An energy-dense, nutrient-poor dietary pattern is inversely associated with bone health in women.

Measures of dietary patterns have been increasingly used to capture the complex nature of dietary intake. Few studies have investigated the impact of specific dietary patterns on bone health. Areal bone mineral density (BMD) at the lumbar spine and total hip and total body bone mineral content (BMC) were measured using DXA in Australian women aged 18-65 y (n = 527). Dietary patterns were assessed using a 4-d food diary and factor analysis. Scores were calculated based on the amount of each food consumed in the pattern and the weightings determined by factor analysis. Analysis was conducted using generalized estimating equation methods. Factor analysis revealed 5 dietary patterns. Pattern 1 (high consumption of refined cereals, soft drinks, fried potatoes, sausages and processed meat, vegetable oils, beer, and takeaway foods and low consumption of other vegetables, vegetable dishes, tea, coffee, fruit, wholegrain breads, and breakfast cereals) were significantly inversely associated with total body BMC (g) [β = -15.4 (95% CI -27.4, -3.3), adjusted for age, height, physical activity, smoking, education, energy, and calcium intake]. Pattern 4 (high consumption of legumes, seafood, seeds, nuts, wine, rice and rice dishes, other vegetables, and vegetable dishes and low consumption of bacon and ham) were directly associated with BMD at both sites and total body BMC in adjusted models [BMC (g): β = 15.2 (95% CI 2.84, 27.6), fully adjusted model]. The remaining dietary patterns were not consistently associated with BMD or BMC. This study identified specific dietary patterns associated with BMD and total body BMC among women and provides evidence that will contribute to potential food-based strategies for improving bone health.