Adherence to the Mediterranean Diet and Bone Fracture Risk in Middle-Aged Women: A Case Control Study.

Anna Palomeras-Vilches,Mªàngels Agüero-Martínez,Anna Bach-Faig,Georgina Pujol-Busquets,Eva Viñals-Mayolas,Concepció Bou-Mias,Mªàngels Jordà-Castro,Lluís Serra-Majem,Marina Bosque-Prous,Montserrat Busquets-Barceló,Carme Carrion

doi:10.3390/nu11102508

Abstract

The prevention of bone mass loss and related complications associated with osteoporosis is a significant public health issue. The Mediterranean diet (MD) is favorably associated with bone health, a potentially modifiable risk factor. The objective of this research was to determine MD adherence in a sample of women with and without osteoporosis. In this observational case-control study of 139 women (64 women with and 75 without osteoporosis) conducted in a primary-care health center in Girona (Spain), MD adherence, lifestyle, physical exercise, tobacco and alcohol consumption, pathological antecedents, and FRAX index scores were analyzed. Logistic multilinear regression modeling to explore the relationship between the MD and bone fracture risk indicated that better MD adherence was associated with a lower bone risk fracture. Non-pharmacological preventive strategies to reduce bone fracture risk were also reviewed to explore the role of lifestyle and diet in bone mass maintenance and bone fracture prevention.

Highlights

The Mediterranean diet (MD) has been recognized as a model of healthy eating because of its contribution to a healthy lifestyle and a better quality of life
We corroborate the present scientific evidence on the Mediterranean Diet and bone health and we review these aspects in relation to lifestyle and bone health
Feart et al [32], higher MD adherence was associated with a non-significant reduced risk of fractures in older individuals, while a meta-analysis by Malmir et al [12] reported that higher adherence to the MD is associated with a 21% decreased hip fracture risk and a higher BMD in the lumbar spine, whole body, and trochanter; note, that these authors concluded that the likelihood of residual confounding should be considered

Summary

Introduction

The Mediterranean diet (MD) has been recognized as a model of healthy eating because of its contribution to a healthy lifestyle and a better quality of life. The principles underlying the MD—widely documented elsewhere [1]—can be summarized as follows: high consumption of fruits, vegetables, cereals (especially whole seeds), legumes, and nuts; relatively high fat consumption (up to 40% of total energy intake), mainly monounsaturated fatty acids (MUFAs) from extra-virgin olive oil, the main fat used for seasoning and cooking; moderate to high consumption of fish; moderate dairy product consumption, usually in the form of yogurt and cheese; low red meat and meat product consumption; moderate alcohol consumption, mainly in the form of red wine during meals; low consumption of simple sugars (pastries, soft drinks, etc.); and high consumption of herbs and spices—an important source of micronutrients, including calcium (Ca)—used to flavor dishes [1,2] This traditional diet, has been affected by the onslaught of dietary trends of recent decades [1,2,3]

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