Dietary habits and fragility fractures

Fragility fractures (FF) are caused by low-energy trauma in patients with osteoporosis (Op) and are associated with a high risk of disability and mortality. Poor nutrition and unhealthy dietary habits are common risk factors for Op, but how they affect FF is unknown. In a cross-sectional study, we evaluated adherence to the Mediterranean diet (MD), salt and calcium intake in Op patients with and without FF.

We enrolled Op patients consecutively referring to Federico II University and Ospedale del Mare in Naples from 6/1/2020 to 5/31/2024. Patients were divided according to whether or not they had experienced FF. All study participants were interviewed using the validated MEDI-LITE, MINISAL and Food Frequency Questionnaires. FF were significantly more frequent among women (p < 0.04) and patients who had a lower adherence to MD (10.9 ± 1.9 vs 11.5 ± 1.8, p = 0.001), higher salt intake (9.3 ± 1.7 vs 8.7 ± 1.7, p < 0.003) and lower calcium intake (478 ± 308 vs 536 ± 260, p = 0.021). FF susceptibility decreased by 14 % (OR 0.86, 95 % C.I. 0.78-0.94, p < 0.001) for each point of increase in MEDI-LITE score, by 19 % (OR 0.81, 95 % C.I. 0.70-0.94, p = 0.005) for each point of decrease in MINISAL score, by 8 % (OR 0.92, 95 % C.I. 086-0.99, p = 0.03) for each rising of 100 mg of calcium intake.

High MD adherence, low salt and high calcium intake are associated with lower risk of FF in Op patients. This study describes the set of dietary habits influencing the FF occurrence in Op patients, and provides also with nutritional recommendations.