title: Effect of increased fruit and vegetable consumption on bone turnover in older adults: a randomised controlled trial.
abstract: Evidence suggests that increased fruit and vegetable (FV) intake may be associated with improved bone health, but there is limited evidence from intervention trials to support this. This 16-week study showed that increased FV consumption (five or more portions per day) does not have any effect on the markers of bone health in older adults.
  
  
  BACKGROUND
  Observational evidence suggests that increased FV consumption may be associated with improved bone health. However, there is lack of evidence from intervention trials to support this. This study examined the effect of increased FV consumption on bone markers among healthy, free-living older adults.
  
  
  METHODS
  A randomised controlled trial was undertaken. Eighty-three participants aged 65-85 years, habitually consuming less than or equal to two portions of FV per day, were randomised to continue their normal diet or to consume five or more portions of FV per day for 16 weeks. FV were delivered to all participants each week, free of charge. Compliance was assessed at baseline and at 6, 12 and 16 weeks by diet histories and biomarkers of micronutrient status. Fasting serum bone markers (osteocalcin (OC) and C-terminal telopeptide of type 1 collagen (CTX)) were measured using enzyme-linked immunosorbent assay.
  
  
  RESULTS
  Eighty-two participants completed the intervention. The five portions per day group showed a significantly greater change in daily FV consumption compared to the two portions per day group (p < 0.001), and this was reflected in significant increases in micronutrient status. No significant differences were evident in change in bone markers between the two portions per day group and the five portions per day group over the 16 weeks (geometric mean of week 16 to baseline ratio (95% confidence interval): OC-0.95 (0.89-1.02) and 1.04 (0.91-1.18), respectively, p = 0.25; CTX-1.06 (0.95-1.19) and 0.98 (0.90-1.06) respectively, p = 0.20).
  
  
  CONCLUSIONS
  Increased FV consumption had no effect on bone markers in older adults. Larger intervention studies of longer duration are warranted to establish whether long-term FV consumption can benefit bone health.
authors.affiliation: Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, BT12 6BJ, UK.
authors.forename: C E
authors.initials: CE
authors.lastname: Neville
authors.forename: I S
authors.initials: IS
authors.lastname: Young
authors.forename: S E C M
authors.initials: SE
authors.lastname: Gilchrist
authors.forename: M C
authors.initials: MC
authors.lastname: McKinley
authors.forename: A
authors.initials: A
authors.lastname: Gibson
authors.forename: J D
authors.initials: JD
authors.lastname: Edgar
authors.forename: J V
authors.initials: JV
authors.lastname: Woodside
mesh_terms: D000368:Aged; D000886:Anthropometry / Q000379:methods; D015415:Biomarkers / Q000097:blood; D016723:Bone Remodeling / Q000502:physiology*; D004032:Diet; D058620:Elder Nutritional Physiological Phenomena / Q000502:physiology*; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D006801:Humans; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage; D008875:Middle Aged; D009752:Nutritional Status / Q000502:physiology; D010349:Patient Compliance; D014675:Vegetables
chemical_list: D015415:Biomarkers; D018977:Micronutrients