A Mediterranean Diet Enriched with Olive Oil Is Associated with Higher Serum Total Osteocalcin Levels in Elderly Men at High Cardiovascular Risk

Background: The intake of olive oil has been related to the prevention of osteoporosis in experimental and in in vitro models. Very few prospective studies have evaluated the effects of olive oil intake on circulating osteocalcin (OC) in humans. Objective: The objective of the study was to examine the longitudinal effects of a low-fat control diet (n = 34), a Mediterranean diet enriched with nuts (MedDiet + nuts, n = 51), or a Mediterranean diet enriched with virgin olive oil (MedDiet + VOO, n = 42) on circulating forms of OC and bone formation markers in elderly men at high cardiovascular risk. Design: Longitudinal associations between baseline and follow-up (2 yr) measurements of total OC, undercarboxylated osteocalcin, C-telopeptide of type I collagen, and procollagen I N-terminal propeptide (P1NP) concentrations were examined in 127 elderly men randomized to three healthy dietary interventions. Results: Baseline characteristics (age, body mass index, waist circumference, lipid profile, fasting insulin levels, and bone formation and resorption markers) were similar in all intervention groups. The total osteocalcin concentration increased robustly in the MedDiet + VOO group (P = 0.007) in parallel to increased P1NP levels (P = 0.01) and homeostasis model assessment-beta-cell function (P = 0.01) but not in subjects on the MedDiet + nuts (P = 0.32) or after the control diet (P = 0.74). Interestingly, the consumption of olives was associated positively with both baseline total osteocalcin (r = 0.23, P = 0.02) and the 2-yr osteocalcin concentrations (r = 0.21, P = 0.04) in the total cohort. Conclusions: Consumption of a Mediterranean diet enriched with virgin olive oil for 2 years is associated with increased serum osteocalcin and P1NP concentrations, suggesting protective effects on bone. (J Clin Endocrinol Metab 97: 3792-3798, 2012)