TY - JOUR
T1 - Dietary Inflammatory Index, Bone Mineral Density, and Risk of Fracture in Postmenopausal Women
T2 - Results From the Women's Health Initiative
AU - Orchard, Tonya
AU - Yildiz, Vedat
AU - Steck, Susan E.
AU - Hébert, James R.
AU - Ma, Yunsheng
AU - Cauley, Jane A.
AU - Li, Wenjun
AU - Mossavar-Rahmani, Yasmin
AU - Johnson, Karen C.
AU - Sattari, Maryam
AU - LeBoff, Meryl
AU - Wactawski-Wende, Jean
AU - Jackson, Rebecca D.
N1 - Funding Information:
The WHI program is funded by the NIH, National Heart, Lung, and Blood Institute (NHLBI) through contracts HHSN268201100046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, and HHSN268201100004C. Kellie Weinhold, Fred Tabung, Nitin Shivappa, and Short List of WHI Investigators: WHI Program Office (National Heart, Lung, and Blood Institute, Bethesda, MD, USA): Jacques Rossouw, Shari Ludlam, Joan McGowan, Leslie Ford, and Nancy Geller. Clinical Coordinating Center (Fred Hutchinson Cancer Research Center, Seattle, WA, USA): Garnet Anderson, Ross Prentice, Andrea LaCroix, and Charles Kooperberg. Investigators and Academic Centers: (Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA) JoAnn E. Manson; (MedStar Health Research Institute/Howard University, Washington, DC, USA) Barbara V. Howard; (Stanford Prevention Research Center, Stanford, CA, USA) Marcia L. Stefanick; (The Ohio State University, Columbus, OH, USA) Rebecca Jackson; (University of Arizona, Tucson/Phoenix, AZ, USA) Cynthia A. Thomson; (University at Buffalo, Buffalo, NY, USA) Jean Wactawski-Wende; (University of Florida, Gainesville/Jacksonville, FL, USA) Marian Limacher; (University of Iowa, Iowa City/Davenport, IA, USA) Jennifer Robinson; (University of Pittsburgh, Pittsburgh, PA, USA) Lewis Kuller; (Wake Forest University School of Medicine, Winston-Salem, NC, USA) Sally Shumaker; (University of Nevada, Reno, NV, USA) Robert Brunner; (University of Minnesota, Minneapolis, MN, USA) Karen L. Margolis. Women's Health Initiative Memory Study: (Wake Forest University School of Medicine, Winston-Salem, NC, USA) Mark Espeland. Authors’ roles: TSO, SES, JRH, and RDJ designed research; VY analyzed data; TSO, VY, SES, YM, JRH, ML, YMR, KJ, WL, MS, JC, JWW, and RDJ wrote the manuscript; TSO and RDJ had primary responsibility for final content.
Publisher Copyright:
© 2016 American Society for Bone and Mineral Research
PY - 2017/5
Y1 - 2017/5
N2 - Previous studies suggest that bone loss and fracture risk are associated with higher inflammatory milieu, potentially modifiable by diet. The primary objective of this analysis was to evaluate the association of the dietary inflammatory index (DII), a measure of the inflammatory potential of diet, with risk of hip, lower-arm, and total fracture using longitudinal data from the Women's Health Initiative Observational Study and Clinical Trials. Secondarily, we evaluated changes in bone mineral density (BMD) and DII scores. DII scores were calculated from baseline food frequency questionnaires (FFQs) completed by 160,191 participants (mean age 63 years) without history of hip fracture at enrollment. Year 3 FFQs were used to calculate a DII change score. Fractures were reported at least annually; hip fractures were confirmed by medical records. Hazard ratios for fractures were computed using multivariable-adjusted Cox proportional hazard models, further stratified by age and race/ethnicity. Pairwise comparisons of changes in hip BMD, measured by dual-energy X-ray absorptiometry from baseline, year 3, and year 6 were analyzed by quartile (Q1 = least inflammatory diet) of baseline DII scores in a subgroup of women (n = 10,290). Mean DII score improved significantly over 3 years (p < 0.01), but change was not associated with fracture risk. Baseline DII score was only associated with hip fracture risk in younger white women (HR Q4,1.48; 95% CI, 1.09 to 2.01; p = 0.01). There were no significant associations among white women older than 63 years or other races/ethnicities. Women with the least inflammatory DII scores had less loss of hip BMD (p = 0.01) by year 6, despite lower baseline hip BMD, versus women with the most inflammatory DII scores. In conclusion, a less inflammatory dietary pattern was associated with less BMD loss in postmenopausal women. A more inflammatory diet was associated with increased hip fracture risk only in white women younger than 63 years.
AB - Previous studies suggest that bone loss and fracture risk are associated with higher inflammatory milieu, potentially modifiable by diet. The primary objective of this analysis was to evaluate the association of the dietary inflammatory index (DII), a measure of the inflammatory potential of diet, with risk of hip, lower-arm, and total fracture using longitudinal data from the Women's Health Initiative Observational Study and Clinical Trials. Secondarily, we evaluated changes in bone mineral density (BMD) and DII scores. DII scores were calculated from baseline food frequency questionnaires (FFQs) completed by 160,191 participants (mean age 63 years) without history of hip fracture at enrollment. Year 3 FFQs were used to calculate a DII change score. Fractures were reported at least annually; hip fractures were confirmed by medical records. Hazard ratios for fractures were computed using multivariable-adjusted Cox proportional hazard models, further stratified by age and race/ethnicity. Pairwise comparisons of changes in hip BMD, measured by dual-energy X-ray absorptiometry from baseline, year 3, and year 6 were analyzed by quartile (Q1 = least inflammatory diet) of baseline DII scores in a subgroup of women (n = 10,290). Mean DII score improved significantly over 3 years (p < 0.01), but change was not associated with fracture risk. Baseline DII score was only associated with hip fracture risk in younger white women (HR Q4,1.48; 95% CI, 1.09 to 2.01; p = 0.01). There were no significant associations among white women older than 63 years or other races/ethnicities. Women with the least inflammatory DII scores had less loss of hip BMD (p = 0.01) by year 6, despite lower baseline hip BMD, versus women with the most inflammatory DII scores. In conclusion, a less inflammatory dietary pattern was associated with less BMD loss in postmenopausal women. A more inflammatory diet was associated with increased hip fracture risk only in white women younger than 63 years.
KW - EPIDEMIOLOGY
KW - FRACTURE RISK ASSESSMENT
KW - MENOPAUSE
KW - NUTRITION
KW - OSTEOPOROSIS
UR - http://www.scopus.com/inward/record.url?scp=85013478370&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85013478370&partnerID=8YFLogxK
U2 - 10.1002/jbmr.3070
DO - 10.1002/jbmr.3070
M3 - Article
C2 - 28019686
AN - SCOPUS:85013478370
SN - 0884-0431
VL - 32
SP - 1136
EP - 1146
JO - Journal of Bone and Mineral Research
JF - Journal of Bone and Mineral Research
IS - 5
ER -
