Influence of Diet and Economic Factors on Bone Health

Osteoporosis is a major public health concern warranting prevention strategies. This thesis research focused on the influence of diet and economic factors on supporting bone health. Data from a large national cohort (Canadian Longitudinal Study on Aging) was used to determine whether having fewer than 20 natural teeth could be used as a surrogate measure of low hip areal bone mineral density (aBMD) among men and women aged 50 to 85 years (Study 1) to undertake an economic analysis of food choices for supporting bone health using the likelihood of having fewer than 20 natural teeth as the primary outcome (Study 2). Study 1 showed that number of teeth as a dichotomous variable (20 or more natural teeth or fewer than 20 natural teeth) was not a sensitive measure of hip aBMD. There was, however, an association between more frequent intake of vegetables, nuts, legumes, whole grains, and fibre and a greater likelihood of having more than 20 natural teeth. Since subjects have different abilities to impact oral health through their financial situation, Study 2 used number of teeth as the primary outcome given the importance of retaining natural teeth for the ability to chew and to sustain a healthy diet that can essentially support overall bone health. Economic factors were significant predictor variables of having fewer than 20 teeth, in which greater perceived financial difficulties and higher prices of fruits, nuts, and meat were associated with a greater likelihood of having fewer than 20 natural teeth (Study 2). Prices of the dairy foods category were not associated with the likelihood of having 20 or more natural teeth versus fewer than 20 natural teeth, but this may be due to Canada’s dairy supply management program that controls the supply of dairy products to maintain relatively consistent prices across Canada. Milk and dairy products are a rich source of bone supporting nutrients (calcium and if fortified, vitamin D) with some foods also containing other components that can modulate bone, including probiotics. The role of probiotics for promoting bone health was investigated in Study 3 and Study 4. The systematic review and meta-analysis of preclinical studies showed favourable effects of probiotic supplementation on volumetric bone mineral density (vBMD) and bone structure using ovariectomy rodent models (Study 3). These findings provided further support to understand the use of probiotic supplements for bone health in women post-menopause. In Study 4, probiotic supplementation for 48 weeks did not affect hip aBMD or fracture risk in postmenopausal women though favourable effects of the probiotic were observed for bone formation and resorption activity. However, these markers were similar to the control group at the end of the study. Overall, this thesis highlights the importance of considering both diet and economic factors that influence bone health with aging.

Name thesis:degree_name

Ph.D. Applied Health Sciences

Level thesis:degree_level

Doctoral

Discipline thesis:degree_discipline

Faculty of Applied Health Sciences

Department dc:contributor.department

Applied Health Sciences Program

Grantor dc:publisher

Brock University

Year dc:date.issued

2025

Author dc:creator

• Yumol, Jenalyn L.

Advisor dc:contributor.advisor

• Ward, Wendy E.

• bone
• oral health
• diet
• economics
• probiotics

Language dc:language.iso

eng

Handle dc:identifier.uri

https://hdl.handle.net/10464/19337

OAI identifier oai:identifier

oai:brocku.scholaris.ca:10464/19337