Volume 57, Issue 10 p. 1789-1798

Mediterranean Diet and High Dietary Acid Load Associated with Mixed Nuts: Effect on Bone Metabolism in Elderly Subjects

Mònica Bulló PhD

Mònica Bulló PhD

From the Human Nutrition Unit, School of Medicine, Institut d'Investigacions Sanitàries Pere i Virgili,

Centros de Investigación Biomédica en Red, CB06/03 Physiopathology Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain

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Pilar Amigó-Correig BSc

Pilar Amigó-Correig BSc

From the Human Nutrition Unit, School of Medicine, Institut d'Investigacions Sanitàries Pere i Virgili,

Centros de Investigación Biomédica en Red, CB06/03 Physiopathology Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain

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Fabiola Márquez-Sandoval BSc

Fabiola Márquez-Sandoval BSc

From the Human Nutrition Unit, School of Medicine, Institut d'Investigacions Sanitàries Pere i Virgili,

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Nancy Babio PhD

Nancy Babio PhD

From the Human Nutrition Unit, School of Medicine, Institut d'Investigacions Sanitàries Pere i Virgili,

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Miquel A. Martínez-González PhD

Miquel A. Martínez-González PhD

Preventive Medicine and Public Health Department, School of Medicine, University of Navarra, Pamplona, Spain; and

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Ramon Estruch PhD

Ramon Estruch PhD

Centros de Investigación Biomédica en Red, CB06/03 Physiopathology Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain

Internal Medicine Department, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clinic, Barcelona, Spain.

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Joseph Basora MD

Joseph Basora MD

From the Human Nutrition Unit, School of Medicine, Institut d'Investigacions Sanitàries Pere i Virgili,

Centros de Investigación Biomédica en Red, CB06/03 Physiopathology Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain

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Rosa Solà PhD

Rosa Solà PhD

Lipids and Atherosclerosis Research Unit, School of Medicine, University Rovira i Virgili, Reus, Spain

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Jordi Salas-Salvadó PhD

Jordi Salas-Salvadó PhD

From the Human Nutrition Unit, School of Medicine, Institut d'Investigacions Sanitàries Pere i Virgili,

Centros de Investigación Biomédica en Red, CB06/03 Physiopathology Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain

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First published: 05 October 2009
Citations: 32
Address correspondence to Mònica Bulló, Human Nutrition Unit, Faculty of Medicine of Reus, University Rovira i Virgili, C/Sant Llorenç 21, 43201 Reus, Spain. E-mail: [email protected]

Abstract

OBJECTIVES: To analyze the effect of differing diet on the acid load content on bone metabolism.

DESIGN: Multicentric, randomized, single-blind, parallel-group clinical trial.

SETTING: Outpatient clinics.

PARTICIPANTS: Two hundred thirty-eight elderly men and women aged 60 to 80 at high risk for cardiovascular disease were randomly assigned to three interventional groups: a recommended low-fat diet (control diet group), a Mediterranean diet supplemented with virgin olive oil, or a Mediterranean diet supplemented with mixed nuts.

MEASUREMENTS: Main outcomes were 12-month changes from baseline in bone formation and resorption markers and bone mass measured according to quantitative ultrasound scanning.

RESULTS: The baseline data on the anthropometric, bone densitometry, and biochemical variables did not differ between the three groups. Dietary potential renal acid load (PRAL) and daily net endogenous acid production (NEAP) at baseline did not differ between groups. After intervention, subjects allocated to the Mediterranean diet with mixed nuts had a significant increase of PRAL and NEAP. In comparison, subjects in the Mediterranean diet with nuts group had higher parathyroid hormone (PTH) levels (2.63, 95% confidence interval (CI)=−1.01–6.35, P=.02) and a nonsignificantly higher (0.31, 95% CI=−0.13–0.74, P=.14) urine free deoxypyridoxine:creatinine ratio, a marker of bone resorption, than the control group and the Mediterranean diet with virgin olive oil group.

CONCLUSION: A Mediterranean dietary pattern associated with a high dietary acid load derived from consumption of mixed nuts does not seem to have a much greater effect on bone metabolism biomarkers, with the exception of PTH levels, than a Mediterranean diet without mixed nuts or a control diet in elderly subjects.