Abstract
Osteoporosis is a serious public health problem, and dietary interventions may potentially be helpful in preventing this disorder. The purpose of this study was to determine the effects of a low sodium diet on bone metabolism in postmenopausal women. This was a longitudinal study to determine the effects of a low sodium (2-g/day) diet on bone. Forty postmenopausal African–American and Caucasian women were enrolled in a 2-g/day sodium diet for 6 months. Sodium and calcium excretion, bone turnover, and calcitropic hormones (intact parathyroid hormone (PTH) and 1,25 dihydroxyvitamin D) were measured before and 6 months after the intervention. In women who had baseline sodium excretions equal to or greater than the average sodium intake in the United States (≥3.4 g/day), the low sodium diet resulted in significant decreases in sodium excretion (P = 0.01), in calcium excretion (P = 0.01), and in a biomarker of bone turnover, aminoterminal propeptide of type I collagen (P = 0.04). However, there were no significant changes in calcitropic hormones, including intact PTH (P = 0.97) or 1,25 dihydroxyvitamin D (P = 0.49) with the low sodium diet. These findings suggest that in postmenopausal women with sodium intakes ≥3.4 g/day, a low sodium diet may have benefits for skeletal health.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
RR Briefel CL Johnson (2004) ArticleTitleSecular trends in dietary intake in the United States Ann Rev 24 401–431
MA Fiatarone Singh (2002) ArticleTitleBenefits of exercise and dietary measures to optimize shifts in body composition with age Asia Pac J Clin Nutr 11 S642–S652 Occurrence Handle10.1046/j.1440-6047.11.supp3.17.x Occurrence Handle12492658
B Dawson-Hughes SS Harris EA Krall GE Dallal (1997) ArticleTitleEffect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older N Engl J Med 337 670–676 Occurrence Handle10.1056/NEJM199709043371003 Occurrence Handle9278463
B Dawson-Hughes (1996) ArticleTitleCalcium and vitamin D nutritional needs of elderly women J Nutr 126 1165–1167S
LD Carbone AJ Bush KD Barrow AH Kang (2003) ArticleTitleThe relationship of sodium excretion to calcium and sodium excretion and bone mineral density in postmenopausal African–American and Caucasian women J Bone Miner Metab 21 415–420 Occurrence Handle10.1007/s00774-003-0437-3 Occurrence Handle14586799
BE Nordin AG Need HA Morris M Horowitz (1993) ArticleTitleThe nature and significance of the relationship between urinary sodium and urinary calcium in women J Nutr 123 1615–1622 Occurrence Handle8360790
M Zarkadas R Gougeon-Reyburn E Marliss E Block M Alton-Mackey (1989) ArticleTitleSodium chloride supplementation and urinary calcium excretion in postmenopausal women Am J Clin Nutr 50 1088–1094 Occurrence Handle2816793
B Dawson-Hughes SE Fowler G Dalsky C Gallagher (1996) ArticleTitleSodium excretion influences calcium homeostasis in elderly men and women J Nutr 126 2107–2112 Occurrence Handle8814198
A Devine RA Criddle IM Dick DA Kerr RL Prince (1995) ArticleTitleA longitudinal study of the effect of sodium and calcium excretions on regional bone density in postmenopausal women Am J Clin Nutr 62 740–745 Occurrence Handle7572702
PH Lin F Ginty L Appel M Aickin A Bohannon P Garnero D Barclay LP Svetkey (2003) ArticleTitleThe DASH diet and sodium reduction improve markers of bone turnover and calcium metabolism in adults J Nutr 133 3130–3136 Occurrence Handle14519796
AG Need HA Morris DB Cleghorn D DeNichilo M Horowitz BE Nordin (1991) ArticleTitleEffect of salt restriction on urine hydroxyproline excretion in postmenopausal women Arch Intern Med 151 757–759 Occurrence Handle10.1001/archinte.151.4.757 Occurrence Handle2012460
Hooper L, Bartlett C, Davey Smith G, Ebrahim S (2003) Reduced dietary salt for prevention of cardiovascular disease. Cochrane Database Syst Rev CD003656
FJ He GA MacGregor (2002) ArticleTitleEffect of modest salt reduction on blood pressure: a meta-analysis of randomized trials. Implications for public health J Hum Hypertens 16 761–770 Occurrence Handle10.1038/sj.jhh.1001459 Occurrence Handle12444537
