Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran.
Eur J Clin Nutr. 2022 Dec;76(12):1657-1664. doi: 10.1038/s41430-022-01093-7. Epub 2022 Feb 16.
We aimed to systematically review the literature and test the dose-response relationship between adherence to the Mediterranean diet (MedDiet) and values of bone mineral density (BMD) in adults.
Relevant observational studies were selected through searching PubMed, Scopus, and Web of Science databases up to March 4, 2021. A random-effects dose-response meta-analysis was performed to estimate the change in total and regional-specific BMD for a 2-point increment in the score of adherence to the MedDiet, and to clarify the shape of these associations.
Seven cross-sectional and one cohort studies with a total number of 13,209 participants were included in the final analyses. Each 2-point increment in the score of adherence to the MedDiet was associated with 0.009 (95% CI: 0.002, 0.016; I = 34%, n = 7), 0.006 (95% CI: 0.001, 0.012; I = 34%, n = 7), 0.005 (95% CI: 0.003, 0.007; I = 1%, n = 4), 0.005 (95% CI: 0.002, 0.008; I = 0%, n = 3), and 0.007 (95% CI: 0.005, 0.009; I = 0%, n = 4) gr/cm higher BMD of lumbar spine, femoral neck, hip, trochanter, and whole body, respectively. There was a positive linear relationship between the MedDiet adherence score and BMD of hip and trochanter. A nonlinear relationship was seen for lumbar spine, femoral neck, and whole body, with sharper increase in the BMD at lower MedDiet scores. The associations remained significant after controlling for important confounders including body weight, physical activity, smoking status, and energy intake.
Greater adherence to the MedDiet was associated with a small but important increase in BMD at the lumbar spine, femoral neck, hip, trochanter, and whole body. Adopting a Mediterranean-style eating pattern may have modest beneficial effects on bone health.
我们旨在系统地回顾文献，并检验成年人对地中海饮食（MedDiet）的依从性与骨密度（BMD）值之间的剂量-反应关系。
通过检索 PubMed、Scopus 和 Web of Science 数据库，筛选截至 2021 年 3 月 4 日的相关观察性研究。采用随机效应剂量-反应荟萃分析，估计依从 MedDiet 评分每增加 2 分，总及局部特定 BMD 的变化，并阐明这些关联的形状。
最终分析纳入了 7 项横断面研究和 1 项队列研究，共计 13209 名参与者。依从 MedDiet 评分每增加 2 分，与腰椎（I=34%，n=7）、股骨颈（I=34%，n=7）、髋部（I=1%，n=4）、转子间区（I=0%，n=3）和全身体（I=0%，n=4）BMD 分别增加 0.009（95%CI：0.002，0.016）、0.006（95%CI：0.001，0.012）、0.005（95%CI：0.003，0.007）、0.005（95%CI：0.002，0.008）和 0.007（95%CI：0.005，0.009）gr/cm²有关。髋部和转子间区的 MedDiet 依从性评分与 BMD 呈正线性关系。腰椎、股骨颈和全身体的关系是非线性的，在较低的 MedDiet 评分下，BMD 增加更为明显。在控制体重、身体活动、吸烟状况和能量摄入等重要混杂因素后，这些关联仍然显著。
对 MedDiet 的较高依从性与腰椎、股骨颈、髋部、转子间区和全身体的 BMD 略有但重要的增加有关。采用地中海式饮食模式可能对骨骼健康有适度的有益影响。
