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The American JournalofClinical Nutrition 37: MARCH © 1983 American Society for Clinical Nutrition 1983, pp 453-456. Printed in USA Bone m i n eral m ass in ad ult lacto-ovo-veg etari an and omnivorous males13 Alice G Marsh, ScD, Tom V Sanchez, BS, Fonda L Chaffee, PhD, Gilbert H Mayor, MD, and OlafMickelsen, PhD ABSTRACT Past studies indicate postmenopausal women who eat meat may experience greater bone mineral loss than lacto-ovo-vegetarian women. The present study extends those findings by comparing bone mineral in adult lacto-ovo-vegetarian and omnivorous males. Bone mineral mass was determined by direct photon absorptiometry in 320 lacto-ovo-vegetarian and 320 omnivorous males 20 to 79 yr old. Lacto-ovo-vegetarians were Seventh-day Adventists committed to their diet for at least 20 yr. Measurements were made at a cortical site along the radius. No statistical differences were identified between bone mineral mass in the lacto-ovo-vegetarian and omnivorous males in any decade examined. When contrasted against significant differences between bone mineral mass in postmenopausal omnivores and lacto-ovo-vegetanans, the data presented here may be interpreted as indicating that some factor associated with meat consumption is increasing bone mineral losses in postmenopausal females while having no observable effect in males. Am J Clin Nutr l983;37:453-456. KEY WORDS Bone physiology, densitometry, diet, dietary protein (therapeutic use), osteo- porosis, vegetarianism Introduction Questions have been raised about the re- lationship between meat consumption and the loss of bone mineral with aging (1). In their survey, Mazess and Mather (2) exam- med bone mineral mass in an Eskimo popu- lation whose major sustenance was meat and compared them with an omnivorous popula- tion. They found that the Eskimo population showed greater bone loss with aging than the omnivorous population and attributed the difference to the Eskimo’s diet. To extend those observations, bone mineral mass in lacto-ovo-vegetarian and omnivorous fe- males, 20 to 89 yr of age, was examined by this group (3, 4). No significant differences were determined between bone mineral mass in lacto-ovo-vegetarians and omnivores to 59 yr of age (3); however, significant differences were seen in the 7th, 8th, and 9th decades (4). These significant differences could not be explained by a greater bone mineral mass in the lacto-ovo-vegetarians during the earlier decades oflife. Apparently, the differences in bone mineral mass among elderly subjects was the result of different degrees of post- menopausal bone loss. The present study brings the investigation of lacto-ovo-vegetar- ian and omnivorous women one step further by examining bone mineral mass in males from the same population. Methods The 320 lacto-ovo-vegetarian and 320 omnivorous subjects were nonhospitalized, ambulatory, right-handed Caucasian males between 20 and 79 yr of age. The lacto- ovo-vegetanians were Seventh-day Adventists from the Andrews University area of Berrien Springs, MI who had followed their dietary habits for at least 20 yr. The omnivores were from the university communities of Ann Arbor and East Lansing, MI. All subjects claimed to be free of medical or activity restrictions and indicated they I From the Department of Home Economics, An- drews University, Berrien Springs, MI 49104 and the Department of Medicine, Michigan State University, East Lansing, MI 48824. 2 An abstract of this work was presented at the Inter- national Symposium on Osteoporosis, Jerusalem May 29-June4, 1981. 3 Address reprint requests to: Dr Alice 0 Marsh, Department of Home Economics, Berrien Springs, MI 49104. Received May 10, 1982. Accepted for publication October 5, 1982. 453 at DALHOUSIE UNIVERSITY on June 5, 2014 ajcn.nutrition.org Downloaded from

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The American JournalofClinical Nutrition 37: MARCH

© 1983 American Society for Clinical Nutrition1983, pp 453-456. Printed in USA

Bone m in eral m ass in ad ult lacto-ovo-veg etari anand omnivorous males13

Alice G Marsh, ScD, Tom V Sanchez, BS, Fonda L Chaffee, PhD, Gilbert H Mayor, MD, and

