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This study examined the association between healthy lifestyle score (HLS), which contained 7 items (smoking, BMI, physical activity, diet, alcohol, sleep and anxiety) and BMD. Results showed HLS was positively associated with BMD at all studied sites, suggesting that healthier lifestyle patterns might be beneficial to bone health., Purpose: Previous studies have reported favourable associations of individual healthy lifestyle factors with bone mineral density (BMD), but limited evidence showed the relationship of a combined healthy lifestyle score (HLS) with BMD. This study examined the association between the HLS and BMD., Methods: This community-based cross-sectional study included 3051 participants aged 40-75 years. The HLS contained 7 items (smoking, BMI, physical activity, diet quality, alcohol intake, sleep and anxiety). BMD values of whole body (WB), lumbar spine 1-4 (L 1-4 ), total hip (TH) and femur neck (FN) were measured using dual-energy X-ray absorptiometry., Results: After adjusting for potential covariates, HLS was positively associated with BMD at all studied sites (P-trend < 0.01). The mean BMDs were 2.69% (WB), 5.62% (L 1-4 ), 6.13% (TH) and 5.71% (FN) higher in participants with HLS of 6-7 points than in those with HLS of 0-2 points. The per 1 of 7 unit increase in the HLS was associated with increases of 7.63 (WB)-13.4 (TH) mg/cm 2 BMD levels at all sites. These favourable associations tended to be more pronounced in men than in women. Among the 7 items, physical activity contributed most to the favourable associations, followed by BMI, non-smoking and diet; the other three items played little roles. Sensitivity analyses showed that the significant associations remained after excluding any one of the 7 components or excluding fracture subjects at all sites., Conclusion: Higher HLS was associated with greater BMD in middle-aged and elderly Chinese, suggesting that healthier lifestyle patterns might be beneficial to bone health.

This study investigated the relationships of fat mass (FM) and lean mass (LM) with estimated hip bone strength in Chinese men aged 50-80 years (median value: 62.0 years). A cross-sectional study including 889 men was conducted in Guangzhou, China. Body composition and hip bone parameters were generated by dual-energy X-ray absorptiometry (DXA). The relationships of the LM index (LMI) and the FM index (FMI) with bone phenotypes were detected by generalised additive models and multiple linear regression. The associations between the FMI and the bone variables in LMI tertiles were further analysed. The FMI possessed a linear relationship with greater estimated hip bone strength after adjustment for the potential confounders ( p < 0.05). Linear relationships were also observed for the LMI with most bone phenotypes, except for the cross-sectional area ( p < 0.05). The contribution of the LMI (4.0%-12.8%) was greater than that of the FMI (2.0%-5.7%). The associations between the FMI and bone phenotypes became weaker after controlling for LMI. Further analyses showed that estimated bone strength ascended with FMI in the lowest LMI tertile ( p < 0.05), but not in the subgroups with a higher LMI. This study suggested that LM played a critical role in bone health in middle-aged and elderly Chinese men, and that the maintenance of adequate FM could help to promote bone acquisition in relatively thin men.

Objective: A few studies have suggested that the consumption of fruit and vegetables (FV) may benefit bone health, but limited data are available in Asian subjects. We examined the association between FV intake and bone mineral density (BMD) and osteoporosis in Chinese adults., Methods: This population-based cross-sectional study involved 2083 women and 1006 men aged 40-75 years in Guangzhou, China. Habitual dietary data was collected from a 79-item food frequency questionnaire by face-to-face interviews. The BMD was measured for the whole body (WB), lumbar spine (LS), total hip (TH) and femur neck (FN) with dual-energy X-ray absorptiometry., Results: After adjustment for potential covariates, we observed dose-dependent associations between total FV intake and BMD and osteoporosis risk. The mean BMD was higher in tertile 3 vs. tertile 1 by 1.33% (TH) and 1.31% (FN) for FV, and 1.10% (WB), 1.57% (TH), and 2.05% (FN) for fruit (all P-trends < 0.05). Significant beneficial associations with BMD at some sites were also found in most fruit categories but not in total vegetables or their subgroups. The odds ratios (95% confidence interval) of osteoporosis (T-score ≤ -2.5) in tertile 3 (vs. 1) were 0.73 (0.58-0.92), 0.37 (0.22-0.60), and 0.71 (0.52-0.97) for FV; 0.82 (0.66-1.03), 0.48 (0.30-0.77) and 0.89 (0.61-1.12) for fruit; and 0.80 (0.64-1.01), 0.57 (0.35-0.92) and 0.76 (0.55-1.05) for vegetables at the LS, TH, and FN, respectively. The favorable association between FV intake and the occurrence of osteoporosis was evident only in subjects with lower BMI (<24.0 kg/m2, P-trends < 0.05)., Conclusions: Greater intake of FV was independently associated with a higher BMD and a lower presence of osteoporosis in middle-aged and elderly Chinese subjects with lower BMI. Fruit tended to have more contribution to the favorable association than vegetables., Competing Interests: The authors have declared that no competing interests exist.

