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Trial registered on ANZCTR
Registration number
ACTRN12611000763943
Ethics application status
Approved
Date submitted
21/07/2011
Date registered
21/07/2011
Date last updated
2/04/2014
Type of registration
Retrospectively registered
Titles & IDs
Public title
Bone Health,Vegetables,Herbs and Fruit Study
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Scientific title
Fruit,Vegetables and Herbs, Post Menopausal Women and Bone Health
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Secondary ID [1]
262675
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Nil
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Universal Trial Number (UTN)
U1111-1123-0770
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Trial acronym
BHVHF study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Bone health in post menopausal women
268378
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Inflammation and metabolic markers in post menopausal women
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Condition category
Condition code
Metabolic and Endocrine
268515
268515
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0
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Metabolic disorders
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Musculoskeletal
268516
268516
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0
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Osteoporosis
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Fruit,Vegetables and Herbs
This intervention study (Bone Health, Vegetables, Herbs and Fruit) involves changing the fruit and vegetables intake of 100 women from less than or equal to 5 to 9 or more serves /day for 3 months. Another group called “Diet and Metabolic Markers in Healthy Post Menopausal Women” or DMM group will involve an additional 50 women. This group will be run concurrently and serve as a negative control group. Using a randomized parallel controlled design the women in the dietary intervention will be assigned to one of the two arms involved in increasing fruit and vegetable intake and including selected herbs. One arm, will be advised to consume a high fruit and vegetable diet (Diet IA) of 9 serves/day (low PRAL, general range of vegetables, fruit and herbs but avoiding those with Bone resorption inhibiting properties BRIPs), The second arm will also consume 9 serves/day but of the 9 serves, 4-5 serves will be selected from a range of BRIP vegetables, fruit and culinary herbs i.e. Diet IB (low PRAL including specific BRIP vegetables, fruit and culinary herbs). Brip vegetables include those from the cruciferous and allium family,fruits include citrus and herbs include those common culinary green herbs in culinary quantities only (.25tsp) such as sage. The negative control group C (DMM) will continue with their normal diet and receive no intervention.
We will monitor for changes in bone resorption and formation markers (serum C-telopeptide of type 1 collagen (CTX) and procollagen 1 N-terminal peptide (P1NP), insulin-like growth factor (IGF-1) and Parathyroid Hormone. We will also monitor changes in anti-inflammatory markers; adiponectin, c reactive protein (CRP), interleukin 6 (IL-6), nuclear factor kappa binding (NF kappaB) and tumour necrosis factor (TNF-alpha) as well as metabolic markers; triglycerides, cholesterol, LDL, HDL, fibrinogen and PAI-1.
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Intervention code [1]
267017
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Lifestyle
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Comparator / control treatment
Negative control group recruited separately consisting of post menopausal women with the same exclusion criteria as the intervention group.
This group to not share the same inclusion criteria as the intervention. They are the same in all respects except they do not choose to make the behaviour change to increase their intake of fruit and vegetables to 9 serves/day
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Control group
Active
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Outcomes
Primary outcome [1]
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The primary endpoints are the change in measurements with bone turnover markers, specifically bone resorption marker serum C-telopeptide of type 1 collagen (CTx) and bone formation markers procollagen 1 N-terminal peptide (P1NP).
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Assessment method [1]
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Timepoint [1]
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Change in bone markers at 3 months (after increasing fruit and vegetable intake and inclusion of selected herbs).
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Secondary outcome [1]
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The secondary outcomes are the changes in pro and anti-inflammatory markers. adiponectin, c reactive protein (CRP), interleukin 6 (IL-6), tumour necrosis factor (TNF-alpha) Metabolic markers triglycerides, cholesterol HDL, LDL and fibrinogen and PAI-1
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Assessment method [1]
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Timepoint [1]
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Inflammatory and metabolic markers at 3 months (after increasing fruit and vegetable intake and inclusion of selected herbs).
