New SA et al., 2000 [78] UK | 62 healthy women pre- and postmenopausal (range 45–54 years old) | FFQ | LS and FN BMD Quantitative CT at the ultradistal radial total, trabecular, and cortical sites Urine concentration of pyridinoline and deoxypyridinoline Serum level of osteocalcin | Daily VC intake: 103.4 ± 65.6 mg/d (23.8–453.2). Mean deoxypyridinoline excretion was significantly lower with higher intakes of VC (p < 0.02). No correlation with BMD parameters in any localisation. |
Simon JA et al., 2001 [65] USA | 3778 premenopausal women (34 ± 8 years old) 3165 postmenopausal women (62 ± 13 years old) 6137 men (44 ± 16 years old) 20–90 years old | 24-h dietary recall | FN BMD Serum level of VC and VE Self-reported fractures | In a premenopausal women group, increasing levels of dietary VC were independently associated with BMD and did not correlate with prevalence of self-reported fractures. In a postmenopausal women group, neither VC intake nor VC serum concentration was associated with BMD and or prevalence of self-reported fractures. Among postmenopausal women who had no history of smoking or oestrogen use, serum ascorbic acid levels were inversely associated with BMD. In smoking postmenopausal women with history of oestrogen use, higher VC supplementation was associated with a lower prevalence of fractures. |
Ilich JZ et al., 2003 [58] USA | 136 postmenopausal (at least 5 years) women, generally health, 68.7 ± 7.1 years old | 3-day dietary record (2 weeks and 1 weekend day); Ca-FFQ | TB, LS, FN, forearm and hand BMD Serum levels of PTH and vitamin D | A weak but statistically significant correlation between VC dietary intake and bone mass was observed. VC intake was a significant element of stepwise regression models explaining loss of Ward’s triangle, trochanter, shaft and total femur BMD. |
Wolf RL et al., 2005 [63] USA | 11,068 postmenopausal women aged 50–79 years old | FFQ 122 food items supplements were estimated with an interviewer-administered questionnaire | TB, LS, TH BMD Serum concentrations of retinol, carotenoids, and tocopherols measured (N = 379) | The beneficial effect of current hormone therapy use on FN TB, LS and TH BMD was greater in women with higher VC level. An independent positive influence of VC intake on BMD was not observed. |
Prynne CJ et al., 2006 [67] UK | Three groups: 101 girls and 111 boys 16–18 years old 90 women 23–37 years old and 67 women and 67 men 60–83 years old | 7-day food diaries | TB, LS, TH, FN and greater trochanter BMD; bone area and bone mineral content | In the group of boys, significant positive associations were found between dietary VC and BMD. A negative association between hip BMD and VC intake was found in the group of older women. |
Pasco JA et al., 2006 [56] Australia | 533 postmenopausal, non-smoking women 48–89 year old (mean 68.3) 26 supplemented vitamin C and 22 vitamin C and/or E | Ca-FFQ Self-reported supplement and medication use, diet, and lifestyle questionnaire | TB BMD Serum bone resorption markers: C-telopeptide and bone-specific AP | Lower concentration of C-telopeptide was observed in group with increased exposure to VC and/or VE. |
Sugiura M et al., 2011 [54] Japan | 293 postmenopausal women | FFQ 97 food items | BMD of nondominant forearm | High intake of VC (170–625 mg/day) with β-cryptoxanthin was inversely associated with low radial BMD and may be beneficial to bone health. |
Rivas A et al., 2012 [59] Spain | 280 women divided into 3 groups: ≤35, 35–45 and ≥45 years old | 24-h diet recall | BMD of calcaneus | BMD was higher in the participants defined as high antioxidant consumers in all age groups. |
De França NA et al., 2013 [60] Brazil | 150 postmenopausal women, 68.7 ± 9.1 year old (range 48–87 year old) | 3-day food diary, non-consecutive days | TB, LS, FN and TF BMD | No relationship between the BMD and daily antioxidant intake was found. |