MH Weinberger (1996) ArticleTitleSalt sensitivity of blood pressure in humans Hypertension 27 481–490 Occurrence Handle8613190
O Gonzalez-Albarran LM Ruilope E Villa R Garcia Robles (1998) ArticleTitleSalt sensitivity: concept and pathogenesis Diabetes Res Clin Pract 39 S15–S26 Occurrence Handle10.1016/S0168-8227(98)00018-7 Occurrence Handle9649956
JF Guthrie BH Lin E Frazao (2002) ArticleTitleRole of food prepared away from home in the American diet, 1977–78 versus 1994–96: changes and consequences J Nutr Educ Behav 34 140–150 Occurrence Handle12047838
L Dipietro CJ Caspersen AM Ostfeld ER Nadel (1993) ArticleTitleA survey for assessing physical activity among older adults Med Sci Sports Exerc 25 628–642 Occurrence Handle8492692
PL Marino (1998) The ICU Book EditionNumber2nd edn. Williams and Wilkins Baltimore 151
HK Genant S Grampp CC Gluer KG Faulkner M Jergas K Engelke S Hagiwara C Van Kuijk (1994) ArticleTitleUniversal standardization for dual X-ray absorptiometry: patient and phantom cross-calibration results J Bone Miner Res 9 1503–1514 Occurrence Handle7817795
Coordinating Committee (1999) Statement from the National High Blood Pressure Education Program. http://www.nhlbi.nih.gov/health/prof/heart/hbp/salt_upd.pdf
S Wilcox ML Irwin C Addy L Stolarczyk BE Ainsworth M Whitt C Tudor-Locke (2001) ArticleTitleAgreement between participant-rated and compendium-coded intensity of daily activities in a triethnic sample of women ages 4 years and older Ann Behav Med 23 253–262 Occurrence Handle10.1207/S15324796ABM2304_4 Occurrence Handle11761342
JR Weisinger (1999) ArticleTitleBone loss in hypercalciuria: cause or consequence? Am J Kidney Dis 33 xlvi–xlviii Occurrence Handle9915260
EM Alhava M Juuti P Karjalainen (1976) ArticleTitleBone mineral density in patients with urolithiasis. A preliminary report Scand J Urol Nephrol 10 154–156 Occurrence Handle948725
M Fuss T Pepersack P Bergman T Hurard J Simon J Corvilain (1990) ArticleTitleLow calcium diet in idiopathic urolithiasis: a risk factor for osteopenia as great as in primary hyperparathyroidism Br J Urol 65 560–563 Occurrence Handle2372668
FM Sacks LP Svetkey WM Vollmer LJ Appel GA Bray D Harsha E Obarzanek PR Conlin ER Miller Suffix3rd DG Simons-Morton N Karanja PH Lin InstitutionalAuthorNameDASH Sodium Collaborative Research Group (2001) ArticleTitleEffects on blood pressure of reduced dietary sodium and the dietary approaches to stop hypertension (DASH) diet N Engl J Med 344 3–10 Occurrence Handle10.1056/NEJM200101043440101 Occurrence Handle11136953
LK Massey SJ Whiting (1996) ArticleTitleDietary salt, urinary calcium and bone loss J Bone Miner Res 11 731–736 Occurrence Handle8725169
P Garnero E Hausherr MC Chapuy C Marcelli H Grandjean C Muller C Cormier G Breart PJ Meunier PD Delmas (1996) ArticleTitleMarkers of bone resorption predict hip fracture in elderly women: the EPIDOS prospective study J Bone Miner Res 11 1531–1538 Occurrence Handle8889854
SB Rosalki (1998) ArticleTitleBiochemical markers of bone turnover Int J Clin Pract 52 255–256 Occurrence Handle9744151
P Garnero PD Delmas (1998) ArticleTitleBiochemical markers of bone turnover. Application for osteoporosis Endocrinol Metab Clin North Am 27 303–323 Occurrence Handle10.1016/S0889-8529(05)70007-4 Occurrence Handle9669140
A Liesegang (2003) ArticleTitlePossibilities of monitoring bone metabolism in ruminats – an overview of the methods in use Acta Vet Scand Suppl 97 23–28 Occurrence Handle14621392
IR Reid JS Davidson D Wattie F Wu J Lucas GD Gamble MD Rutland T Cundy (2004) ArticleTitleComparative responses of bone turnover markers to bisphosphonate therapy in Paget's disease of bone Bone 35 224–230 Occurrence Handle10.1016/j.bone.2004.03.023 Occurrence Handle15207761
NH Bjarnason S Sarkar T Duong B Mitlak PD Delmas C Christiansen (2001) ArticleTitleSix- and twelve-month changes in bone turnover are related to reduction in vertebral fracture risk during 3 years of raloxifene treatment in postmenopausal osteoporosis Osteoporosis Int 12 922–930 Occurrence Handle10.1007/s001980170020
