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Association between Healthy Eating Index-2015 total and component food scores with osteoporosis in middle-aged and older Americans: a cross-sectional study with U.S. National Health and Nutrition Examination Survey

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Abstract

Summary

We used NHANES data to explore the association between dietary quality estimated by the HEI-2015 and osteoporosis in middle-aged and elderly US adults. We found that higher dietary quality is significantly associated with a reduced risk of osteoporosis among middle-aged and elderly Americans.

Introduction

Through this research, we assess whether increasing the overall dietary quality reduces the risk of osteoporosis.

Methods

For our analyses, we combined data collected from four NHANES 2-year cycles (2007–2008, 2009–2010, 2013–2014, and 2017–2018), including 10,033 participants. Associations between osteoporosis and HEI-2015 total/component scores among middle-aged and elderly adults were examined using logistic regression models. Osteoporosis was defined as femur neck BMD values equal to or less than 2.5 standard deviations (SDs) below the mean of the young adult reference group, and dietary intake data were obtained from two NHANES 24-h recall interviews.

Results

After multivariable adjustment, middle-aged and elderly populations with quintile 4 (OR: 0.54, 95% CI 0.34, 0.84; P = 0.007) and quintile 5 HEI-2015 total scores (OR: 0.43, 95% CI 0.26, 0.70; P = 0.001) were associated with reduced odds of osteoporosis compared with quintile 1. Higher intake of total vegetables, greens and beans, total fruits, whole fruits, and whole grains was associated with decreased odds of osteoporosis among elderly adults. Surprisingly, saturated fat intake can also protect against osteoporosis.

Conclusion

Higher dietary quality estimated from HEI-2015 total and component food scores was significantly associated with a reduced risk of osteoporosis among the middle-aged and elderly Americans participating in NHANES included in this study.

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Availability of data and material

The data of this study will be made available on reasonable request.

Code availability

The code of this study will be made available on reasonable request.

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Acknowledgements

We would like to give our sincere gratitude to the reviewers for their valuable comments. And, the authors would like to thank Miao Zhang for the comments that greatly improved the manuscript.

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Contributions

H.F. Zhang and Y.G. Fan contributed to the conception of the study; S.F. Ni contributed significantly to analysis and manuscript preparation; H.F. Zhang, Y.G. Fan, and S.F. Ni performed the data analyses and wrote the manuscript.

Corresponding authors

Correspondence to Shuangfei Ni or Huafeng Zhang.

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NHANES was approved by the National Center for Health Statistics Research Ethics Review Board.

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Fan, Y., Ni, S. & Zhang, H. Association between Healthy Eating Index-2015 total and component food scores with osteoporosis in middle-aged and older Americans: a cross-sectional study with U.S. National Health and Nutrition Examination Survey. Osteoporos Int 33, 921–929 (2022). https://doi.org/10.1007/s00198-021-06247-0

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