Karamati M et al., 2014 [57] Iran | 151 postmenopausal women aged 60.3 years old | FFQ 168 food item | LS and FN BMD | Mean BMD of the lumbar spine of women in the highest tertile of the first pattern contain folate, total fiber, potassium, vitamin A, C, K, B6, b-carotene, magnesium, copper, and manganese scores was significantly higher than those in the lowest tertile (mean difference 0.08; 95% confidence interval 0.02–0.15; p = 0.01). No correlation between separate nutrients or nutrient patterns and BMD was found. |
Kim YA et al., 2015 [51] South Korea | 1196 postmenopausal female | 24-h dietary recall | LS, FN and TH BMD | Dietary vitamin C intake tertile was significantly positively associated with BMD at all sites (R = 0.513 for LS and R = 0.657 for FN; p < 0.05 for each). The multiple-adjusted odds ratio for osteoporosis for dietary VC <100 mg/day was 1.790 (95% CI 1.333–2.405; p < 0.001). However, a significant association between VC intake and BMD was only observed in subjects with vitamin D deficiency and aged 50–59 years or >70 years. |
Finck H et al., 2015 [52] UK | 4510 participants (women: 2616, men 1898), the mean age 60 ± 10 years old | 7-day diet diary | History of bone fractures VC plasma concentration | A linear inverse relationship between quintiles of plasma VC and the prevalence of hip fractures (HR: 0.82; P-trend = 0.016) in men. |
Liu ZM et al., 2015 [61] China | 2000 men and 2000 women aged 65 years and older 72.5 ± 5.2 years old | FFQ 266 food items | BMD, bone mineral content, and bone area at TB, TH, LS and FN | TB and FN BMD were significantly positively associated with fruit intake in both men and women. Adjustment for VC intake, but not dietary acid load, attenuated the association between fruit intake and bone mass. |
Kim MH et al., 2015 [55] South Korea | 1467 postmenopausal women Age 65.2 ± 0.3 years old | 24-h recall | TF, FN and LS BMD | Participants consuming less VC than the estimated average requirement showed higher odds (OR = 1.49; 95% Cl 1.10–2.03; p < 0.05) of having osteoporosis than their counterparts. |
Kim MH et al., 2016 [50] South Korea | Osteoporosis (N = 244 men and 968 female) Healthy control (N = 1382 men and 453 female) 50 years old and over | 24-h recall | BMD (no specific location) | Higher VC intake levels were associated with a lower risk of osteoporosis; the result was statistically significant (OR = 0.67; 95% CI: 0.47–0.97; p = 0.0371) only in the highest intake quartile group. No association was seen in the group with high physical activity. Significantly lower VC intake (81 ± 2.1 vs. 113.1 ± 2.0 mg/d; p < 0.05) was noted in the osteoporosis patients group. |
Kim DE et al., 2016 [53] South Korea | 189 postmenopausal women aged 60.63 ± 6.39 years old | FFQ 103 food items | LS, FN and TH BMD | T-score of the LS, FN and TH was positively correlated with intake of VC (r2 = 0.157, p = 0.048; r2 = 0.324, p < 0.001; r2 = 0.182, p = 0.003, respectively). |
Casale M et al., 2016 [66] New Zealand | 175 post-menarcheal and pre-menopausal women 16–45 years old | FFQ 220 food items | TB BMD | There was no relationship between VC intake and total body BMD. |
Melaku YA et al., 2017 [64] Australia | 1135 participants (N = 520 men, 615 female) 50 year old and over | FFQ 167 food items | BMD (no specific location) | Three nutritional patterns: mixed (potassium, calcium, fibre, retinol and vitamin B12); animal-sourced (cholesterol, protein, vitamin B12 and fat) and plant-sourced (fibre, carotene, VC and lutein). Whereas animal- and plant-sourced nutrient patterns were not associated with BMD, mixed source pattern may have had a beneficial effect on BMD reduction prevention. |