MB Zemel BA Bedford PR Standley JR Sowers (1989) ArticleTitleSaline infusion causes rapid increase in parathyroid hormone and intracellular calcium levels Am J Hypertens 2 185–187 Occurrence Handle2920098
NA Breslau JL McGuire JE Zerwekh CY Pak (1982) ArticleTitleThe role of dietary sodium on renal excretion and intestinal absorption of calcium and on vitamin D metabolism J Clin Endocrinol Metab 55 369–373 Occurrence Handle6896338
M Harrington T Bennett J Jakobsen L Ovesen C Brot A Flynn KD Cashman (2004) ArticleTitleThe effect of a high-protein, high-sodium diet on calcium and bone metabolism in postmenopausal women and its interaction with vitamin D receptor genotype Br J Nutr 91 41–51 Occurrence Handle10.1079/BJN20031016 Occurrence Handle14748937
C Bieglmayer G Prager B Niederle (2002) ArticleTitleKinetic analyses of parathyroid hormone clearance as measured by three rapid immunoassays during parathyroidectomy Clin Chem 48 1731–1738 Occurrence Handle12324490
NH Bell A Greene S Epstein MJ Oexmann S Shaw J Shary (1985) ArticleTitleEvidence for alteration of the vitamin D–endocrine system in blacks J Clin Invest 76 470–473 Occurrence Handle3839801
H Yamakawa H Suzuki M Nakamura Y Ohno T Saruta (1992) ArticleTitleDisturbed calcium metabolism in offspring of hypertensive parents Hypertension 19 528–534 Occurrence Handle1592447
Mundy GR, Chen D, Oyajobi B (2003) Bone remodeling. In: Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, 5th edn. American Society for Bone and Mineral Research, Washington, DC, p 46–58
JE Kerstetter KO O'Brien KL Insogna (2003) ArticleTitleLow protein excretion: the impact on calcium and bone homeostasis in humans J Nutr 133 855–861S
JE Kerstetter ME Mitnick CM Gundberg DM Caseria AF Ellison TO Carpenter KL Insogna (1999) ArticleTitleChanges in bone turnover in young women consuming different levels of dietary protein J Clin Endocrinol Metab 84 1052–1055 Occurrence Handle10.1210/jc.84.3.1052 Occurrence Handle10084594
B Dawson-Hughes (2003) ArticleTitleCalcium and protein in bone health Proc Nutr Soc 62 505–509 Occurrence Handle10.1079/PNS2003267 Occurrence Handle14506898
RO Mendez MA Gomez AM Lopez H Gonzalez CJ Wyatt (2002) ArticleTitleEffects of calcium and phosphorus excretion on bone density in postmenopausal women in Herosillo, Mexico Ann Nutr Metab 46 249–253 Occurrence Handle10.1159/000066497 Occurrence Handle12464724
M Hegsted HM Linkswiler (1981) ArticleTitleLong-term effects of level of protein excretion on calcium metabolism in young adult women J Nutr 111 244–251 Occurrence Handle7463168
RJ Wood MD Sitrin GJ Cusson IH Rosenberg (1986) ArticleTitleReduction of total parenteral nutrition-induced urinary calcium loss by increasing the phosphorus in the total parenteral nutrition prescription J Parenter Enteral Nutr 10 188–190
PB Rapuri HK Kinyamu JC Gallagher V Haynatzka (2002) ArticleTitleSeasonal changes in calcitropic hormones, bone markers, and bone mineral density in elderly women J Clin Endocrinol Metab 87 2024–2032 Occurrence Handle10.1210/jc.87.5.2024 Occurrence Handle11994336
A Blumsohn KE Naylor W Timm AC Eagleton RA Hannon R Eastell (2003) ArticleTitleAbsence of marked seasonal change in bone turnover: a longitudinal and multicenter cross-sectional study J Bone Miner Res 18 1274–1281 Occurrence Handle12854838
AM Sharma C Cetto U Schorr KP Spies A Distler (1993) ArticleTitleRenal acid–base excretion in normotensive salt-sensitive humans Hypertension 22 884–890 Occurrence Handle8244521
SA New HM MacDonald MK Campbell JC Martin MJ Garton SP Robins DM Reid (2004) ArticleTitleLower estimates of new endogenous non-carbonic acid production are positively associated with indexes of bone health in premenopausal and perimenopausal women Am J Clin Nutr 79 131–138 Occurrence Handle14684409
M Slama D Susic ED Frohlich (2002) ArticleTitlePrevention of hypertension Curr Opin Cardiol 17 531–536 Occurrence Handle10.1097/00001573-200209000-00014 Occurrence Handle12357131
S Havas EJ Roccella C Lenfant (2004) ArticleTitleReducing the public health burden from elevated blood pressure in the United States by lowering excretion of dietary sodium Am J Public Health 94 19–22 Occurrence Handle14713688