Abstract
BackgroundChronic inflammation contributes to the risk of osteoporosis and fracture. Dietary Inflammatory Index (DII), a novel method appraising the inflammatory potential of diet, has been utilized to examine the association between diet and bone health among postmenopausal women or the elderly. However, its relationship with bone density (BD) in lactating women has not been studied.MethodsThe prospective study was conducted to assess the possible association between DII and maternal BD during lactation. We enrolled 150 lactating women in the cohort. Participants were measured ultrasonic BD as baseline values at 1 month postpartum. After five-month follow up, the participants’ BD were measured again. DII scores were calculated from semi-quantitative food frequency questionnaires (FFQ) and divided into tertiles. We compared the differences in the changes of BD at 6 months postpartum without or with adjustment for potential covariates across the tertiles.ResultsThe women in Q1 of DII scores had less bone mass loss than those in Q2 and Q3 without adjustment for any covariates (p < 0.01); after adjusting demographic characteristics such as BMI (kg/m2) at 6 months postpartum, educational level, metabolic equivalent (MET), daily energy intake (kcal/d), we found that participants in the highest tertile of DII scores had much more bone loss than those in the lowest tertile (p = 0.038). However, in the test for trend, no significant association between DII and the changes of maternal BD at 6 months postpartum was observed.ConclusionsChinese lactating women with higher DII scores have more bone mass loss; however significant differences and trends are attenuated and/or disappear depending on covariates and confounders that are taken into account in statistical analysis. The further study should be conducted in larger population to explore whether the significant association between DII and BD exists in Chinese lactating women.
Highlights
Chronic inflammation contributes to the risk of osteoporosis and fracture
General characteristics across tertiles of Dietary Inflammatory Index (DII) Distribution of food groups across tertiles of DII is shown in Table 2: decreasing trends were observed for energy daily intake (p < 0.01), soy and soy products (p = 0.01), dark leafy vegetables (p = 0.002), light vegetables (p = 0.001), dark fruits (p = 0.003), and light fruits (p = 0.023)
Women in the Q1 of DII had less bone mass loss than those in Q2 and Q3 without adjustment (p < 0.01); after adjusting demographic characteristics such as BMI6, educational level, metabolic equivalent (MET), daily energy intake, we found that participants in the highest tertile had much more bone loss than those in the Q1 (p = 0.038)
Summary
Chronic inflammation contributes to the risk of osteoporosis and fracture. Dietary Inflammatory Index (DII), a novel method appraising the inflammatory potential of diet, has been utilized to examine the association between diet and bone health among postmenopausal women or the elderly. Its relationship with bone density (BD) in lactating women has not been studied. Chinese women reach the peak bone mass (PBM) at the age of 30 [1] and that age is the peak period of their child-bearing [2]. In order to maintain the calcium balance in milk, calcium from maternal bones is dissolved, which leads to maternal PBM loss. According to the data on Chinese National Nutrition and Health Surveillance, more than 50% of breastfeeding women consumed less milk than the recommendation, which could not meet the demands of calcium of the population. The data showed that Chinese breastfeeding women had lower intake of vitamin D and calcium. Chinese lactating women are at high risk of the lack of PBM reserve
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