Previous studies showed that better adherence to the Mediterranean diet (MD) is associated with lower risk of chronic diseases, but limited data are available on bone health. We investigated the association of the MD with bone mineral density (BMD) in Chinese adults. We included 2371 participants aged 40-75 years in this community-based cross-sectional study. Dietary information was assessed at baseline and a 3-year follow-up. Alternate Mediterranean diet (aMed) scores were calculated. BMD was determined at the second survey. After adjusting for potential covariates, higher aMed scores were positively and dose-dependently associated with BMD (all P-trends < 0.05). The BMD values were 1.94% (whole body), 3.01% (lumbar spine), 2.80% (total hip), 2.81% (femur neck), 2.62% (trochanter), and 2.85% (intertrochanter) higher in the quintile 5 (highest, vs. quintile 1) aMed scores for all of the subjects (all P-values < 0.05). Similar associations were found after stratifying by gender (P-interaction = 0.338-0.968). After excluding the five non-significant components of vegetables, legumes, fish, monounsaturated to saturated fat ratio, and alcohol intake from the aMed scores, the percentage mean differences were substantially increased by 69.1-150% between the extreme quintiles. In conclusion, increased adherence to the MD shows protective associations with BMD in Chinese adults.

Background and Objective: Previous studies have suggested a positive link between serum uric acid (UA) and bone mineral density (BMD). In this study, we re-examined the association between UA and BMD and further explored whether this was mediated by skeletal muscle mass in a general Chinese population., Method: This community-based cross-sectional study was conducted among 3079 (963 men and 2116 women) Chinese adults aged 40-75 years. Face-to-face interviews and laboratory analyses were performed to determine serum UA and various covariates. Dual-energy X-ray absorptiometry was used to assess the BMD and appendicular skeletal muscle mass. The skeletal muscle mass index (SMI = ASM/Height(2), kg/m(2)) for the total limbs, arms, and legs was then calculated., Results: The serum UA was graded and, in general, was significantly and positively associated with the BMD and muscle mass, after adjustment for multiple covariates in the total sample. Compared with participants in lowest quartile of UA, those participants in highest quartile showed a 2.3%(whole body), 4.1%(lumbar spine), 2.4%(total hip), and 2.0% (femoral neck) greater BMDs. The mean SMIs in the highest (vs. lowest) quartile increased by 2.7% (total), 2.5% (arm), 2.7% (leg) respectively. In addition, path analysis suggested that the favorable association between UA and BMD might be mediated by increasing SMI., Conclusion: The elevated serum UA was associated with a higher BMD and a greater muscle mass in a middle-aged and elderly Chinese population and the UA-BMD association was partly mediated by muscle mass.

