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Eur J Nutr. 2018 Sep;57(6):2147-2160. doi: 10.1007/s00394-017-1490-3. Epub 2017 Jun 21.

Adherence to Mediterranean diet in relation to bone mineral density and risk of fracture: a systematic review and meta-analysis of observational studies.

Author information

1
Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
2
Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, PO Box 14155-6117, Tehran, Iran.
3
Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
4
Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, PO Box 14114-13137, Tehran, Iran. larijanib@sina.tums.ac.ir.
5
Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. a-esmaillzadeh@sina.tums.ac.ir.
6
Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, PO Box 14155-6117, Tehran, Iran. a-esmaillzadeh@sina.tums.ac.ir.
7
Food Security Research Center, Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran. a-esmaillzadeh@sina.tums.ac.ir.

Abstract

PURPOSE:

We aimed to systematically review available data on the association between adherence to MD and BMD as well as risk of fractures and to summarize this information through a meta-analysis.

METHODS:

Previous studies in the field of adherence to MD in relation to BMD and risk of fracture were selected through searching PubMed, Scopus, ISI Web of Science and Google Scholar databases prior to June, 2016 using Mesh and non-Mesh relevant keywords.

RESULTS:

In the meta-analysis of four effect sizes, obtained from three studies, we found that adherence to MD was associated with a 21% reduced risk of hip fracture (overall RR 0.79; 95% CIs 0.72-0.87). Adherence to MD was positively associated with lumber spine's (mean difference of BMD comparing highest and lowest categories of MD score 0.12; 95% CI 0.06-0.19 g/cm2), femoral neck (0.10; 0.06-0.15 g/cm2) and total hip (0.11; 0.09-0.14 g/cm2) BMD. Meta-regression of included observational studies revealed a significant inverse linear association between Mediterranean diet score and risk of hip fracture, such that one unit increase in the score of Mediterranean diet was associated with a reduction in the risk of hip fracture (RR 0.95, 95% CI 0.92-0.98 p = 0.01).

CONCLUSION:

Adherence to MD was associated with a reduced risk of fracture as well as with a higher mean BMD.

KEYWORDS:

Bone mineral density; Fracture; Mediterranean diet; Meta-analysis; Systematic review

PMID:
28638994
DOI:
10.1007/s00394-017-1490-3
[Indexed for MEDLINE]

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