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Our understanding of the influence of overall nutrient intake on bone mineral density (BMD) is limited because most studies to date have focused on the intakes of calcium, vitamin D, or a few isolated nutrients. Therefore, we examined the association of major nutrient patterns with BMD in a sample of postmenopausal Iranian women. In this cross-sectional study, 160 women aged 50-85 years were studied and their lumbar spine and femoral neck BMDs were measured using dual-energy X-ray absorptiometry. Dietary intakes were assessed using a validated 168-item food frequency questionnaire, and daily intakes of 30 nutrients were calculated. All nutrient intakes were energy adjusted by the residual method and were submitted to principal component factor analysis to identify major nutrient patterns. Overall, three major nutrient patterns were identified, among which only the first pattern, which was high in folate, total fiber, vitamin B6, potassium, vitamin A (as retinol activity equivalent), vitamin C, β-carotene, vitamin K, magnesium, copper, and manganese, had a significant association with BMD. After controlling for potential confounders, multivariate adjusted mean of the lumbar spine BMD of women in the highest tertile of the first pattern scores was significantly higher than those in the lowest tertile (mean difference 0.08; 95% confidence interval 0.02-0.15; P = 0.01). A nutrient pattern similar to pattern 1, which is associated with high intakes of fruits and vegetables, may be beneficial for bone health in postmenopausal Iranian women.

Findings of studies on the link between dietary acid-base balance and bone mass are relatively mixed. We examined the association between dietary acid-base balance and bone mineral density (BMD) in a sample of Iranian women, hypothesizing that a higher dietary acidity would be inversely associated with BMD, even when dietary calcium intake is adequate. In this cross-sectional study, lumbar spine and femoral neck BMDs of 151 postmenopausal women aged 50-85 years were measured using dual-energy x-ray absorptiometry. Dietary intakes were assessed using a validated food frequency questionnaire. Renal net acid excretion (RNAE), an estimate of acid-base balance, was then calculated indirectly from the diet using the formulae of Remer (based on dietary intakes of protein, phosphorus, potassium, and magnesium; RNAERemer) and Frassetto (based on dietary intakes of protein and potassium; RNAEFrassetto), and was energy adjusted by the residual method. After adjusting for potential confounders, multivariable adjusted means of the lumbar spine BMD of women in the highest tertiles of RNAERemer and RNAEFrassetto were significantly lower than those in the lowest tertiles (for RNAERemer: mean difference -0.084 g/cm2; P=0.007 and for RNAEFrassetto: mean difference -0.088 g/cm2; P=0.004). Similar results were observed in a subgroup analysis of subjects with dietary calcium intake of >800 mg/day. In conclusion, a higher RNAE (i. e. more dietary acidity), which is associated with greater intake of acid-generating foods and lower intake of alkali-generating foods, may be involved in deteriorating the bone health of postmenopausal Iranian women, even in the context of adequate dietary calcium intake.

Purpose: Diet has been shown to be associated with bone mineral density (BMD); however, the inflammatory potential of diet in modulating BMD has not yet been studied. Methods: We examined the association between a newly developed dietary inflammatory index (DII) and BMD in a sample of postmenopausal Iranian women. In this cross-sectional study, 160 postmenopausal women aged 50-85 years were studied and their femoral neck and lumbar spine BMDs were measured by dual-energy X-ray absorptiometry. The DII was computed based on dietary intake assessed using a previously validated, 168-item semiquantitative food frequency questionnaire. Logistic and linear regression models were fit to derive beta estimates and odds ratios (ORs), with DII fit as continuous and as a dichotomous variable. Results: After adjusting for potential confounders, women with higher DII scores were more likely to have BMD below the median in the lumbar spine with the DII being used as both a continuous variable [OR 1.64, 95 % confidence interval (CI) 1.11-2.43, p value = 0.01; one-unit increase corresponding to ≈17 % of its range in the current study] and a categorical variable (OR 2.30, 95 % CI 1.05-5.07, p value = 0.04). Similar associations were observed when lumbar spine BMD was used as a continuous outcome. No significant association was observed with BMD in femoral neck, although the direction was along expected lines. Conclusion: These data suggest a pro-inflammatory diet, as indicated by increasing DII score, may be a risk factor for lower BMD in lumbar spine in postmenopausal Iranian women. [ABSTRACT FROM AUTHOR]