Prunes found mitigating toward bone loss from oral contraception
In a recent study, similar bone health results were reported between oral contraceptive users with and without prune consumption, as well as nonusers.
Prunes found mitigating toward bone loss from oral contraception | Image Credit: © Karyna - © Karyna - stock.adobe.com.
Oral contraceptive (OC) use has minimal effects on bone health, which are mediated through prune consumption, according to a recent study published in Current Developments in Nutrition.1
The use of hormonal contraception has been linked to increased risks of osteoporosis later in life. Hormonal contraception is used by approximately 2 in 3 young women using contraception, with approximately 68% using OCs.
OCs use both ethinyl estradiol and progestin, and while endogenous estrogen can promote bone health, exogenous estrogen used in modern OC formulations has been linked to bone loss.2 This indicates a need to identify nutritional interventions to prevent adverse bone health outcomes.1
Prunes have been identified as the most effective fruit in preventing bone loss. Therefore, they may mediate adverse effects on bone health caused by OCs.
Investigators conducted a study to determine the impact of prune consumption on the association between OC use and bone health. Participants’ menstrual history and OC use was determined through questionnaires, with the answers used to group patients into an OC use group or a non-OC or other hormonal contraception use group.
Participants in the OC group were randomly assigned to a prune consumption group or a non-consumption group. Those in the prune consumption group took 50 g prunes daily for 12 months.
Non-pregnant and nonsmoking women aged 18 to 25 years with less than 2 alcoholic beverages consumed daily were included in the analysis. Those in the OC group had to have at least 1 year and under 5 years of OC use.
Data obtained prior to treatment initiation included medical history, a reproductive health survey, and dietary vitamin D and calcium questionnaires. Additionally, participants’ height and weight were measured at baseline, 6 months, and 12 months. Participants were also asked to record days when they failed to consume prunes.
Dual-energy X-ray absorptiometry (DXA; GE Healthcare Lunar) was used to determine bone density. This technique had a precision of 0.65% for the lumbar spine, 0.73% for the total hip, 0.85% for the forearm, and 0.55% for total body locations.
There were 86 women included in the final analysis, 30 of whom did not use OCs, 28 used OCs, and 28 used OCs and consumed 50 g prunes. The age, height, weight, body mass index, age of first OC use, mean age between periods, alcohol consumption and calcium and vitamin D intake did not significantly differ between groups at baseline.
The age at menarche was significantly lower in the non-OC group, and the OC prune group had a compliance rate of 87%. Most participants were White women.
Differences were not found for bone biomarkers such as TRAP-5b and bone alkaline phosphatase (BAP; Quidel) between groups. However, lower C-reactive protein (CRP; Immundiagnostik AG) was reported in non-OC users vs OC users. Vitamin D concentrations were lower in the OC prune group at 12 months vs baseline.
Bone mineral density (BMD) at the lumbar spine, left femur, right femur, nondominant radius and ulna, and total body did not significantly differ between groups, not did total body T score. However, a significant increase in BMD at the nondominant ultradistal radius was observed at 12 months vs baseline in the non-OC group.
Significant differences were not observed for the 4%, 38%, and 66% sites of the tibia between groups. Additionally, there were no significant differences for intermuscular adipose tissue, muscle area, or muscle density.
These results indicated minor adverse effects from OC use on bone health, with these effects mitigated by prune consumption. Investigators recommended further research about these associations with early life OC initiation.
References
- DeMasi T, Tsang M, Mueller J, et al. Prunes may blunt adverse effects of oral contraceptives on bone health in young adult women: A randomized clinical trial. Current Developments in Nutrition. 2024;8(9):104417. doi:10.1016/j.cdnut.2024.104417
- Herrmann M, Seibel MJ. The effects of hormonal contraceptives on bone turnover markers and bone health. Clin Endocrinol (Oxf). 2010;72(5):571-83. doi:10.1111/j.1365-2265.2009.03688.x
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