Dietary carotenoid intake and osteoporosis: the National Health and Nutrition Examination Survey, 2005-2018.

ABSTRACT

Higher intake of ß-carotene and ß-cryptoxanthin were associated with lower risk of osteoporosis. A very high intake of lutein + zeaxanthin was also associated with lower risk of osteoporosis. These results support the beneficial role of carotenoids on bone health. PURPOSE: To examine the associations of α-carotene, ß-carotene, ß-cryptoxanthin, lycopene, and lutein + zeaxanthin intake with the risk of osteoporosis based on the cross-sectional data from the National Health and Nutrition Examination Survey (NHANES), 2005-2018. METHODS: This study identified individuals ≥ 50 years old with valid and complete data on carotenoid intake and bone mineral density (BMD). Intake of α-carotene, ß-carotene, ß-cryptoxanthin, lycopene, and lutein + zeaxanthin was averaged from two 24-h recall interviews. BMD was measured by dual-energy X-ray absorptiometry (DXA) and converted to T-scores; osteoporosis was defined as a T-score ≤ - 2.5. We used logistic regression models to test the associations between carotenoids and osteoporosis, adjusting for factors such as age, sex, race, and education. RESULTS: Participants were on average 61.9 years of age, with 57.5% identifying as females. Higher quintiles of ß-carotene (odds ratio [OR] for quintile 5 vs. 10.33; 95% CI 0.19-0.59; P for trend = 0.010) and ß-cryptoxanthin intake (OR for quintile 5 vs. 10.61; 95% CI 0.39-0.97; P for trend = 0.037) were associated with reduced risk of osteoporosis. Similar and marginally significant results for lutein + zeaxanthin intake was found (OR for quintile 5 vs. 10.53; 95% CI 0.30-0.94; P for trend = 0.076). There was no association of α-carotene and lycopene intake with osteoporosis. These associations did not differ by sex (all P_interaction > 0.05). CONCLUSIONS: Higher ß-carotene and ß-cryptoxanthin intake was associated with decreased osteoporosis risk. A very high intake of lutein + zeaxanthin was also associated with lower risk of osteoporosis.