| Summary: | This prospective study investigated the association between nutrient intake, dietary patterns, and changes in bone turnover and bone mineral density (BMD) in postmenopausal urban black South African women over two years. These women (<i>n</i> = 144) underwent BMD measurements at the distal radius, lumbar spine, femoral neck (FN), as well as a biochemical analysis which included the parathyroid hormone (PTH), 25-hydroxyvitamin D, C-Telopeptide of type I collagen (CTX-1) in 2010 and 2012. Their dietary intake was assessed in 2010 using a food frequency questionnaire, and sociodemographic and health information was collected. Four dietary patterns explained 54.4% of the variance of dietary intake, namely staple foods and processed meats, home cooking, snacking, and high sugar. Dietary magnesium negatively correlated with CTx-1 in 2012 (r = −0.21, <i>p</i> = 0.02), calcium correlated with distal radius BMD in 2010 (r = 0.22, <i>p</i> = 0.01) and 2012 (r = 0.24, <i>p</i> = 0.005), and the snacking dietary pattern score correlated with FN BMD in 2010 (r = 0.18, <i>p</i> = 0.03) and 2012 (r = 0.21, <i>p</i> = 0.02). The baseline CTx-1 and dietary magnesium intake predicted 22% of the variance in percentage change of CTx-1 over two years (<i>p</i> < 0.001).The magnesium intake predicted short-term bone resorption over two years.
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