This study aimed to elucidate the associations of age, BMI, and years of menstruation with proximal femur strength in Chinese postmenopausal women, which may improve the prediction of hip fracture risk. A cross-sectional study was conducted in 1322 Chinese postmenopausal women recruited from communities. DXA images were used to generate bone mineral density (BMD) and geometric parameters, including cross-sectional area (CSA), outer diameter (OD), cortical thickness (CT), section modulus (SM), buckling ratio (BR) at the narrow neck (NN), intertrochanter (IT), and femoral shaft (FS). Relationships of age, BMI, and years of menstruation with bone phenotypes were analyzed with the adjustment of height, age at menarche, total daily physical activity, education, smoking status, calcium tablet intake, etc. Age was associated with lower BMD, CSA, CT, SM, and higher BR (p < 0.05), which indicated a weaker bone strength at the proximal femur. BMI and years of menstruation had the positive relationships with proximal femur strength (p < 0.05). Further analyses showed that the ranges of absolute value of change slope per year, per BMI or per year of menstruation were 0.14%-1.34%, 0.20%-2.70%, and 0.16%-0.98%, respectively. These results supported that bone strength deteriorated with aging and enhanced with higher BMI and longer time of years of menstruation in Chinese postmenopausal women.

Previous studies have suggested that vitamin E (VE) may affect bone health, but the findings have been inconclusive. We examined the relationship between VE status (in both diet and serum) and bone mineral density (BMD) among Chinese adults. This community-based study included 3203 adults (2178 women and 1025 men) aged 40-75 years from Guangzhou, People's Republic of China. General and dietary intake information were collected using structured questionnaire interviews. The serum α-tocopherol (TF) level was quantified by reversed-phase HPLC. The BMD of the whole body, the lumbar spine and left hip sites (total, neck, trochanter, intertrochanter and Ward's triangle) were measured using dual-energy X-ray absorptiometry. In women, the dietary intake of VE was significantly and positively associated with BMD at the lumbar spine, total hip, intertrochanter and femur neck sites after adjusting for covariates (P(trend): 0·001-0·017). Women in quartile 3 of VE intake typically had the highest BMD; the covariate-adjusted mean BMD were 2·5, 3·06, 3·41 and 3·54% higher, respectively, in quartile 3 (v. 1) at the four above-mentioned sites. Similar positive associations were observed between cholesterol-adjusted serum α-TF levels and BMD at each of the studied bone sites (P(trend): 0·001-0·022). The covariate-adjusted mean BMD were 1·24-4·83% greater in quartile 4 (v. 1) in women. However, no significant associations were seen between the VE levels (dietary or serum) and the BMD at any site in men. In conclusion, greater consumption and higher serum levels of VE are associated with greater BMD in Chinese women but not in Chinese men.

Increasing dietary Ca intake may prevent the excessive mobilisation of bone mineral in nursing mothers. We aimed to investigate whether higher Ca intake could positively modulate the bone mineral changes in Chinese postpartum lactating women. The study was a 12-month randomised, double-blinded, parallel group trial conducted over 12 months. A total of 150 postpartum women were randomly selected to receive either 40 g of milk powder containing 300 mg of Ca and 5 μg of vitamin D (Low-Ca group) or same milk powder additionally fortified with 300 mg of Ca (Mid-Ca group) or 600 mg of Ca (High-Ca group). Bone mineral density (BMD) for the whole body, the lumbar spine, the total left hip and its sub-regions was measured using dual-energy X-ray absorptiometry. A total of 102 subjects completed the whole trial. The duration of total lactating time was 7·9 (SD 2·8) months on average. The intention-to-treat analysis yielded the following mean percentage changes in BMD for the whole body, the lumbar spine and the total left hip, respectively: -0·93 (SD 1·97), 2·11 (SD 4·90) and -1·60 (SD 2·65)% for the Low-Ca group; -0·56 (SD 1·89), 2·21 (SD 3·77) and -1·43 (SD 2·30)% for the Mid-Ca group; and -0·44 (SD 1·67), 2·32 (SD 4·66) and -0·95 (SD 4·08)% for the High-Ca group. The differences between the groups were not statistically significant (P: 0·5-0·9). The results of the complete case analysis were similar. In sum, we found no significant differences in the bone mineral changes from baseline to 12 months in postpartum lactating women consuming milk powder fortified with different levels of Ca.

