Excessive Dietary Intake of Vitamin A Is Associated with Reduced Bone Mineral Density and Increased Risk for Hip Fracture
Publication: Annals of Internal Medicine
Volume 129, Number 10
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Abstract
Background:
The highest incidence of osteoporotic fractures is found in northern Europe, where dietary intake of vitamin A (retinol) is unusually high. In animals, the most common adverse effect of toxic doses of retinol is spontaneous fracture.
Objective:
To investigate whether excessive dietary intake of vitamin A is associated with decreased bone mineral density and increased risk for hip fracture.
Design:
A cross-sectional study and a nested case–control study.
Setting:
Two counties in central Sweden.
Participants:
For the cross-sectional study, 175 women 28 to 74 years of age were randomly selected. For the nested case–control study, 247 women who had a first hip fracture within 2 to 64 months after enrollment and 873 age-matched controls were selected from a mammography study cohort of 66 651 women 40 to 76 years of age.
Measurements:
Retinol intake was estimated from dietary records and a food-frequency questionnaire. Bone mineral density was measured with dual-energy x-ray absorptiometry. Hip fracture was identified by using hospital discharge records and was confirmed by record review.
Results:
In multivariate analysis, retinol intake was negatively associated with bone mineral density. For every 1-mg increase in daily intake of retinol, risk for hip fracture increased by 68% (95% CI, 18% to 140%; P for trend, 0.006). For intake greater than 1.5 mg/d compared with intake less than 0.5 mg/d, bone mineral density was reduced by 10% at the femoral neck (P = 0.05), 14% at the lumbar spine (P = 0.001), and 6% for the total body (P = 0.009) and risk for hip fracture was doubled (odds ratio, 2.1 [CI, 1.1 to 4.0]).
Conclusion:
High dietary intake of retinol seems to be associated with osteoporosis.
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Information & Authors
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Published In
Annals of Internal Medicine
Volume 129 • Number 10 • 15 November 1998
Pages: 770 - 778
History
Published in issue: 15 November 1998
Published online: 15 August 2000
Keywords
Copyright
© 1998 American College of Physicians.
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Excessive Dietary Intake of Vitamin A Is Associated with Reduced Bone Mineral Density and Increased Risk for Hip Fracture. Ann Intern Med.1998;129:770-778. doi:10.7326/0003-4819-129-10-199811150-00003
Excessive Dietary Intake of Vitamin A Is Associated with Reduced Bone Mineral Density and Increased Risk for Hip Fracture. Ann Intern Med.1998;129:770-778. doi:10.7326/0003-4819-129-10-199811150-00003
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