Dietary carotenoid intake and osteoporosis: the National Health and Nutrition Examination Survey, 2005-2018

A Summary Higher intake of beta-carotene and beta-cryptoxanthin were associated with lower risk of osteoporosis. A very high intake of lutein + zeaxanthin was also associated with lower risk of osteoporosis. These results support the beneficial role of carotenoids on bone health. Purpose To examine the associations of alpha-carotene, beta-carotene, beta-cryptoxanthin, lycopene, and lutein + zeaxanthin intake with the risk of osteoporosis based on the cross-sectional data from the National Health and Nutrition Examination Survey (NHANES), 2005-2018. Methods This study identified individuals >= 50 years old with valid and complete data on carotenoid intake and bone mineral density (BMD). Intake of alpha-carotene, beta-carotene, beta-cryptoxanthin, lycopene, and lutein + zeaxanthin was averaged from two 24-h recall interviews. BMD was measured by dual-energy X-ray absorptiometry (DXA) and converted to T-scores; osteoporosis was defined as a T-score <= - 2.5. We used logistic regression models to test the associations between carotenoids and osteoporosis, adjusting for factors such as age, sex, race, and education. Results Participants were on average 61.9 years of age, with 57.5% identifying as females. Higher quintiles of beta-carotene (odds ratio [OR] for quintile 5 vs. 1:0.33; 95% CI: 0.19-0.59; P for trend= 0.010) and beta-cryptoxanthin intake (OR for quintile 5 vs. 1:0.61; 95% CI: 0.39-0.97; P for trend =0.037) were associated with reduced risk of osteoporosis. Similar and marginally significant results for lutein + zeaxanthin intake was found (OR for quintile 5 vs. 1:0.53; 95% CI: 0.30-0.94; P for trend =0.076). There was no association of alpha-carotene and lycopene intake with osteoporosis. These associations did not differ by sex (all P_interaction > 0.05). Conclusions Higher beta-carotene and beta-cryptoxanthin intake was associated with decreased osteoporosis risk. A very high intake of lutein + zeaxanthin was also associated with lower risk of osteoporosis.