Investigating the Influence of Spinach Sauce in Modulating Serum Calcium in Osteoporotic Females

Main Article Content

Hira Iftikhar
Anjum Raza
Ali Ahsan
Hafiz Bilal Murtaza


Background: The modulation of serum calcium levels through diet is a critical aspect of managing osteoporosis, particularly in postmenopausal women. Spinach, known for its high calcium content, offers potential benefits for bone health due to its rich nutrient profile. This study aimed to develop a spinach sauce, evaluate its consumer acceptability, and investigate its impact on serum calcium levels in osteoporotic females.

Objective: To develop a nutritionally rich spinach sauce, assess its sensory acceptability, and evaluate its effectiveness in modulating serum calcium levels among osteoporotic females.

Methods: The spinach sauce was formulated using various recipes to maximize calcium bioavailability. The preparation process involved controlled cooking techniques to preserve nutrients, followed by proximate composition analysis. A sensory evaluation was conducted with osteoporotic females and a control group using standard hedonic scales. Participants were instructed to incorporate the spinach sauce into their daily diet for a specified period. Serum calcium levels were measured before and after the intervention. Statistical analysis was conducted using SPSS version 25, controlling for covariates such as age, baseline dietary habits, and baseline serum calcium levels. Ethical approval was obtained, and informed consent was provided by all participants.

Results: Treatment T2, containing 40% spinach and 60% mint, scored highest in sensory evaluation with color (8.94 ± 0.26), flavor (8.92 ± 0.30), taste (8.98 ± 0.27), texture (8.22 ± 0.29), and overall acceptability (8.94 ± 0.31). The proximate composition of the spinach sauce showed moisture (79.84%), crude protein (6.27%), crude fat (1.91%), fiber (0.57%), ash (4.21%), and nitrogen-free extract (10.27%). Serum calcium levels increased significantly in the spinach sauce group from 0.84 ± 0.01 to 1.03 ± 0.04, and in the combined spinach sauce and calcium supplement group from 0.69 ± 0.01 to 0.91 ± 0.07. ANOVA revealed significant effects of treatments (F = 1.99, p ≤ 0.01) and days (F = 41.96, p ≤ 0.01) on bone mineral density.

Conclusion: The developed spinach sauce was nutritionally rich and well-received, particularly in treatment T2. It demonstrated potential in improving serum calcium levels among osteoporotic females, suggesting that dietary interventions with spinach could be a viable strategy for managing osteoporosis. Further research with larger sample sizes and longer durations is recommended to substantiate these findings.

Article Details

How to Cite
Mehbatool, Iftikhar, H., Raza, A., Laiba, Rida, Zunaib, Ahsan, A., & Murtaza, H. B. (2024). Investigating the Influence of Spinach Sauce in Modulating Serum Calcium in Osteoporotic Females. Journal of Health and Rehabilitation Research, 4(2), 719–724.
Author Biographies

Mehbatool, University of Agriculture Faisalabad Pakistan.

MSc. (Hons) in Food and Nutrition, University of Agriculture, Faisalabad, Pakistan.

Hira Iftikhar, University of Agriculture Faisalabad Pakistan.

Lecturer, University of Agriculture, Faisalabad, Pakistan.

Anjum Raza, Riphah International University Faisalabad Pakistan.

PhD Scholar (Biochemistry), Riphah International University, Faisalabad, Pakistan.

Laiba, University of Agriculture Faisalabad Pakistan.

Student, University of Agriculture, Faisalabad, Pakistan.

Rida, University of Agriculture Faisalabad Pakistan.

Student, University of Agriculture, Faisalabad, Pakistan.

Zunaib, University of Agriculture Faisalabad Pakistan.

Student, University of Agriculture, Faisalabad, Pakistan.

Ali Ahsan, University of Agriculture Faisalabad Pakistan

Student, University of Agriculture, Faisalabad, Pakistan.

Hafiz Bilal Murtaza, University of Agriculture Faisalabad Pakistan.

Ph.D. Scholar (Statistics), University of Agriculture, Faisalabad, Pakistan.


AACC. Approved Methods of American Association of Cereal Chemists. The American Association of Cereal Chemists, Inc. St. Paul. Minnesota; 2000.