Background: Former studies suggested an adverse effect of hypervitaminosis A on bone health, while the effects of retinol and its precursor (β-carotene) remain uncertain in populations consuming vitamin A (VA) mainly from plant sources., Objective: We investigated the association of serum, dietary retinol, and β-carotene with bone mineral density (BMD) in Chinese adults., Methods: We recruited 2101 women and 1053 men (aged 40-75 years) in Guangzhou, China. Dietary intake was assessed through face-to-face interviews with food-frequency questionnaires at baseline and 3 years later. Serum levels of retinol and β-carotene were determined by HPLC using a baseline specimen, and the BMD for the whole body (WB), lumbar spine (LS), total hip (TH), and femur neck (FN) were measured using dual energy X-ray absorptiometry at follow-up., Results: In general, greater levels of serum retinol, β-carotene, and the β-carotene-to-retinol ratio were associated with a higher BMD after adjustment for potential covariates in the total sample. BMD values in the top (vs. bottom) quartile were increased by 2.06% (TH) for retinol; 2.87% (WB), 2.51% (LS), 3.10% (FN) for β-carotene; 2.21% (WB) and 2.05% (FN) for the β-carotene-to-retinol ratio in the total sample (all p<0.05). A significant positive association with BMD was observed for dietary intake of β-carotene and total VA in retinol equivalents at the hip sites in the total sample., Conclusion: Higher circulating and dietary levels of VA and β-carotene and higher serum β-carotene-to-retinol ratios were positively associated with BMD in Chinese adults consuming relatively low levels of VA, mainly from plant foods., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: Although it is well established that a higher body weight is protective against osteoporosis, the effects of body fat and fat distribution on bone mineral density (BMD) after adjustment for body weight remains uncertain., Objective: To examine the relationship between body fat and fat distribution and BMD beyond its weight-bearing effect in middle-aged Chinese adults., Method: The study had a community-based cross-sectional design and involved 1,767 women and 698 men aged 50-75 years. The BMD of the lumbar spine, total hip, and whole body, and the fat mass (FM) and percentage fat mass (%FM) of the total body and segments of the body were measured by dual-energy X-ray absorptiometry. General information on the participants was collected using structured questionnaire interviews., Result: After adjusting for potential confounders, an analysis of covariance showed the weight-adjusted (WA-) total FM (or %FM) to be negatively associated with BMD in all of the studied sites (P<0.05) in both women and men. The unfavorable effects of WA-total FM were generally more substantial in men than in women, and the whole body was the most sensitive site related to FM, followed by the total hip and the lumbar spine, in both genders. The mean BMD of the lumbar spine, total hip, and whole body was 3.93%, 3.01%, and 3.65% (in women) and 5.02%, 5.57%, 6.03% (in men) lower in the highest quartile (vs. lowest quartile) according to the WA-total FM (all p<0.05). Similar results were noted among the groups for WA-total FM%. In women, abdominal fat had the most unfavorable association with BMD, whereas in men it was limb fat., Conclusion: FM (or %FM) is inversely associated with BMD beyond its weight-bearing effect. Abdominal fat in women and limb fat in men seems to have the greatest effect on BMD.

Objective: Previous studies showed an inconsistent association of fruit and vegetable consumption with bone health. We assessed the associations in Chinese adolescents, young and postmenopausal women., Design: A cross-sectional study conducted in China during July 2009 to May 2010., Setting: Bone mineral density (BMD) and content (BMC) at the whole body, lumbar spine and left hip were measured with dual-energy X-ray absorptiometry. Dietary intakes were assessed using an FFQ. All these values were separately standardized into Z-scores in each population subgroup., Subjects: One hundred and ten boys and 112 girls (11-14 years), 371 young women (20-34 years, postpartum within 2 weeks) and 333 postmenopausal women (50-70 years)., Results: After adjustment for potential covariates, analysis of covariance showed a significantly positive association between fruit intake and BMD and BMC in all participants combined (P-trend: < 0.001 to 0.002). BMD Z-score increased by 0.25 (or 2.1 % of the mean), 0.22 (3.5 %), 0.23 (3.0 %) and 0.25 (3.5 %), and BMC Z-score increased by 0.33 (5.7 %), 0.25 (5.8 %), 0.34 (5.9 %) and 0.29 (4.7 %), at the total body, lumbar spine, total hip and femoral neck in participants belonging to the top tertile compared with the bottom tertile of fruit intake (all P < 0.05), respectively. There was no significant association between vegetable intake and bone mass at all bone sites studied except for total body BMD (P = 0.030). Relatively more pronounced effects were observed in boys and postmenopausal women., Conclusion: Our findings add to the existing evidence that fruits and vegetables may have a bone sparing effect.

