Study shows how alternative eating habits prevent osteoporosis

A recent study published in the journal Nutrients Explores the role of different dietary patterns in protecting older people from osteoporosis and related fractures.

Study: Association of alternative dietary patterns with osteoporosis and fracture risk in older people: a comprehensive review.  Image Credit: Art_Photo / Shutterstock.comStudy: Association of alternative dietary patterns with osteoporosis and fracture risk in older people: a comprehensive review., Image Credit: Art_Photo /

What is osteoporosis?

Aging affects bone health and hormone levels, which can lead to reduced bone mineral density (BMD). Osteoporosis is a bone disease associated with decreased BMD and bone mass, which increases the risk of fractures.

Osteoporosis is a significant cause of disease and death in older people and affects women more than men. Current estimates suggest that more than 200 million people suffer from osteoporosis, which has become one of the most common non-communicable diseases in the world. Osteoporosis can be effectively treated, even prevented, but it is often not detected until a fall or fracture occurs.

Identifying factors that prevent bone density loss and fractures may help create guidelines to reduce osteoporosis risk. For example, modifying diet may reduce the burden of disease.

Nutritionists have established that consuming more fruits, vegetables and seafood can be beneficial. Diet including the Mediterranean diet (MD) and foods with low dietary inflammation index (DII) scores also has a protective effect; However, the potential benefits of other dietary patterns have not been thoroughly studied.

about the study

Although most previous studies used traditional MD scores to determine the impact of MD on osteoporotic fracture risk in Mediterranean populations, traditional MD content is not always available in other regions of the world. As a result, the authors of the present study examined the modified MD (MMED) and alternative MD (AMED) as well as other traditional dietary patterns such as the Nordic or Chinese diets.

Various scoring systems of diet quality are currently available, such as the Alternative Health Eating Index (AHEI), the Healthy Eating Index (HEI), the Baltic Sea Diet (BSD), and the Dietary Approaches to Stop Hypertension (DASH), among which Each was evaluated. In this study. These dietary scoring systems treat different components such as meat products, dairy, fat, and sodium separately.

A comprehensive literature review was conducted using the EMBASE, MEDLINE and Scopus databases to identify scientific articles published between 2000 and 2022. All papers were based on original research, which studied the relationship between different diets and osteoporosis and its symptoms.

Each study selected for review was observational and used a cross-sectional or prospective cohort design. Study participants were over the age of 50 and could be of any race or ethnicity.

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR) was applied to the present review. The initial search yielded 507 results, ultimately resulting in six relevant papers being identified for analysis.

From these articles, information related to participant characteristics, sample size, dietary scores, dietary findings, and outcomes was obtained. This information was examined through a descriptive synthesis and a multivariable-adjusted analysis.

study findings

Two of the six studies were cross-sectional, while the others were prospective cohort studies, all published after 2015. The study population was European, American and Asian and ranged in age from 50 to 85 years.

Sample sizes varied widely, with the smallest having less than 1,000 individuals and the highest having more than 10,000 people. Two studies examined BMD as the outcome, while the other examined hip and other osteoporotic fractures. Medical data were either self-reported or obtained from patient registers.

Two studies examined the association between diet scores and osteoporosis or BMD. In this regard, no correlation was reported between bone density and BSD scores or DASH scores.

However, strict adherence to DASH guidelines reduced the chance of developing lumbar spine osteoporosis. The DASH diet was associated with lower lumbar and femoral neck BMD compared to the BSD.

Four studies examined the association between dietary scores and osteoporotic fractures. Furthermore, following the MMED or MED diet reduced the risk of hip fracture in both the Swedish and American groups. Although other diets did not show the same association, better adherence was more protective than lower adherence.


The study findings provide important insights into how healthy diets, in addition to the well-known Mediterranean diet, can prevent bone density loss and osteoporotic fractures. Still, further studies are needed to create overall health guidelines.

Similarly, future observational studies should follow study participants from multiple races, ethnicities, and geographic regions over a more extended period. Future studies should also aim to be consistent with respect to sample size and age range so that findings can be compared. Regional cuisine should also be included.

A healthy diet alone is insufficient to prevent osteoporosis, as many studies have emphasized the important role of exercise in preventing osteoporosis. Thus, a combination of diet and exercise may reduce fracture risk and improve osteoporosis outcomes.

Journal Reference:

  • Chen, H. and Avgerinou, C. (2023). Association of alternative dietary patterns with osteoporosis and fracture risk in older people: a comprehensive review. Nutrients (2023). doi:10.3390/nu15194255

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