Greater fruit intake was associated with better bone mineral status among Chinese elderly men and women: results of Hong Kong Mr. Os and Ms. Os studies

J Am Med Dir Assoc. 2015 Apr;16(4):309-15. doi: 10.1016/j.jamda.2014.11.001. Epub 2014 Dec 15.


Objectives: Although studies in white populations have reported the beneficial effects of intakes of fruit and vegetables (F&V) on bone mass, limited data are available in Asians, especially among the elderly population. We examined the association of F&V intakes and bone mineral status in Chinese elderly adults and explored the potential mechanisms.

Design, setting, and participants: The study was a population-based cross-sectional study among 4000 Hong Kong Chinese men and women aged 65 years and older.

Measurements: Habitual F&V intakes were ascertained from a validated food frequency questionnaire. Bone mineral measurements of the whole body, hip, lumber spine, and femoral neck were made by dual-energy X-ray absorptiometry. Information on demographic, health, and lifestyles factors was obtained by standardized questionnaire. Relations between F&V intakes and bone mass at various sites were assessed by regression models.

Results: Whole-body and femoral neck bone mineral density and content were significantly and positively associated with fruit intake in both men and women, even when adjustment for a range of potential confounders was made. A daily increase of 100 g/kcal total fruit intake was associated with 4.5% and 6.4% increase of BMD at whole body, and 3.9% and 4.8% increase at the femoral neck in men and women, respectively. No significant association was found between vegetable intake and bone mass. The adjustment for vitamin C intake, but not dietary acid load, attenuated the association between fruit intake and bone mass.

Conclusions: Greater fruit intake was independently associated with better bone mineral status among Chinese elderly men and women. The association is probably modified by dietary vitamin C.

Keywords: Chinese elderly population; Fruits and vegetables; bone mineral content; bone mineral density.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon
  • Aged
  • Aged, 80 and over
  • Aging / physiology
  • Bone Density / physiology*
  • China
  • Cross-Sectional Studies
  • Diet*
  • Female
  • Fruit*
  • Geriatric Assessment / methods
  • Humans
  • Male
  • Multivariate Analysis
  • Nutrition Assessment*
  • Osteoporosis / prevention & control*
  • Regression Analysis
  • Surveys and Questionnaires
  • Vegetables