Akhtar N, Ibrar M, Aman N. The Effects of Different Soaking Times and Concentrations of GA3 on Seed Germination and Growth of Spinacia oleracea. Pak J Plant Sci. 2008;144(1):9-13.

Akhter P, Baloch NZ, Mohammad D, Orfi SD, Ahmad N. Assessment of Strontium and Calcium Levels in Pakistani Diet. J Environ Radioact. 2004;73:247-56.

Kulczyński B, Sidor A, Brzozowska A, Gramza-Michałowska A. The role of carotenoids in bone health–a narrative review. Nutrition. 2023 Dec 1:112306.

Aljarallah B, Fernandes G, Jejeebhoy KN, Gramlich LM, Whittaker JS, Armstrong D, Duerksen DR, Allard JP. The Canadian Home Total Parenteral Nutrition (HTPN) Registry: Vitamin K Supplementation and Bone Mineral Density. J Parenter Enteral Nutr. 2012;36(4):415-20.

Almeida D, Rosa E, Monteiro AA. Protein and Mineral Concentration of Portuguese Kale (Brassica oleracea var. acephala) Related to Soil Composition. Acta Hortic. 1996;407:269-276.

Qin Y, Pillidge C, Harrison B, Adhikari B. Pathways in formulating foods for the elderly. Food Research International. 2024 Apr 17:114324.

AOAC. Official Methods of Analysis of Association of Official Analytical Chemists International. Horwitz W, editor. 18th ed. AOAC Press, Arlington, VA, USA; 2006.

Apalset EM, Gjesdal CG, Eide GE, Tell GS. Intake of Vitamin K1 and K2 and Risk of Hip Fractures: The Hordaland Health Study. Bone. 2011;49:990-995.

Atkins GJ, Welldon KJ, Wijenayaka AR, Bonewald LF, Findlay DM. Vitamin K Promotes Mineralization, Osteoblast to Osteocyte Transition and an Anticatabolic Phenotype by Carboxylation Dependent and Independent Mechanisms. Am J Physiol Cell Physiol. 2009;297:C1358-C1367.

Gaikwad J, Jogdand S, Pathan A, Mahajan A, Darak A, Ahire ED, Surana KR. Nutraceuticals Potential of Fat‐Soluble Vitamins. Vitamins as Nutraceuticals: Recent Advances and Applications. 2023 May 26:107-28.

Bangash JA, Arif M, Khan MF, Khan F, Rahman AU, Hussain I. Proximate Composition, Minerals and Vitamins Content of Selected Vegetables Grown in Peshawar. J Chem Soc Pak. 2011;33(1):118-122.

Wei RR, Lin QY, Adu M, Huang HL, Yan ZH, Shao F, Zhong GY, Zhang ZL, Sang ZP, Cao L, Ma QG. The sources, properties, extraction, biosynthesis, pharmacology, and application of lycopene. Food & Function. 2023;14(22):9974-98.

Foroutan B. Osteoporosis Etiology, Epidemiology, Diagnosis, Diet, and Treatment: A Narrative Review. OBM Geriatrics. 2024 Apr;8(2):1-60.

Bergman M, Varshavsky L, Gottlieb HE, Grossman S. The Antioxidant Activity of Aqueous Spinach Extract: Chemical Identification of Active Fractions. Phytochemistry. 2001;58(1):143-152.

Binkley N, Harke J, Krueger D, Engelke J, Vallarta-Ast N, Gemar D, Checovich M, Chappell R, Suttie J. Vitamin K Treatment Reduces Undercarboxylated Osteocalcin but Does Not Alter Bone Turnover, Density or Geometry in Healthy Postmenopausal North American Women. J Bone Miner Res. 2009;24:983-991.

Bolton-Smith C, Price RJ, Fenton ST, Harrington DJ, Shearer MJ. Compilation of a Provisional UK Database for the Phylloquinone (Vitamin K1) Content of Foods. Br J Nutr. 2000;83:389-399.

Crupi P, Faienza MF, Naeem MY, Corbo F, Clodoveo ML, Muraglia M. Overview of the potential beneficial effects of carotenoids on consumer health and well-being. Antioxidants. 2023 May 10;12(5):1069.

Booth SL. Roles for Vitamin K Beyond Coagulation. Annu Rev Nutr. 2009;29:89-110.

Most read articles by the same author(s)