Objective: Calcium demand is increased during pregnancy. However, few randomized controlled trials examined the effects of calcium supplementation on bone mass during pregnancy. This study determined effects of calcium and milk supplementation on maternal bone mineral density (BMD) and bone turnover in pregnant Chinese women with habitual low calcium intake., Methods: In this randomized controlled trial, 36 Chinese pregnant women (24-31 years, 18 gestational weeks) were randomly assigned to the following three arms (12 each): I, usual diet; II, "I" + 45 g milk powder (containing 350 mg calcium); or III, "II" + 600 mg calcium/day from gestational age of 20 weeks to 6 weeks post-partum (PP). BMD was measured post-treatment using dual-energy X-ray absorptiometry. Dietary intakes, 24-h urinary calcium, bone resorption (urinary hydroxyproline) and formation (serum osteocalcin) biomarkers were examined at the gestational age of 20 and 34 weeks, and 6 weeks PP., Results: A dose-dependent relationship was observed between calcium intake and BMDs. The BMD values were significantly higher in subjects with calcium and milk supplementation than those in the controls at the whole body and spine (p < 0.05) but not at the hip sites. We found significant decreases in changes of urinary hydroxyproline, and significant increases in serum osteocalcin during the intervention period in the calcium/milk intervention groups than those in the control group (all p < 0.05)., Conclusion: Calcium/milk supplementation during pregnancy is associated with greater BMD at the spine and whole body and suppresses bone resorption in Chinese women with habitual low calcium intake.

Introduction: A number of RCTs have examined the role of soy isoflavones on bone mineral density (BMD) and yielded inconsistent results. This meta-analyses aims to assess the overall effect of soy isoflavones on BMD., Methods: We searched for all articles published in English from January 1990 to March, 2008. We included RCTs of soy isoflavone supplementation in women of at least one year duration. The main outcomes were BMD changes from baseline at the lumbar spine, total hip and femoral neck., Results: We identified 10 eligible RCTs containing 896 women. A mean dose of 87 mg soy isoflavones for at least one year did not significantly affect BMD changes. The mean (95%CI) differences in BMD changes (in mg/cm(2)/year) were 4.1 (-1.6, 9.8) (0.4%) at the lumbar spine, -1.5 (-7.2, 4.3) (-0.3%) at the femoral neck under random-effects model, and 2.5 (-0.5, 5.4) (0.2%) at the total hip by fix-effects model, respectively. Similar results were obtained in subgroup analyses by isoflavone sources (soy protein vs. isoflavone extract), ethnic differences (Asian vs. Western). Larger dose (>or=80 mg/d), but not lower dose (<80 mg/d), of isoflavone intervention tended to have a weak beneficial effect on spine BMD (p=0.08 vs. p=0.94)., Conclusions: Soy isoflavone supplementation is unlikely to have significant favorable on BMD at the lumbar spine and hip in women.

We assessed the main and interaction effects of interleukin-6 and estrogen receptor gene polymorphisms on bone mass accrual in Chinese adolescent girls. A total of 228 premenarche Chinese girls (9-11.5 years old) were recruited for a 2-year follow-up study. Bone mineral density (BMD) at the total body, lumbar spine (L1-L4), and total left hip were measured by dual-energy X-ray absorptiometry at baseline and follow-up. The -174G/C and -634C/G polymorphism of IL-6 gene, and PvuII and XbaI polymorphisms of the estrogen receptor (ER)-alpha gene, were determined. The -634C/G polymorphism of the IL-6 gene and PvuII polymorphism of ER-alpha gene were significantly associated with bone mass accrual after adjusting the potential confounding factors. Girls with pp genotype of ER-alpha gene had greater percentage accrual in BMD of total body (P = 0.010) and femoral intertrochanter (P = 0.038) than their PP and Pp counterparts. Girls with CC genotype of IL-6 -634G/C gene had higher percentage accrual in BMD of total body (P = 0.032) and femoral trochanter (P = 0.048) than their CG + GG counterparts. Significant interaction effects of IL-6 -634C/G polymorphism and ER-alpha PvuII polymorphism were observed on percentage change in BMD of total left hip (P = 0.009) and femoral intertrochanter (P = 0.007). The genotype CC (IL-6 -634C/G) x pp (ER-alpha PvuII) was associated with greater BMD accrual than other genotype combination in Chinese adolescent girls. We found that the IL-6 -634C/G and ER-alpha PvuII polymorphism were significantly associated with BMD accrual and that they have an interactional effect on BMD accrual in Chinese adolescent girls.

