Pro-inflammatory dietary pattern is associated with fractures in women: an eight-year longitudinal cohort study

Osteoporos Int. 2018 Jan;29(1):143-151. doi: 10.1007/s00198-017-4251-5. Epub 2017 Oct 10.

Abstract

In this study, during 8 years of follow-up, we reported that higher dietary inflammatory index values were associated with a higher risk of incident fractures in women, but not in men, after adjusting for potential confounders.

Introduction: Inflammation is a key risk factor for many adverse outcomes in older people. While diet is a potential source of inflammation, little is known about the impact of inflammatory diet on fractures. Thus, we investigated whether higher Dietary Inflammatory Index (DII)™ ® scores are associated with fractures in a cohort of North American people.

Methods: This longitudinal study with a follow-up of 8 years included 3648 participants (1577 males and 2071 females; mean age = 60.6 years) with/at risk of knee osteoarthritis participating with in the Osteoarthritis Initiative. DII scores were calculated using the validated Block Brief 2000 Food Frequency Questionnaire, categorized into sex-specific quintiles. Information on fractures was obtained through self-reported history of fractures at hip, spine, and forearm. The relationship between baseline DII score and incident fracture was assessed through a Cox's regression analysis, adjusted for potential baseline confounders, and reported as hazard ratios (HRs).

Results: During 8 years of follow-up, 560 individuals developed fractures (15.4%). Adjusting for 10 potential confounders, women in the highest DII score quintile (i.e., most pro-inflammatory diet) had a significantly higher risk for fractures (HR = 1.46; 95% CI = 1.02-2.11) compared to women in the lowest quintile. An increase in one standard deviation of DII scores significantly predicted fracture onset in women (adjusted HR = 1.14; 95% CI = 1.02-1.27). The association between DII score and fractures was not significant among men or in the sample as whole.

Conclusion: Pro-inflammatory diet is associated with a higher incidence of fractures in women but not men.

Keywords: Aged; Dietary Inflammatory Index; Fracture; Inflammation; Osteoporosis.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cohort Studies
  • Diet / adverse effects*
  • Diet / statistics & numerical data
  • Diet Surveys
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Inflammation / complications*
  • Inflammation / epidemiology
  • Male
  • Middle Aged
  • Osteoporotic Fractures / epidemiology
  • Osteoporotic Fractures / etiology*
  • Risk Assessment / methods
  • Sex Factors
  • United States / epidemiology