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Eligibility
Key inclusion criteria
Healthy, post menopausal women between the age of 50-70 years who haven’t had a period for 5 years willing to increase their intake of fruit and vegetables to 9 serves/day. Target population for the negative control group Diet and Metabolic Markers in Healthy NZ women (DMM) women in the same category as above who will be required to make no changes to diet or lifestyle
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Minimum age
50
Years
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Maximum age
70
Years
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Sex
Females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Post menopausal women having had a hysterectomy. Those with osteoporosis previously diagnosed or who have osteoporosis diagnosed as result of screening for this study. Those with both hips replaced. Those with previous fractures of the lower vertebra or hip, those who have severe osteoarthritis* of the lower spine or hips. History of gastrointestinal, liver or renal disease. Currently on medication for diabetes, heart disease, osteoporosis (including HRT) or any medication that may affect bone or calcium metabolism (oral corticosteroids, warfarin, dilantin. potassium sparing diuretics). Any severe diseases including treatment for cancer within the last 3 years. Smokers, alcohol consumption greater than 20 standard drinks/week).Women already consuming more than 6 standard serves fruit and vegetables every day. Those taking calcium supplements and unwilling to stop a month before the study and for the duration of the study. Those unable to consume 2 serves/dairy or soy (with calcium) or alternative every day. Those participants who develop an illness during the study that requires treatment with steroids or medication that affects bone, inflammatory and other metabolic markers.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Block randomisation was used in each of the 3 cities. A similar number of participants in each city was assigned to each group.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
A negative control group has been recruited separately as this is a dietary and lifestyle intervention and we didnt want to rectruit women ready to make the behaviour change and then advise them not to.The 100 women in the intervention will be randomly allocated to two groups of 50 consuming differing veg,herbs and fruit.One group of the intervention will emphasise those foods (Fruit,veg and herbs) shown to be bone friendly in animals.
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Phase
Phase 1 / Phase 2
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Parametric statistical analysis was done for normally distributed data otherwise non parametric tests (Kruskal-Wallis Test) were used (potassium urinary excretion) or logarithmic transformations were applied prior to one way analysis of variance analysis (ANOVA). Log transformed values were back transformed for tables. ANOVA was used to compare inflammatory, bone and urinary mineral excretion data. Post hoc tests (Scheffe and Tukey-B) were used to determine group difference as well as student t-tests for within group differences. Two way ANOVA was used to determine interaction effects between groups and BMD groups on bone markers using MANOVA with adjustments for multiple comparisons (Sidak).The number of subjects required in each group was calculated to be 32 (minimum). This was determined using a power calculation based on demonstrating a difference of ~8% in the primary outcome variable C-telopeptides of collagen (CTx) with 80% power and alpha of 0.05 (2 sided test) and accepting 0.4 micrmeters/ml as mean CTx of this population (Kruger, M.C, 2010). To detect any differences between the 2 diets and allowing for withdrawals, non-compliance or maintenance (~ 25%) approximately 50 women were needed in each group. Since there were 2 different diets emphasizing different vegetables and fruit and a control group who consumed their usual diet (= 5 servings F/V/day), three groups of 50 participants were required.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
31/07/2011
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Actual
12/06/2011
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Date of last participant enrolment
Anticipated
30/08/2011
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
150
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
3739
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New Zealand
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State/province [1]
3739
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Palmerston North
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Country [2]
3740
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New Zealand
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State/province [2]
3740
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Auckland
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Country [3]
3741
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New Zealand
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State/province [3]
3741
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Hawkes Bay
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Funding & Sponsors
Funding source category [1]
267496
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Charities/Societies/Foundations
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Name [1]
267496
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Hawkes Bay Medical Research Foundation
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Address [1]
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P.O.Box 596
Napier
Hawkes Bay
NZ 4140
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Country [1]
267496
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New Zealand
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Primary sponsor type
Individual
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Name
Professor Marlena Kruger
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Address
Professor Marlena Kruger
IFNHH
Massey University
PO box 11 222
Palmerston North 4442
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Country
New Zealand
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Secondary sponsor category [1]
266540
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Individual
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Name [1]
266540
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Associate Professor Welma Stonehouse
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Address [1]
266540
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Institute of Food, Nutrition and Human Health
Private Bag 102 904
North Shore City Post code 0745
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Country [1]
266540
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New Zealand
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Other collaborator category [1]
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Individual
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Name [1]
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Anne-Thea McGill FRNZCGP MBChB BSc
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Address [1]