Objective: To assess the association of physical activity with bone mass in premenarche girls., Methods: Bone mineral density (BMD) and bone mineral content (BMC) at the whole body, femoral neck, Ward triangle and L1-L4 spine were measured using dual-energy X-ray absorptiometry (DXA) in 194 premenarche girls (10 +/- 1, year). Physical activity and dietary calcium intakes were assessed by using frequency questionnaire and diary., Results: It was found that BMD and BMC were significantly and positively associated with weight-bearing physical activities (WBPA) (P < 0.01), total physical activities (TPA) (P < 0.01) rather than non-weight-bearing physical activity (P > 0.05) at all the studied bone sites (P < 0.01). Both BMC and BMD were tending to a better increase of WBPA. When WBPA increases from 227 to 415 (kcal/d), mean BMC and BMD were increased in 17.5%-29.0% and 8.8%-17.1%, respectively., Conclusion: It should be helpful for premenarche girls to improve bone mass by increasing physical activities, especially weight-bearing physical activities.

Although studies in Caucasian populations have reported the beneficial effects of intakes of fruit and vegetables on bone mass, limited data are available in the Asian populations. We examined the association of the intake of fruits and vegetables with bone mineral density (BMD) in a population-based cross-sectional study of 670 postmenopausal Chinese women aged 48-63 years. Habitual dietary intakes were assessed using a food frequency questionnaire. BMD at the whole body, lumbar spine and left hip were measured with dual-energy X-ray absorptiometry. Univariate regression analyses showed that the total intake of fruits and vegetables was significantly associated with greater BMD at the whole body, lumbar spine (L1-L4), total hip, trochanter and intertrochanter. An independently positive association between fruit and vegetable intake and BMD at the whole body (P = 0.005), lumbar spine (P < 0.001) and total hip (P = 0.024) remained even after adjusting for age, years since menopause, body weight and height, dietary energy, protein and Ca, and physical activities. A daily increase of 100 g fruit and vegetable intake was associated with 0.0062 (95 % CI 0.0019, 0.0105) g/cm2, 0.0098 (95 % CI 0.0041, 0.0155) g/cm2 and 0.0060 (95 % CI 0.0011, 0.0109) g/cm2 increases in BMD at the whole body, lumbar spine and total hip, respectively. In conclusion, greater fruit and vegetable intake is independently associated with better BMD among postmenopausal Chinese women.

The role of circulatory proteomics in osteoporosis is unclear. Proteome‐wide profiling holds the potential to offer mechanistic insights into osteoporosis. Serum proteome with 413 proteins was profiled by liquid chromatography–tandem mass spectrometry (LC–MS/MS) at baseline, and the 2nd, and 3rd follow‐ups (7704 person‐tests) in the prospective Chinese cohorts with 9.8 follow‐up years: discovery cohort (n = 1785) and internal validation cohort (n = 1630). Bone mineral density (BMD) was measured using dual‐energy X‐ray absorptiometry (DXA) at follow‐ups 1 through 3 at lumbar spine (LS) and femoral neck (FN). We used the Light Gradient Boosting Machine (LightGBM) to identify the osteoporosis (OP)‐related proteomic features. The relationships between serum proteins and BMD in the two cohorts were estimated by linear mixed‐effects model (LMM). Meta‐analysis was then performed to explore the combined associations. We identified 53 proteins associated with osteoporosis using LightGBM, and a meta‐analysis showed that 22 of these proteins illuminated a significant correlation with BMD (p < 0.05). The most common proteins among them were PHLD, SAMP, PEDF, HPTR, APOA1, SHBG, CO6, A2MG, CBPN, RAIN APOD, and THBG. The identified proteins were used to generate the biological age (BA) of bone. Each 1 SD‐year increase in KDM‐Proage was associated with higher risk of LS‐OP (hazard ratio [HR], 1.25; 95% CI, 1.14–1.36, p = 4.96 × 10−06), and FN‐OP (HR, 1.13; 95% CI, 1.02–1.23, p = 9.71 × 10−03). The findings uncovered that the apolipoproteins, zymoproteins, complements, and binding proteins presented new mechanistic insights into osteoporosis. Serum proteomics could be a crucial indicator for evaluating bone aging. [ABSTRACT FROM AUTHOR]

