Calcium alternatives: Eggshell and vitamin D-fortified diets could prevent bone loss in postmenopausal women – Ottogi-funded study
Calcium intake in Asian countries, including China, India, Japan, and Korea, has been reported to be “very low” — in the range of 300 to 600mg per day — and is associated with a higher risk of fractures in older women.
The intake of essential nutrients for bone health, such as calcium and vitamin D, is especially crucial during the menopausal transition period due to the fall in oestrogen level.
While milk and dairy products are a good source of dietary calcium, the high incidence of lactose malabsorption among Asians is a major obstacle, underscoring an urgent need for alternative calcium sources for these populations.
Carotenoids are abundant in brightly coloured fruits and vegetables. For instance, green vegetables such as spinach are rich in xanthophylls like lutein, orange vegetables such as carrots are rich in beta-carotene, and red vegetables and fruits such as tomatoes and watermelon are rich in lycopene.
Eggshells are mainly composed of calcium carbonate and reportedly contain about 39% calcium.
At the same time, the Home Meal Replacement (HMR) sector is growing rapidly due to ageing populations and increasing single-person households worldwide. HMRs are partially or fully prepared meal solutions for convenient consumption at home.
To determine the effect of eggshell and vitamin D-fortified HMRs on BMD in postmenopausal women, a randomised, double-blind, controlled intervention study was conducted by Korean researchers.
The study was funded by Ottogi Ham Taiho Foundation, established by South Korean food manufacturing major Ottogi Corporation.
Participants aged between 50 and 64 were randomly assigned to two groups for the six-month intervention.
The treatment group consumed three ready-to-heat HMRs weekly, consisting of curry, black bean sauce, and sweet pumpkin porridge, which are fortified with eggshell powder and vitamin D. Tomatoes were added to the curry only in this group.
The control group had the same HMRs but without fortification.
Participants who agreed to continue the study consumed the same HMRs per week for an additional six months. In total, 25 participants completed the six-month trial, and 11 completed the 12-month intervention.
At baseline, the intake of calcium and vitamin D was inadequate in both groups.
The average content of calcium and vitamin D in the study diets was 609.4mg and 24.1μg respectively. During the intervention period, the participants ultimately consumed an additional 261mg of calcium and 10.3μg of vitamin D per day from the HMRs.
Particularly in the treatment group, the total calcium intake was 931mg/day and vitamin D 13.5μg/day, which met the recommended intake of 800mg/day and 10μg/day, respectively, for Koreans.
It was also found that after consuming fortified HMRs for six months, the decrease in femoral neck BMD in the treatment group was significantly smaller than that in the control group (p = 0.035).
There was no significant difference in other bone markers between the two groups.
“Our study demonstrated that consumption of eggshell powder- and vitamin D-fortified HMR three times a week for six months to a year effectively prevents a rapid decline in femoral neck BMD in postmenopausal women.
“This suggests that a daily diet containing adequate amounts of natural calcium and vitamin D may ultimately prevent bone loss and fractures in populations vulnerable to calcium and vitamin D deficiency, and who do not routinely consume milk and dairy products,” the researchers wrote.
According to the researchers, their findings are consistent with a previous study reporting the beneficial effects of a vitamin-mineral supplement enriched with chicken eggshell powder.
“However, we believe that our study is the first successful attempt to prevent bone loss in a population with insufficient calcium and vitamin D intake through a regular diet fortified with chicken eggshell powder and vitamin D, rather than supplements. This may be a better dietary strategy to ensure sustainable calcium intake.”
Opportunities for functional HMRs
A recent study indicated the incidence of osteoporosis among postmenopausal women to be 38.4% in Korea and 30.3% in China.
Dietary habits play an important role in bone health. As the demand for functional, customised HMRs is rising alongside health and wellness trends, these products could be an approach to increase intake of bone-support nutrients.
Notably, the HMRs chosen for this study were well tolerated by all participants, with no adverse events found.
The results also showed that eggshells, an “inexpensive source of calcium”, may be a good alternative for people who have difficulty consuming milk or dairy products.
Additionally, carotenoids are known for its bioactivities, including antioxidant, anti-inflammatory, anticancer, and reducing the risk of cardiovascular disease and macular degeneration.
In this study, serum lutein and beta-carotene concentrations significantly increased in both control and treatment groups, which can be attributed to the lutein-rich sweet pumpkin porridge.
Furthermore, serum lycopene concentration significantly increased only in the treatment group that consumed tomato-added curry.
“It should not be overlooked that lycopene may exert beneficial effects on bone health, given that tomatoes were added only to the study diet of the treatment group, and that lycopene has been previously proven to prevent bone loss in an animal model.”
Nevertheless, this study was limited by the small number of participants and the lack of quantitative measurement of exercise among them.
“Sarcopenia prevention and interventions, including exercise, have been identified to have beneficial effects on bone health. We are currently conducting another intervention study to find answers about the impact of diet and exercise.
“Large-scale intervention trials are needed to evaluate the effects of different amounts of eggshell powder and vitamin D-containing foods on bone health in different age groups. An investigation into the complementary effect of tomatoes would also provide valuable information,” the researchers concluded.
Source: Nutrients
https://doi.org/10.3390/nu16081152
“Home Meal Replacement Fortified with Eggshell Powder and Vitamin D Prevents Bone Loss in Postmenopausal Women: A Randomized, Double-Blind, Controlled Study”
Authors: Nam-Seok Joo, et al
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