 25(OH)D, serum 25-hydroxyvitamin D concentration. Data are adjusted for age, BMI, total calorie intake, calcium intake, job education, smoking, alcohol, moderate physical activity. p for trend analyzed by general linear model in complex data analysis.
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nutrients-07-01716-f002: The bone mineral density of total hip and femur neck by serum 25-hydroxyvitamin D concentration and dietary vitamin A intake. Three bars represent tertiles of vitamin A intakes (A1, mean 217.8; A2, mean 577.4; A3, mean 1353.4 μg RE) for men and (A1, mean 156.4; A2, mean 449.6; A3, mean 1163.6 μg RE) for women. BMD, bone mineral density; serum 25(OH)D, serum 25-hydroxyvitamin D concentration. Data are adjusted for age, BMI, total calorie intake, calcium intake, job education, smoking, alcohol, moderate physical activity. p for trend analyzed by general linear model in complex data analysis.

Mentions: We categorized dietary vitamin A intakes into tertiles and compared these with each BMD by the serum 25(OH)D concentrations (<50, 50–75, >75 nmol/L) after adjusting for relevant variables. When the interaction of two independent variables, vitamins A tertile and D, was determined after adjusting for age, BMI, job education, smoking alcohol intake, physical activity, energy intake, dietary calcium intake and menopause, oral contraceptives, hormone replacement therapy in case of women, there was significant interaction in the femoral neck of men (p = 0.038), but not in the other sites (total hip, p = 0.067; lumbar spine, p = 0.395). Women did not show any interaction. Among men with serum 25(OH)D <50 nmol/L, both the top (mean 1353 μg RE; 801.3–2990.4 μg RE) and bottom (mean 218 μg RE; ≤378.6 μg RE) tertiles of dietary vitamin A intake had a lower BMD than the middle group (mean 577 μg RE; 378.7~801.2). In this population, BMD was the highest among men and women with serum 25(OH)D 50–75 nmol/L, and there were no differences in vitamin A intake in these vitamin D adequate groups (Figure 2).


Vitamin A intake, serum vitamin D and bone mineral density: analysis of the Korea National Health and Nutrition Examination Survey (KNHANES, 2008-2011).

Joo NS, Yang SW, Song BC, Yeum KJ - Nutrients (2015)

The bone mineral density of total hip and femur neck by serum 25-hydroxyvitamin D concentration and dietary vitamin A intake. Three bars represent tertiles of vitamin A intakes (A1, mean 217.8; A2, mean 577.4; A3, mean 1353.4 μg RE) for men and (A1, mean 156.4; A2, mean 449.6; A3, mean 1163.6 μg RE) for women. BMD, bone mineral density; serum 25(OH)D, serum 25-hydroxyvitamin D concentration. Data are adjusted for age, BMI, total calorie intake, calcium intake, job education, smoking, alcohol, moderate physical activity. p for trend analyzed by general linear model in complex data analysis.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4377877&req=5

nutrients-07-01716-f002: The bone mineral density of total hip and femur neck by serum 25-hydroxyvitamin D concentration and dietary vitamin A intake. Three bars represent tertiles of vitamin A intakes (A1, mean 217.8; A2, mean 577.4; A3, mean 1353.4 μg RE) for men and (A1, mean 156.4; A2, mean 449.6; A3, mean 1163.6 μg RE) for women. BMD, bone mineral density; serum 25(OH)D, serum 25-hydroxyvitamin D concentration. Data are adjusted for age, BMI, total calorie intake, calcium intake, job education, smoking, alcohol, moderate physical activity. p for trend analyzed by general linear model in complex data analysis.
Mentions: We categorized dietary vitamin A intakes into tertiles and compared these with each BMD by the serum 25(OH)D concentrations (<50, 50–75, >75 nmol/L) after adjusting for relevant variables. When the interaction of two independent variables, vitamins A tertile and D, was determined after adjusting for age, BMI, job education, smoking alcohol intake, physical activity, energy intake, dietary calcium intake and menopause, oral contraceptives, hormone replacement therapy in case of women, there was significant interaction in the femoral neck of men (p = 0.038), but not in the other sites (total hip, p = 0.067; lumbar spine, p = 0.395). Women did not show any interaction. Among men with serum 25(OH)D <50 nmol/L, both the top (mean 1353 μg RE; 801.3–2990.4 μg RE) and bottom (mean 218 μg RE; ≤378.6 μg RE) tertiles of dietary vitamin A intake had a lower BMD than the middle group (mean 577 μg RE; 378.7~801.2). In this population, BMD was the highest among men and women with serum 25(OH)D 50–75 nmol/L, and there were no differences in vitamin A intake in these vitamin D adequate groups (Figure 2).

Bottom Line: Mean dietary vitamin A intakes were 737 and 600 μg RE (Retinol Equivalents) in men and women, respectively.Total hip and femoral neck BMD in men and lumbar spine BMD in women were both positively correlated with dietary vitamin A intake in subjects with serum 25(OH)D >75 nmol/L.This cross-sectional study indicates that vitamin A intake does not affect bone mineral density as long as the serum 25(OH)D concentration is maintained in the moderate level of 50-75 nmol/L.

View Article: PubMed Central - PubMed

Affiliation: Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon 443-781, Korea. jchcmc@daum.net.

ABSTRACT
The association of high vitamin A intake and low bone mineral density (BMD) is still controversial. To determine the association of dietary vitamin A intake and serum 25-hydroxyvitamin D (25(OH)D) concentration with BMD, a total of 6481 subjects (2907 men and 3574 women) aged ≥50 years from the Korean National Health and Nutrition Examination Survey (2008-2011) were divided into groups according to dietary vitamin A intake (tertiles) and serum 25(OH)D (<50, 50-75, >75 nmol/L), and evaluated for BMD after adjusting for relevant variables. Mean dietary vitamin A intakes were 737 and 600 μg RE (Retinol Equivalents) in men and women, respectively. Total hip and femoral neck BMD in men and lumbar spine BMD in women were both positively correlated with dietary vitamin A intake in subjects with serum 25(OH)D >75 nmol/L. Among men with serum 25(OH)D <50 nmol/L, both the top (mean 1353 μg RE) and bottom (mean 218 μg RE) tertiles of dietary vitamin A intake had lower BMD than the middle group (mean 577 μg RE). In this population, BMD was the highest among men and women with serum 25(OH)D = 50-75 nmol/L and that there were no differences in BMD by vitamin A intake in these vitamin D adequate groups. This cross-sectional study indicates that vitamin A intake does not affect bone mineral density as long as the serum 25(OH)D concentration is maintained in the moderate level of 50-75 nmol/L.

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