Sodium intake and osteoporosis. Findings from the Women's Health Initiative

Laura Carbone, Karen Johnson, Ying Huang, Mary Pettinger, Fridtjof Thomas, Jane Cauley, Carolyn Crandall, Lesley Tinker, Meryl Susan LeBoff, Jean Wactawski-Wende, Monique Bethel, Wenjun Li, Ross Prentice

Research output: Contribution to journalArticle

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Abstract

Background: The relationship of sodium intake to changes in bone mineral density (BMD) in postmenopausal women has not been established, and no study to date has examined its relationship with fracture risk. Methods: This was a prospective observational cohort study including 69 735 postmenopausal women in the Women's Health Initiative during an average of 11.4 years of followup to examine whether sodium intake is associated with changes in BMD at the lumbar spine, total hip, femoral neck, and total body and with incident fractures and whether this relationship is modified by potassium and/or calcium intake. Results: In adjusted models, there was no association of calibrated sodium intake with changes in BMD at the hip or lumbar spine from baseline to 3 or 6 years (P ≥ .06). Higher sodium intakes were associated with greater increases in total body BMD from baseline to 3 years (P = .00) with a trend from baseline to 6 years (P = .08) and with reduced hip fractures (hazard ratio, 0.81; 95% confidence interval, 0.67-0.97). In sensitivity analyses that included body mass index as an additional covariate in the models, there was no association of sodium intake with changes in BMD at any skeletal site (P ≥ .32) or with incident fractures (P > .28). There was no association of sodium intake with incident fractures after adjusting for potassium intake (P ≥ .30). Calcium intake did not modify the association between sodium intake and incident fractures (P ≥ .20). Levels of sodium intake above or below currently recommended guidelines for cardiovascular disease (≤ 2300 mg/d) were not associated with changes in BMD at any skeletal site from baseline to 3 (P ≥ .66) or 6 years (P ≥ .74) or with incident fractures (P ≥ .70). Conclusion: Current population-based recommendations for sodium intake are unlikely to significantly affect osteoporosis.

Original languageEnglish (US)
Pages (from-to)1414-1421
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Volume101
Issue number4
DOIs
StatePublished - Apr 1 2016

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Women's Health
Osteoporosis
Sodium
Bone Density
Minerals
Bone
Hip
Potassium
Spine
Calcium
Femur Neck
Hip Fractures
Observational Studies
Hazards
Body Mass Index
Cohort Studies
Cardiovascular Diseases
Guidelines
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Sodium intake and osteoporosis. Findings from the Women's Health Initiative. / Carbone, Laura; Johnson, Karen; Huang, Ying; Pettinger, Mary; Thomas, Fridtjof; Cauley, Jane; Crandall, Carolyn; Tinker, Lesley; LeBoff, Meryl Susan; Wactawski-Wende, Jean; Bethel, Monique; Li, Wenjun; Prentice, Ross.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 101, No. 4, 01.04.2016, p. 1414-1421.

Research output: Contribution to journalArticle

Carbone, L, Johnson, K, Huang, Y, Pettinger, M, Thomas, F, Cauley, J, Crandall, C, Tinker, L, LeBoff, MS, Wactawski-Wende, J, Bethel, M, Li, W & Prentice, R 2016, 'Sodium intake and osteoporosis. Findings from the Women's Health Initiative', Journal of Clinical Endocrinology and Metabolism, vol. 101, no. 4, pp. 1414-1421. https://doi.org/10.1210/jc.2015-4017
Carbone, Laura ; Johnson, Karen ; Huang, Ying ; Pettinger, Mary ; Thomas, Fridtjof ; Cauley, Jane ; Crandall, Carolyn ; Tinker, Lesley ; LeBoff, Meryl Susan ; Wactawski-Wende, Jean ; Bethel, Monique ; Li, Wenjun ; Prentice, Ross. / Sodium intake and osteoporosis. Findings from the Women's Health Initiative. In: Journal of Clinical Endocrinology and Metabolism. 2016 ; Vol. 101, No. 4. pp. 1414-1421.
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abstract = "Background: The relationship of sodium intake to changes in bone mineral density (BMD) in postmenopausal women has not been established, and no study to date has examined its relationship with fracture risk. Methods: This was a prospective observational cohort study including 69 735 postmenopausal women in the Women's Health Initiative during an average of 11.4 years of followup to examine whether sodium intake is associated with changes in BMD at the lumbar spine, total hip, femoral neck, and total body and with incident fractures and whether this relationship is modified by potassium and/or calcium intake. Results: In adjusted models, there was no association of calibrated sodium intake with changes in BMD at the hip or lumbar spine from baseline to 3 or 6 years (P ≥ .06). Higher sodium intakes were associated with greater increases in total body BMD from baseline to 3 years (P = .00) with a trend from baseline to 6 years (P = .08) and with reduced hip fractures (hazard ratio, 0.81; 95{\%} confidence interval, 0.67-0.97). In sensitivity analyses that included body mass index as an additional covariate in the models, there was no association of sodium intake with changes in BMD at any skeletal site (P ≥ .32) or with incident fractures (P > .28). There was no association of sodium intake with incident fractures after adjusting for potassium intake (P ≥ .30). Calcium intake did not modify the association between sodium intake and incident fractures (P ≥ .20). Levels of sodium intake above or below currently recommended guidelines for cardiovascular disease (≤ 2300 mg/d) were not associated with changes in BMD at any skeletal site from baseline to 3 (P ≥ .66) or 6 years (P ≥ .74) or with incident fractures (P ≥ .70). Conclusion: Current population-based recommendations for sodium intake are unlikely to significantly affect osteoporosis.",
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AU - Carbone, Laura

AU - Johnson, Karen

AU - Huang, Ying

AU - Pettinger, Mary

AU - Thomas, Fridtjof

AU - Cauley, Jane

AU - Crandall, Carolyn

AU - Tinker, Lesley

AU - LeBoff, Meryl Susan

AU - Wactawski-Wende, Jean

AU - Bethel, Monique

AU - Li, Wenjun

AU - Prentice, Ross

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