Benefits of Mediterranean Diet Extend to Bone Health
CHICAGO -- Adhering to the Mediterranean diet may be beneficial for bone mass after menopause, according to new research presented here.
Women from a non-Mediterranean region who consumed this type of diet were found to have higher bone mineral density, specifically of the lumbar spine (1.076 ± 0.149 versus 0.997 ± 0.143 g/cm2, P=0.007), reported lead author Thaís Rasia Silva, PhD, of the Hospital de Clínicas de Porto Alegre in Brazil, and colleagues at ENDO 2018.
Higher compliance to this diet was also associated with having a higher appendicular lean mass index versus women with low compliance (6.6 ± 0.8 kg/m2 versus 6.3 ± 0.7 kg/m2; P=0.039).
Total femoral bone mineral density and in the femoral neck specifically were similar across women regardless of diet, however.
"This dietary pattern has been associated with lower risk for diabetes and cardiovascular disease, but data on body composition are limited," Silva stated during a presentation of the findings.
The analysis included 103 healthy postmenopausal women from southern Brazil. Adherence to the diet was assessed via a food-frequency questionnaire. The researchers scored the level of intake in the past month across several food categories including fruits, vegetables and legumes, cereals, fish, alcohol, olive oil, dairy and meat -- with higher scores representing higher adherence.
Outcomes including bone mineral density, percentage of body fat and appendicular lean mass index were measured by dual-energy x-ray absorptiometry. Pedometer readings and indirect calorimetry were used to measure physical activity and resting metabolic rate.
Women who adhered to the Mediterranean diet tended to have higher levels of education, although no other significant differences were noted between highest- and lowest-compliance groups. Silva noted that this was an expected link since education level and diet quality are closely associated in Brazil.
Across the food groups taken into account, higher intake of olive oil was most closely related to lower percentage of body fat. Greater intake of meat and vegetables were also closely linked to appendicular lean mass index.
After adjustment for potentially confounding variables -- including age, body mass index, smoking status, energy intake and prior hormone replacement therapy use -- Mediterranean diet score was found to be independently related to both lumbar spine bone mineral density (mean difference 0.085 g/cm, 95% CI 0.003-0.140, P=0.003) and appendicular lean mass index (mean difference 0.317 kg/m, 0.002-0.613, P=0.037), according to a multivariate regression analysis.
When asked how hormone therapy use was controlled for, Silva told MedPage Today her group excluded postmenopausal women who were currently using hormonal therapy or who have used it within the past 3 months. Her group also found that women who were previously on hormone therapy had similar outcomes compared with women who hadn't used hormones -- a finding that she called surprising.
"More studies are necessary to clarify the effect of Mediterranean diet on body composition," she concluded. "In the meantime, the emerging evidence suggests that the Mediterranean diet combined with other healthy lifestyle habits may be a useful non-pharmacological strategy for the primary prevention of osteoporosis and fractures in" women after menopause.
The research was funded by the Ministry of Science, Technology, Innovation and Communications/Brazilian National Institute of Hormones and Women's Health, and from the Research Group of Hospital de Clínicas de Porto Alegre in Brazil.
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