Abstract
Post menopause is considered a critical period for bone-mass loss. Impaired bone metabolism during this phase can increase the risk of fractures in old age. Inflammation is a risk factor for bone health, and diet is a potential source of inflammation. However, few studies have examined the association between the dietary inflammatory index (DII®) and bone-mineral density (BMD) in postmenopausal women in Korea. The objective of this study was to determine, by means of a Korean cross-sectional investigation, whether higher DII scores are associated with decreased BMD in postmenopausal women. To that end, the raw data from the fourth and fifth Korea National Health and Nutrition Examination Surveys (KNHANES, 2009–2011) for 2778 postmenopausal women aged over 50 years were analyzed. The subjects’ BMD were measured by dual-energy x-ray absorptiometry, and their DII® scores were calculated from a single 24-h dietary recall. Further, the participants were classified into three groups according to DII® score. Women with more pro-inflammatory diets (i.e., those in the highest tertile of DII®) had significantly lower BMD in the femoral neck as compared with women in the lowest tertile (p for trend <0.05) after adjustment for age, body-mass index (BMI), household income, education status, smoking habits, physical activity, total calcium intake, female-hormone use, age at menopause, and blood vitamin D levels. Multiple logistic regression analyses revealed that the odds ratio (OR) of total femur osteopenia/osteoporosis was higher in women in the highest tertile of DII® than in those in the lowest (OR 1.27, 95% CI 1.00-1.62, p for trend < 0.05). This study established that more pro-inflammatory diets might be associated with lower BMD in postmenopausal Korean women.
Highlights
We found that increased DII® was associated with lower bone-mineral density (BMD) and increased risk of osteoporosis in femur bone only
With a nationwide sample of Americans aged between 40 and early 50s, demonstrated that a lower mean value of BMD in total femur and femoral neck is associated with higher DII® in both men and women [30]
In a study on postmenopausal Iranian women, subjects with higher DII® scores were not associated with BMD in the femoral neck [20]
Summary
Due to the fact that osteoporotic fractures in the elderly impose a great health care burden on them [6,7], it is important to understand the risk factors of osteoporosis and manage them, not to mention diagnose and treat them early. Pro-inflammatory cytokines such as Intereukin-1 (IL-1), Interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) are important regulators of bone resorption [8,9]. It has been reported that deficiency of estrogen causes increased IL-1 production by cellular monocytes, and that TNF-α levels increase in women who experience osteoporotic fractures [10]. The pro-inflammatory mediators play an important role in estrogen deficiency-associated bone loss in postmenopausal women
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