Dietary patterns explaining differences in bone mineral density and hip structure in the elderly: the Rotterdam Study

Area of Science:

• Nutritional Epidemiology
• Bone Physiology
• Gerontology

Background:

• Limited evidence exists on the relationship between dietary patterns, hip bone geometry, and fracture risk.
• Understanding these associations is crucial for developing targeted nutritional strategies to prevent fractures.

Purpose of the Study:

• To investigate if specific dietary patterns associated with bone mineral density (BMD) and hip bone geometry predict subsequent fracture risk.
• To identify dietary patterns that influence bone health and fracture outcomes.

Main Methods:

• The Rotterdam Study included 4028 participants aged 55+ years.
• Dietary intake was assessed using food-frequency questionnaires, and hip bone geometry (BMD, bone width, section modulus, cortical buckling ratio) was measured via dual-energy X-ray absorptiometry.
• Reduced rank regression identified BMD and geometry-specific dietary patterns, with fracture data collected over a median of 14.8 years.

Main Results:

• Two major dietary patterns were identified: 'fruit, vegetables, and dairy' and 'sweets, animal fat, and low meat'.
• Adherence to the 'fruit, vegetables, and dairy' pattern was associated with higher BMD, better bending strength (section modulus), lower bone instability (buckling ratio), and reduced risk of osteoporotic and hip fractures.
• Adherence to the 'sweets, animal fat, and low meat' pattern was linked to wider bones, higher bending strength, increased bone instability, and a higher risk of osteoporotic and hip fractures, independent of BMD.

Conclusions:

• The 'fruit, vegetables, and dairy' dietary pattern may lower fracture risk through improved BMD, bending strength, and bone stability.
• The 'sweets, animal fat, and low meat' dietary pattern might elevate fracture risk due to widened, unstable bones, irrespective of BMD.
• Dietary recommendations considering both bone geometry and BMD may be beneficial for fracture risk reduction.