OlafMickelsen, PhD

ABSTRACT Past studies indicate postmenopausal women who eat meat may experiencegreater bone mineral loss than lacto-ovo-vegetarian women. The present study extends those

findings by comparing bone mineral in adult lacto-ovo-vegetarian and omnivorous males. Bone

mineral mass was determined by direct photon absorptiometry in 320 lacto-ovo-vegetarian and 320

omnivorous males 20 to 79 yr old. Lacto-ovo-vegetarians were Seventh-day Adventists committed

to their diet for at least 20 yr. Measurements were made at a cortical site along the radius. Nostatistical differences were identified between bone mineral mass in the lacto-ovo-vegetarian and

omnivorous males in any decade examined. When contrasted against significant differences

between bone mineral mass in postmenopausal omnivores and lacto-ovo-vegetanans, the data

presented here may be interpreted as indicating that some factor associated with meat consumptionis increasing bone mineral losses in postmenopausal females while having no observable effect in

males. Am J Clin Nutr l983;37:453-456.

KEY WORDS Bone physiology, densitometry, diet, dietary protein (therapeutic use), osteo-

porosis, vegetarianism

Introduction

Questions have been raised about the re-lationship between meat consumption andthe loss of bone mineral with aging (1). In

their survey, Mazess and Mather (2) exam-med bone mineral mass in an Eskimo popu-lation whose major sustenance was meat andcompared them with an omnivorous popula-tion. They found that the Eskimo populationshowed greater bone loss with aging than theomnivorous population and attributed thedifference to the Eskimo’s diet. To extendthose observations, bone mineral mass inlacto-ovo-vegetarian and omnivorous fe-males, 20 to 89 yr of age, was examined bythis group (3, 4). No significant differenceswere determined between bone mineral massin lacto-ovo-vegetarians and omnivores to 59yr of age (3); however, significant differenceswere seen in the 7th, 8th, and 9th decades (4).These significant differences could not beexplained by a greater bone mineral mass inthe lacto-ovo-vegetarians during the earlierdecades oflife. Apparently, the differences inbone mineral mass among elderly subjectswas the result of different degrees of post-

menopausal bone loss. The present study

brings the investigation of lacto-ovo-vegetar-ian and omnivorous women one step further

by examining bone mineral mass in males

from the same population.

Methods

The 320 lacto-ovo-vegetarian and 320 omnivoroussubjects were nonhospitalized, ambulatory, right-handed

Caucasian males between 20 and 79 yr of age. The lacto-ovo-vegetanians were Seventh-day Adventists from the

Andrews University area of Berrien Springs, MI whohad followed their dietary habits for at least 20 yr. Theomnivores were from the university communities of AnnArbor and East Lansing, MI. All subjects claimed to befree of medical or activity restrictions and indicated they

I From the Department of Home Economics, An-

drews University, Berrien Springs, MI 49104 and theDepartment of Medicine, Michigan State University,

East Lansing, MI 48824.2 An abstract of this work was presented at the Inter-

national Symposium on Osteoporosis, Jerusalem May

29-June4, 1981.

3 Address reprint requests to: Dr Alice 0 Marsh,Department of Home Economics, Berrien Springs, MI

49104.Received May 10, 1982.Accepted for publication October 5, 1982.

453

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Paired t test demonstrated no significant differencebetween lacto-ovo-vegetanians and omnivores in anydecade.

S

S

.x2: 0.182

P NS

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20 30 40 50

Age (years)

454 MARSH ET AL

did not use mineral or vitamin supplements. The proce-

dunes followed were in accordance with the ethical stan-

dards of the committees for research involving human

subjects at Andrews University and Michigan State Uni-

versity.

Bone mineral content (g/cm) and bone width (cm) of

the left radius were measured by direct photon absorp-

tiometry. The scan site on the radius was at a point one-third the distance from the ulnar styloid to the olecranon

using the model 178 bone mineral analyzer or model 278

bone densitometer (Norland Instruments, Fort Atkinson,

WI). Studies have shown photon absorptiometry to be

accurate, reproducible and able to compare well to values

obtained by ash studies of the same bone (5, 6). The

term, bone mineral mass, was used to refer to the ratio

of bone mineral content to bone width (7).

Data on bone mineral mass in the 320 lacto-ovo-

vegetarians were segregated into decade pools and values

from 132 subjects (22 per decade) were drawn at random.

