The Oslo Health Study: A Dietary Index Estimating Frequent Intake of Soft Drinks and Rare Intake of Fruit and Vegetables Is Negatively Associated with Bone Mineral Density

Abstract

Background. Since nutritional factors may affect bone mineral density (BMD), we have investigated whether BMD is associated with an index estimating the intake of soft drinks, fruits, and vegetables. Methods. BMD was measured in distal forearm in a subsample of the population-based Oslo Health Study. 2126 subjects had both valid BMD measurements and answered all the questions required for calculating a Dietary Index = the sum of intake estimates of colas and non-cola beverages divided by the sum of intake estimates of fruits and vegetables. We did linear regression analyses to study whether the Dietary Index and the single food items included in the index were associated with BMD. Results. There was a consistent negative association between the Dietary Index and forearm BMD. Among the single index components, colas and non-cola soft drinks were negatively associated with BMD. The negative association between the Dietary Index and BMD prevailed after adjusting for gender, age, and body mass index, length of education, smoking, alcohol intake, and physical activity. Conclusion. An index reflecting frequent intake of soft drinks and rare intake of fruit and vegetables was inversely related to distal forearm bone mineral density.

Current Evidence on the Association of Dietary Patterns and Bone Health: A Scoping Review

“…Thirty-two of these articles used the data-driven dietary pattern method, and 20 of them (14,19,34,(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61) used an a priori dietary pattern approach. Three articles (14,19,34) assessed both dietary pattern approaches in association with bone.…”

“…In adult and elderly populations, findings revealed a beneficial impact of higher adherence to the Mediterranean diet in 6 of 10 studies (47,49,55,(57)(58)(59); higher adherence to the HEI or AHEI in 3 of 7 studies (34,45,55); higher adherence to the Dietary Diversity Score in 2 of 2 studies (19,54); and higher adherence to the Diet Quality IndexInternational (55), BMD Diet Score (51), Healthy Diet Indicator (51), and Korean Diet Score (53) in the sole studies evaluating their effects on bone health. A negative impact of higher adherence to the Oslo Health Study Index (45), Dietary Inflammatory Index (48) and Recommended Food Score (46) on bone outcomes was reported in the studies evaluating their impact.…”

“…Adherence to the Oslo Health Study Index, which is the ratio of soft drink intake to fruit and vegetable intake, had a negative relation with BMD in one study (45).…”

“…The most frequent measurement sites were lumber spine (14-24, 37, 39, 40, 48, 49), femoral neck (15, 17, 19-22, 25, 36, 37, 40, 48, 49, 51), and total body (22,23,39,44,46,49,50). Some studies also measured BMD at the trochanter (22,36,37,49), Ward's area (22,36,49), total hip (15,16,39), distal radius (13,39,41,60), radius shaft (18,36,39), total femur (24,37), calcaneus (43,47), intertrochanteric area (49), distal ulna (13), whole arm, whole leg and whole pelvis (23), distal and ultradistal forearm (45), and distal tibia and tibia shaft (38). Bone mineral content (BMC) also was measured in some studies (n = 7) (13,14,16,19,(42)(43)(44).…”

Associations between apriori-defined dietary patterns and longitudinal changes in bone mineral density in adolescents

“…Such information is of major interest and can be obtained with the Oslo Health Study (OHS) dietary index built on prevailing knowledge about foods that potentially influence bone health. The OHS is computed as the ratio between soft drinks and fruit and vegetables consumption and has been directly associated with metabolic syndrome and inversely associated with BMD (19,20) . In addition to being a critical period in the acquisition of bone mass (5) , adolescence is also a period of social and psychological influences on food choices (21) .…”