Lack of association between dietary inflammatory index and low impact fractures in the Brazilian population: the Brazilian Osteoporosis Study (BRAZOS)

Melissa Morimoto,Nitin Shivappa,Patricia De Souza Genaro,Natielen Jacques Schuch,Lígia Araújo Martini,James R Hebert,Marcelo Medeiros Pinheiro

doi:10.1186/s42358-019-0059-7

Abstract

IntroductionAdequate nutrition, including intake of dietary calcium and vitamin D, is important to maintain bone health. Evidence suggests that a deficiency in micronutrients may contribute to bone loss during aging and exert generalized effects on chronic inflammation. Recently, the Dietary Inflammatory Index (DII) was developed to assess the inflammatory potential of individual diets. Our aim was to evaluate the DII in a representative sample and verify its association with low-impact fractures.MethodsIndividuals from The Brazilian Osteoporosis Study (BRAZOS) database had their DII calculated. BRAZOS is an important cross-sectional epidemiological study carried out with a representative sample of men and women ≥40 years old. The research was conducted through in-home interviews administered by a trained team. Nutrition Database System for Research (NDSR) software was used to analyze data on the intake of nutrients, which were employed to calculate the DII using Statistical Analysis Software (SAS®) and Statistical Package for the Social Sciences (SPSS®) to assess its association with low-impact fractures.ResultsA total of 2269 subjects had their DII score calculated using information from 24-h recall data. Males had lower DII than females (DII = 1.12 ± 1.04 vs DII = 1.24 ± 0.99, p = 0.012). Women taking statins had lower DII (DII = 0.65 ± 1.14 vs DII + 1.26 ± 0.98, p = 0.002), indicating a greater potential for diet-related anti-inflammatory effects.ConclusionOur findings suggest that women might have a pro-inflammatory diet pattern compared to men. However, we did not find any association between DII scores and low-impact fractures.

Highlights

Adequate nutrition, including intake of dietary calcium and vitamin D, is important to maintain bone health
Our findings suggest that women might have a pro-inflammatory diet pattern compared to men
There were no significant differences between genders in terms of race, geographic regions, area, and current smoking status

Summary

Introduction

Adequate nutrition, including intake of dietary calcium and vitamin D, is important to maintain bone health. The Dietary Inflammatory Index (DII) was developed to assess the inflammatory potential of individual diets. Our aim was to evaluate the DII in a representative sample and verify its association with low-impact fractures. Osteoporosis is a systemic skeletal disease characterized by loss of bone mineral density (BMD), impairment of resistance and bone microarchitecture, and higher risk for low-impact fractures [1]. According to the Brazilian Osteoporosis Study (BRAZOS), about 15.1% of women and 12.8% of men reported fragility fractures [2]. Osteoporosis Risk Index), showed that 33% of postmenopausal women had osteoporosis as diagnosed by Dual-energy X-ray absorptiometry (DXA) measurements, supporting the original findings of BRAZOS [3, 4]. Recent evidence indicates a relationship between oxidative stress and osteoporosis, but its role in fractures is still poorly understood [7, 8]. The Morimoto et al Advances in Rheumatology (2019) 59:16 intake of antioxidants could possibly influence BMD in a positive way

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