Healthy eating index-2015 and bone mineral density among adult Iranian women

Abstract

The HEI-2015 is a multidimensional measure of diet quality used to assess how well people's dietary behaviors align with key recommendations of the 2015-2020 Dietary Guidelines for Americans for achieving a healthy dietary pattern. We examined the potential association of the HEI-2015 and bone mineral density (BMD) among adult Iranian women, hypothesizing that a higher HEI-2015 score is associated with greater BMD. Four-hundred sixteen participants (mean age 48.0years; 64.7% premenopausal) participated in this cross-sectional study. Lumbar spine and femoral neck BMDs were measured via dual-energy X-ray absorptiometry. Dietary intakes were assessed using a valid and reliable food frequency questionnaire. The HEI-2015 score was calculated based on dietary intakes of 13 components emphasized or minimized in the HEI-2015. The higher the HEI-2015 score, the better the diet quality. After adjusting for potential covariates in the multiple linear regression analysis, higher HEI-2015 scores were associated with greater lumbar spine and femoral neck BMDs (lumbar spine: standardized beta-coefficient [β] = 0.292; femoral neck: β= 0.192; both P< 0.001). Similar significant associations were found among premenopausal (lumbar spine: β= 0.337; femoral neck: β= 0.262; both P< 0.001) and postmenopausal women (lumbar spine: β= 0.198; femoral neck: β= 0.287; both P< 0.050). Overall, every 10-unit increase in the HEI-2015 score was associated with a 0.03g/cm2 higher multivariable-adjusted BMD at both lumbar spine and femoral neck (both P< 0.001). Findings suggest that better diet quality, as indicated by a higher HEI-2015 score, is significantly associated with a small but clinically important increase in BMD among adult Iranian women.