Background: It is unclear whether overall dietary patterns influence bone mineral density (BMD) in populations with a relatively high dairy intake. The objective was to identify dietary patterns that are associated with BMD in Dutch middle-aged and elderly subjects.
Methods: Participants were subjects 50 years and over (n=5435) from The Rotterdam Study, a population-based prospective cohort study. Baseline intake of 28 pre-defined food groups was determined by a validated food frequency questionnaire. Dietary patterns were identified using Principal Component Analysis on these food groups. BMD of the femoral neck was measured by Dual Energy X-ray Absorption at baseline and at three subsequent visits between 1993 and 2004. Linear mixed modelling was used to analyse adherence to each pattern with repeatedly measured BMD (both in Z-scores). Results were stratified by status of body weight change.
Results: After adjustment for potential confounders related to lifestyle, socioeconomic status and prevalent chronic diseases, two dietary patterns were associated with high BMD. A Traditional pattern, characterised by high intake of potatoes, meat and fat (β=0.08; 95% CI: 0.05, 0.11) and a Mediterranean-like pattern, characterised by high intake of fruits, vegetables, poultry and fish (β=0.06; 95% CI: 0.04, 0.09). The Processed pattern, characterised by high intake of processed meat and alcohol was associated with low BMD (β=-0.03; 95% CI: -0.06, -0.01). The associations of the Mediterranean- like and Processed pattern were independent of body weight. Furthermore, no effect modification by body weight change was observed.
Conclusion: In a population with relatively high dairy intake, a Mediterranean-like and Traditional dietary pattern may have additional benefits for BMD whereas adherence to Processed dietary pattern may pose a risk for low BMD.
Disclosure: Nestlé Nutrition (Nestec Ltd.), Metagenics Inc. and AXA had no role in design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review or approval of the manuscript. Dr Fernando Rivadeneira received a grant from the Netherlands Organization for Scientific Research (NWO, VIDI 016.136.367). E. de Jonge is supported by a grant from the NWO for the graduate program of 2010 (project number: 022.002.023). This work is funded by Nestlé Nutrition (Nestec Ltd.), Metagenics Inc. and AXA.