The values from these 132 subjects were then plotted

against the Michigan omnivore mean line (calculated

from the 320 omnivorous subjects). Significance of the

distribution of lacto-ovo-vegetarian values above and

below the omnivore mean line was analyzed by the x2test. In a separate analysis by the paired t test, differences

in bone mineral mass were tested between 56 lacto-ovo-

vegetarian subjects carefully matched to 56 omnivores

for age, weight, and height. Matching for age was within

2 yr. weight within 4.5 kg and height within 10 cm.

Results

The distribution of bone mineral mass by

lacto-ovo-vegetarian subjects above and be-

1.2

1.0

FIG 1. Decade by decade distribution ofbone mineral

mass from lacto-ovo-vegetarian males (#{149})along the

Michigan omnivore mean (-0-0-). The x2 test values in

low the omnivore mean line did not differsignificantly from omnivores when analyzedby the �3 test (Fig 1). Of the 132 lacto-ovo-vegetarians, 65 (49.2%) distributed above theMichigan omnivore mean indicating no sig-nificant difference between the populations.

In no decade between 20 and 79 yr of age

did a paired t test analysis show significantdifferences between lacto-ovo-vegetariansand omnivores. Table 1 shows, decade bydecade, the mean bone mineral mass of the

TABLE 1

Mean bone mineral mass, by decade, in carefullymatched pairs of lacto-ovo-vegetarian

and omnivorous males5

Age Pairs (n)

Bone mineral mass (gJcm2)

Lacto-ovo-.

vegetarianOmnivore

yr

20-29 10 0.801 0.82030-39 9 0.816 0.830

40-49 10 0.820 0.84550-59 9 0.812 0.80060-69 10 0.780 0.770

70-79 8 0.775 0.761

60 70 � 80

each decade indicate no significant difference between

the lacto-ovo-vegetarians and the Michigan omnivore

mean.

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20 40 60 80 100Age (years)

BONE MINERAL MASS IN ADULT MALES 455

56 Fairs of carefull7 matched lacto-ovo-ve�-

clarians and omnivorcs.

Discussion

The present data indicates men are not

affected by those factors that cause bonemineral loss in aging women. The similarity

in bone mineral mass of older omnivorous

and lacto-ovo-vegetanan men is in contrast

to the significantly greater loss of bone min-

era! mass among postmenopausal omnivo-rous and Eskimo women when compared to

lacto-ovo-vegetarian women of similar age.The consumption of meat appears to be one

factor that is common to these women whomanifest a marked loss in bone mineral mass.Further, the data on older Eskimo women (2)

imply that greater meat consumption leads togreater losses in bone mineral. Several mech-anisms have been suggested by which meat-containing diets may indeed affect bone min-eral mass. The possibility of a deleterious

effect originating from sulfur (8), phosphorus(9), a high fixed acid load (10), or a protein-induced hypercalciuria (1 1) in the meat-con-

taining diet may answer to the significantdifference in bone mineral mass of agingwomen in the contrasting dietary groups.

However, men on similarly contrasting

diets do not demonstrate the differences inbone mineral loss, at least at the ages so easilydemonstrated in aging women. The loss ofbone mineral seen in the aging women raisesthe question of changes in estrogen produc-tion being the source of bone loss. Heaney(12) in 1976, proposed a model suggestingthat in the presence of estrogen, bone is pro-tected from a multitude of factors that wouldotherwise act to increase bone mineral loss.According to that model, estrogen makes the

skeleton resistant to “importune” demands

for calcium that can be met in other ways.With menopause, and decreased estrogenproduction, minor demands for calcium be-gin to make themselves felt at the skeletonresulting in increased bone loss. The signifi-cant difference in bone mineral mass amongaging women of contrasting dietary habits, inthe absence of differences among men andyounger women, suggests an interaction be-tween meat consumption and loss of estrogenproduction leading to bone loss. Such inter-

actions and results would be consistent with

the conce ts of the model ro osed b Hea-

ney. Viewed throu�h this modeL �,one would

be protected from the effect of a meat-con-

taming diet (one of the multitude of factorsthat could produce bone loss) until meno-

pause removed the protective shield available

through estrogen. Thus, elderly meat-con-suming women show the greatest losses in

bone mineral mass, 35%; elderly lacto-ovo-vegetarian women show lesser losses, 18%;

and meat-consuming and lacto-ovo-vegetar-ian men show the least loss, 7 and 3%, re-spectively (Fig 2).

