Ghadiri Marzieh, Cheshmazar Elhameh, Shateri Zainab, Gerami Shirin, Nouri Mehran, Gargari Bahram Pourghassem
Nutrition Research Center, Student Research Committee, Department of Biochemistry and Diet Therapy, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
Front Nutr. 2023 Jan 12;9:1083685. doi: 10.3389/fnut.2022.1083685. eCollection 2022.
The association between plant-based diet indices and bone mineral density (BMD) of women with osteoporosis have not been studied in Iranian women. This study aimed to evaluate the association between plant-based diet indices and BMD in postmenopausal women with osteopenia/osteoporosis.
The present research was a case-control study conducted on 131 postmenopausal women with osteoporosis/osteopenia and 131 healthy women. The BMD of the femoral neck and lumbar vertebrae was measured by the Dual-energy X-ray absorptiometry (DXEA) method. Participants were asked to complete a validated semi-quantitative food frequency questionnaire (FFQ). We used three versions of plant-based diet indices, including plant-based diet index (PDI), healthy plant-based diet index (hPDI), and unhealthy plant-based diet index (uPDI). Two different multivariable logistic regression was used for the crude and adjusted model to assess the relationship between PDI, hPDI, and uPDI with odds of femoral and lumbar BMD.
There was a reverse association between last tertile of hPDI with femoral BMD abnormality in the both adjusted model [Model 1: odds ratio (OR): 0.33; 95% confidence interval (CI): 0.19-0.63 and Model 2: OR: 0.30; 95% CI: 0.15-0.58, respectively]. Furthermore, we found a reverse relationship between hPDI with lumbar BMD abnormality in the first adjusted model (OR: 0.36; 95% CI: 0.19-0.67). On the other hand, a negative association was observed in the second and last tertile of hPDI with lumbar BMD abnormality (OR: 0.47; 95% CI: 0.24-0.90 and OR: 0.34; 95% CI: 0.17-0.64, respectively). According to the results, the association of femoral BMD abnormality in the last tertile of uPDI compared to the first tertile in the both adjusted models (Model 1: OR: 2.85; 95% CI: 1.52-5.36 and Model 2: OR: 2.63; 95% CI: 1.37-5.06) were significant. Also, we observed a positive relationship between the last tertile of uPDI with lumbar BMD abnormality compared to the lowest tertile in the both adjusted models (Model 1; OR: 4.16; 95% CI: 2.20-7.85, Model 2; OR: 4.23; 95% CI: 2.19-8.19).
Overall, the findings indicated that in postmenopausal women with osteoporosis, a healthy plant-based diet could prevent bone loss, and an unhealthy plant-based diet might have detrimental effects on BMD.
植物性饮食指数与伊朗女性骨质疏松症患者骨矿物质密度（BMD）之间的关联尚未得到研究。本研究旨在评估植物性饮食指数与绝经后骨质减少/骨质疏松女性骨密度之间的关联。
本研究为病例对照研究，对象为131名绝经后骨质疏松/骨质减少女性和131名健康女性。采用双能X线吸收法（DXEA）测量股骨颈和腰椎的骨密度。参与者被要求完成一份经过验证的半定量食物频率问卷（FFQ）。我们使用了三种版本的植物性饮食指数，包括植物性饮食指数（PDI）、健康植物性饮食指数（hPDI）和不健康植物性饮食指数（uPDI）。使用两种不同的多变量逻辑回归对粗模型和调整模型进行分析，以评估PDI、hPDI和uPDI与股骨和腰椎骨密度异常几率之间的关系。
在两个调整模型中，hPDI最高三分位数与股骨骨密度异常呈负相关[模型1：比值比（OR）：0.33；95%置信区间（CI）：0.19 - 0.63；模型2：OR：0.30；95% CI：0.15 - 0.58]。此外，在第一个调整模型中，我们发现hPDI与腰椎骨密度异常呈负相关（OR：0.36；95% CI：0.19 - 0.67）。另一方面，在hPDI的第二个和最高三分位数与腰椎骨密度异常之间观察到负相关（分别为OR：0.47；95% CI：0.24 - 0.90和OR：0.34；95% CI：0.17 - 0.64）。根据结果，在两个调整模型中，uPDI最高三分位数与最低三分位数相比，股骨骨密度异常的关联显著（模型1：OR：2.85；95% CI：1.52 - 5.36；模型2：OR：2.63；95% CI：1.37 - 5.06）。此外，在两个调整模型中，与最低三分位数相比，uPDI最高三分位数与腰椎骨密度异常呈正相关（模型1；OR：4.16；95% CI：2.20 - 7.85，模型2；OR：4.23；95% CI：2.19 - 8.19）。
总体而言，研究结果表明，在绝经后骨质疏松女性中，健康的植物性饮食可以预防骨质流失，而不健康的植物性饮食可能对骨密度产生有害影响。