Objectives: Previous studies found that tea consumption was related to a reduction in the risks of some chronic diseases, but limited data are available on bone health. This study aimed to examine the associations of tea consumption with hip bone strength in Chinese women.Design: Cross-sectional study.Setting: The participants were from the ongoing Guangzhou Nutrition and Health Study. This was a cohort study started in 2008. The examination data conducted between June 2010 and December 2013 were used.Participants: A total of 1,495 Chinese women aged more than 40 years were included.Measurements: Tea consumption, sociodemographic information and lifestyle habits were collected by a face-to-face questionnaire. Hip bone mineral density (BMD) and geometric parameters, i.e. cross-sectional area (CSA), section modulus (Z) and buckling ratio (BR), were generated by dual-energy X-ray absorptiometry. The associations of tea consumption with bone phenotypes were detected by analysis of covariance and multiple linear regression models after adjusting for age, body mass index, years since menopause, physical activity, dietary-protein intake, dietary-calcium intake, calcium tablet intake, drinking status and smoking status.Results: Tea drinkers (n = 732) had approximately 1.9% higher BMD (p < 0.05) and 3.6% lower BR (p < 0.05) than non-tea drinkers (n = 763). The dose-response relationships of BMD, BR or CSA with total tea consumption were identified (p-trend < 0.05). Tea drinking was found to be a significant and independent predictor of BMD (β = 0.068, p < 0.05) or BR (β = -0.079, p < 0.05).Conclusion: Tea consumption was associated with increased bone strength in middle-aged and elderly Chinese women. [ABSTRACT FROM AUTHOR]

Abstract: Background/objective: Adequate calcium intakes may enhance bone mineral accumulation during childhood. Little is known about the optimal calcium intake in Chinese adolescents. We examined the effects of three levels of calcium intake on bone mineral accretion in adolescents. Methods: This was a 2-year randomized, double-blind, controlled trial. The subjects were randomly assigned to receive 40g of milk powder containing 300mg of calcium and 200IU of vitamin D (Low-Ca group), or same milk powder additionally fortified with 300mg of calcium (Mid-Ca group) or 600mg of calcium (High-Ca group) for 2years. The subjects' bone mineral density (BMD) and bone mineral content (BMC) at the total body, lumbar spine and left hip were determined by dual-energy X-ray absorptiometry at baseline and after the second year of treatment. Of the 111 girls and 109 boys (aged 12–14years) enrolled, 91 girls and 91 boys completed the trial. Results: The girls in the High-Ca group (1,110mg/d) had 2.3%, 2.7% and 2.6% greater BMD accretion at the total hip, femoral neck and shaft (P<0.05) but not at total body less head and spine than those in the Low-Ca group (655mg/d). A significant effect of higher calcium intake was also observed for percentage change of size-adjusted BMC at femur neck (P=0.047). Bonferroni tests indicated no significant differences in the percentage changes in BMD, BMC or size-adjusted BMC between the Mid- and Low-Ca groups and between the High- and Mid-Ca groups. Extra calcium had no observable additional effect in the boys (P>0.05). Conclusion: An intake of 1000mg/d or more might be helpful in maximizing bone mineral accretion in the hip for girls. But further large studies are required to identify its long-term effects and the optimal calcium intake for boys. [Copyright &y& Elsevier]