The lacto-ovo-vegetarian subjects neithersmoked nor drank caffeinated beverages. Theomnivorous subjects drank caffeinated bev-erages and did, or did not, smoke or usealcoholic beverages. Lacto-ovo-vegetariansubjects quite generally reported a personalprogram of physical exercise. Few of theomnivorous subjects did so.

These dietary and lifestyle difference ap-parently did not affect the observable bonemineral densities of the men. If these factors

were operative in a measureable way in the

bone density of women, further studies in-cluding other lifestyle groups should give in-

FIG 2. Mean bone mineral mass, calculated by dcc-ades, of carefully matched pairs of lacto-ovo-vegetarians(filled symbols) and omrnvores (open symbols). Data formale subjects (circles) are from the present study anddata for female subjects (squares) are adapted fromMarsh et al (3) with permission from J Am Diet Assoc.

Fracture region defined by Smith and Cameron (13).Note that by the 7th decade omnivorous females are well

into the fracture region.

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456 MARSH ET AL

sight. However, the Eskimo studies (2) whichincluded both sexes of adults and childrenattributed the differences observed mainly tothe food protein choices and amounts eaten.Further studies are indicated that would sep-arate certain lifestyle factors that could affect,at least to some extent, the multifactoralcauses of bone mineral loss in aging.

In conclusion, the study found no signifi-

cant differences between bone mineral massin lacto-ovo-vegetarian and omnivorousmales. The lack of differences in males is insharp contrast to the significant differencesseen between elderly female omnivores andlacto-ovo-vegetarians and suggests that diet

may have an influence on bone loss in womenwho no longer produce estrogen.

References

1. Wachman A, Bernstein DS. Diet and osteoporosis.

Lancet 1968; 1:958-9.

2. Mazess RB, Mather W. Bone mineral content of

North Alaskan Eskimos. Am J Clin Nutr

1974;27:9 16-20.3. Marsh AG, Sanchez TV, Mickelsen 0, Keiser J,

Mayor G. Cortical bone density of adult lacto-ovo-

vegetarian and omnivorous women. J Am Diet Assoc

l980;76: 148-51.

4. Sanchez TV, Mickelsen 0, Marsh AG, Garn SM,

Mayor GH. Bone mineral in elderly vegetarian and

omnivorous females. In: Mazess RB, ed. Proceedings

of the fourth international conference on bone meas-

urement. Bethesda, MD: NIAMDD (NIH publica-

tion no 80-1938), 1980:94-8.

5. Cameron JR. Mazess RB, Sorenson JA. Precision

and accuracy of bone mineral determination by di-

rect photon absorptiometry. Invest Radiol 1968;

3: 14 1-50.

6. Smith DM, Johnson CC, Yu P-L. In vivo measure-

ment of bone mass: Its use in demineralized states

such as osteoporosis. JAMA l972;219:325-9.

7. Mazess RB, Cameron JR. Bone mineral content in

normal U.S. whites. In: Mazess RB, ed. Proceedings

of the international conference on bone measure-

ment. Bethesda, MD: NIAMDD (NIH publication

no 75-683), 1973:228-238.

8. Whiting SJ, Draper HH. The role of sulfate in the

calciuria of high protein diets in adult rats. J Nutr

1980; 1:21-22.9. Smith DA, Nordin BEC. The effect of a high phos-

phorus intake on total and ultrafilterable plasma

calcium and on phosphate clearance. Clin Scil964;26:479-86.

10. Barzel US. The role ofbone in acid-base metabolism.

In: Barzel US, ed. Osteoporosis. New York, NY:

Grune and Statton, 1970:199-206.

11. Allen LH, Oddoye EA, Margen S. Protein-induced

hypercalciunia: a longer term study. Am J Clin Nutr

l979;32:741-9.

12. Heaney RP. Estrogens and postmenopausal osteo-

porosis. Clin Obstet Gynecol 1976; 19:791-803.

13. Smith E, Cameron JR. Interpretation of fracture

index charts (Norland-Cameron bone mineral ana-

lyzer applications note no 1; 1972). (A periodic pub-

lication ofNorland Instruments; Fort Atkinson, WI.)

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