Taking folate may reduce osteoporosis risk in older women: Study

Writing in BMC Musculoskeletal Disorders​, researchers in China assessed data from the U.S. National Health and Nutrition Examination Survey (NHANES) between 2017–2020 to investigate the relationship between folate consumption and osteoporosis.

“This study provides valuable insight into the cross-sectional association between lower dietary folate intake and increased osteoporosis risk in the general American population,” the researchers wrote. “This finding suggests the potential importance of dietary folate intake for preventing and managing osteoporosis.”

Bone integrity​

Osteoporosis is a systemic skeletal disorder that diminishes bone mineral density (BMD) and alters bone microstructure, causing an increased likelihood of fractures and disability. The condition is becoming more common with the significant expansion of life expectancy in the last century. A lack of certain nutrients such as calcium and vitamin D contributes to the development of osteoporosis, as well as little exercise.

Folate, also known as vitamin B9, is a water-soluble vitamin that prevents DNA damage and reduces oxidative stress and apoptosis. It also is a critical part of bone health as it impacts homocysteine, an amino acid known to support bone integrity.

“The level of homocysteine is affected by various B vitamins, including folate,” the researchers explained. “Folate deficiency leads to an increase in homocysteine levels, thereby reducing BMD and increasing osteoporosis risk. Consequently, augmenting dietary intake of folate may be a crucial strategy for preventing osteoporosis.”

Study details​

The study analyzed data from 2,297 participants, with a mean age of 64 years and nearly 50% of whom were female.

Dietary folate intake was measured through two 24-hour recall interviews, and the BMD of the femur, femoral neck, trochanter and intertrochanter was measured by radiologists using dual-energy X-ray absorptiometry (DXA).

A total of 159 participants were classified as having osteoporosis, or approximately 7%. A majority of those with osteoporosis were older, female, non-Hispanic white and had a lower dietary folate intake. Osteoporosis was defined by specific BMD values for both men and women.

“The results of this study showed that folate had a protective effect against osteoporosis in the participant population when the daily dietary intake of folate was over 264 µg/d (OR < 1),” the researchers wrote. “Although this study was not able to show an upper limit for folate intake in the prevention of osteoporosis, another study suggested that postmenopausal women should not consume more than 528 ~ 569 µg of dietary folate daily for optimal bone health.”

The researchers suggested that dietary folate intake ranging from 264 to 569 µg/day could prevent osteoporosis in postmenopausal women. They noted that this range is supported by the National Academy of Sciences.

“However, further longitudinal research and randomized controlled trials are necessary to elucidate the causal association between dietary folate intake and the risk of osteoporosis,” they noted. “Additionally, validation of these findings across diverse populations and settings is warranted.”

Source: BMC Musculoskeletal Disorders​
doi: 10.1186/s12891-024-07605-9​
“Association between dietary folate intake and the risk of osteoporosis in adults: a cross-sectional study”
Authors: Li Zhou et al.