252116
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Human Nutrition Unit, 18 Carrick Place, Mt Eden, Faculty of Medical and Health Sciences University of Auckland, Private Bag 92019
Auckland, New Zealand
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Country [1]
252116
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
269465
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Massey University Human Ethics Committee: Southern A
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Ethics committee address [1]
269465
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Research Ethics Office Sir Geoffrey Peren Building Turitea Campus Massey University Palmerston North 4442
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Ethics committee country [1]
269465
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New Zealand
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Date submitted for ethics approval [1]
269465
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Approval date [1]
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30/05/2011
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Ethics approval number [1]
269465
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11/11/2011
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Summary
Brief summary
Bone health and fruit and vegetable intake are positively linked. This has been attributed to the varying micronutrients, phytochemicals and/or alkali precursors which reduce potential renal acid load (PRAL).Animal studies demonstrate specific vegetables, fruit and herbs possess bone resorption inhibiting properties (BRIP). Very few human intervention studies have been done with post menopausal women using a food specific approach to significantly reduce dietary PRAL and no study has included these specific vegetables, fruit and herbs to determine change in bone turnover and inflammatory markers, though several animal studies have shown beneficial effects on markers and bone density. This intervention study (Bone Health, Vegetables, Herbs and Fruit) involves changing the fruit and vegetables intake of 100 women from less than or equal to 5 to 9 or more serves /day for 3 months. Another group called “Diet and Metabolic Markers in Healthy Post Menopausal Women” or DMM group will involve an additional 50 women. This group will be run concurrently and serve as a negative control group. Using a randomized parallel controlled design the women in the dietary intervention will be assigned to one of the two arms involved in increasing fruit and vegetable intake and including selected herbs. One arm, will be advised to consume a high fruit and vegetable diet (Diet IA) of 9 serves/day (low PRAL, general range of vegetables, fruit and herbs but avoiding those with BRIPs), The second arm will also consume 9 serves/day but of the 9 serves, 4-5 serves will be selected from a range of BRIP vegetables, fruit and culinary herbs i.e. Diet IB (low PRAL including specific BRIP vegetables, fruit and culinary herbs). The negative control group C (DMM) will continue with their normal diet and receive no intervention. We will monitor for changes in bone resorption and formation markers (serum C-telopeptide of type 1 collagen (CTX) and procollagen 1 N-terminal peptide (P1NP), insulin-like growth factor (IGF-1) and Parathyroid Hormone. We will also monitor changes in anti-inflammatory markers; adiponectin, c reactive protein (CRP), interleukin 6 (IL-6), nuclear factor kappa binding (NF kappa B) and tumour necrosis factor (TNF-alpha) as well as metabolic markers; triglycerides, cholesterol, LDL, HDL, fibrinogen and PAI-1.
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Trial website
http://www.massey.ac.nz/?h02970424n
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Trial related presentations / publications
Midlife women, bone health, vegetables, herbs and fruit study. The Scarborough Fair study protocol CA Gunn, JL Weber, MC Kruger - BMC public health, 2013 - biomedcentral.com Increasing fruits and vegetables in midlife women: a feasibility study CA Gunn, JL Weber, J Coad, MC Kruger - Nutrition Research, 2013 - Elsevier Diet, weight, cytokines and bone health in post-menopausal women CA Gunn, JL Weber, MC Kruger - Journal of Nutrition, Health and Ageing 2013
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Public notes
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Contacts
Principal investigator
Name
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Prof Marlena Kruger
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Address
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IFNHH Massey University POBox 11 222 Palmerston North 4442
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Country
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New Zealand
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Phone
32904
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64 6 3569099 ext 5905
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Fax
32904
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Email
32904
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[email protected]
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Contact person for public queries
Name
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Caroline Gunn
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Address
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IFNHH
Massey University
POBox 11 222
Palmerston North
4442
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Country
16151
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New Zealand
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Phone
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64 6 3569099 ext 2311
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Fax
16151
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64 6 350 5657
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Email
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[email protected]
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Contact person for scientific queries
Name
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Professor Marlena kruger
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Address
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IFNHH
Massey University
POBox 11 222
Palmerston North
4442
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Country
7079
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New Zealand
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Phone
7079
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64 6 3569099 ext 5905
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Fax
7079
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64 6 350 5657
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Email
7079
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Midlife women, bone health, vegetables, herbs and fruit study. The Scarborough Fair study protocol.
2013
https://dx.doi.org/10.1186/1471-2458-13-23
Embase
Increased intake of selected vegetables, herbs and fruit may reduce bone turnover in post-menopausal women.
2015
https://dx.doi.org/10.3390/nu7042499
N.B. These documents automatically identified may not have been verified by the study sponsor.
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