Healthy Eating Index and Bone in Obesity

Individuals living with overweight or obesity have a higher bone mineral density, however bone quality may be compromised, leading to an increased susceptibility to fractures and impaired skeletal integrity. Nutrition is a potentially modifiable factor that may influence both body weight and bone metabolism through effects on inflammation, body composition, and metabolic regulation. In particular, dietary quality indices such as the Healthy Eating Index (HEI) provide a comprehensive assessment of adherence to dietary guidelines and may offer insight into how overall eating patterns influence bone quality among individuals with excess body weight.

In this review, we have summarized the impact of dietary quality using the HEI on bone health in individuals who are living with overweight or obesity. Recent studies show a positive relationship of high HEI with bone parameters in overweight and obese individuals. Specifically, studies report on a higher Trabecular bone score (TBS), lumbar and femoral neck BMD, lower osteoporosis risk and higher serum 25 hydroxy vitamin D levels in populations with a higher HEI. Currently studies assessing impact of HEI on bone health in obesity are cross sectional in nature. Future studies should assess the impact of increasing HEI on bone health in a prospective design and the impact of weight loss and increasing HEI on bone quality in individuals living with overweight and obesity.