Skip to main content

Dietary Pattern Analysis in Nutritional Science Research: A Review of Current Evidence Relating Dietary Patterns to Indices of Bone Health and Fracture Risk

  • Chapter
  • First Online:
Nutrition and Bone Health

Part of the book series: Nutrition and Health ((NH))

Abstract

The dietary pattern approach to nutritional science research may help to overcome some of the limitations associated with single nutrient studies such as colinearity of nutrients and inaccuracies of food composition databases. We provide a step by step outline of how to generate dietary patterns with commonly available statistical software and then examine their association with bone mineral density (measured by dual energy X-ray absorptiometry) using data collected from a well-characterised group of postmenopausal women as an example. We then review and summarise the current evidence relating dietary patterns to indices of bone health and fracture risk.

Published research data shows that nutrient dense dietary patterns, characterised generally by high intakes of plant based foods, as well as lean protein or oily fish, have been consistently positively associated with surrogate markers of bone health (such as bone mineral density (BMD)) irrespective of population demographics. A small number of studies (predominantly prospective in nature) have progressed beyond surrogate markers to assess dietary pattern associations with incident fracture. Overall it is difficult to make recommendations either in support of or against specific dietary patterns or food groups to help maintain bone mass or prevent fracture given the marked heterogeneity of published studies.

There is a requirement for consistency in future dietary pattern research with thorough consideration of potential confounding factors and recognition of the limitations of the general approach.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Scientific Advisory Committee on Nutrition. Update on Vitamin D. London: TSO; 2007.

    Google Scholar 

  2. Wood AD, Macdonald HM. Interactions of dietary patterns, systemic inflammation, and bone health. In: Burckhardt P, Dawsonhughes B, Weaver C, editors. Nutritional influences on bone health. London, UK: Springer; 2013.

    Google Scholar 

  3. Fung TT, Willett WC, Stamper MJ, Manson JE, Hu FB. Dietary patterns and the risk of coronary heart disease in women. JAMA Intern Med. 2001;161:1857–62.

    Article  CAS  Google Scholar 

  4. Fung TT, Schulze M, Manson JE, Willet WC, Hu FB. Dietary patterns, meat intake and the risk of type 2 diabetes in women. JAMA Intern Med. 2004;164:2235–40.

    Article  Google Scholar 

  5. Fung TT, Hu FB, Fuchs C, Giovannucci E, Hunter DJ, Stampfer MJ, et al. Major dietary patterns and the risk of colorectal cancer in women. JAMA Intern Med. 2003;163:309–14.

    Article  Google Scholar 

  6. Trichopoulou A, Costacou T, Bamia C, Trichopoulos D. Adherence to a Mediterranean diet and survival in a Greek population. NEJM. 2003;348(26):2599–608.

    Article  PubMed  Google Scholar 

  7. Macdonald HM, Hardcastle AC. Dietary patterns and bone health. In: Burckhardt P, Dawsonhughes B, Weaver C, editors. Nutritional influences on bone health. London, UK: Springer; 2010.

    Google Scholar 

  8. Macdonald HM, New SA, Reid DM. Longitudinal changes in dietary intake in Scottish women around the menopause: changes in dietary pattern result in minor changes in nutrient intake. Public Health Nutr. 2005;8:409–16.

    Article  PubMed  Google Scholar 

  9. New SA. An epidemiological investigation into rhe influence of nutritional factors on bone mineral density and bone metabolism:. Aberdeen, UK: University of Aberdeen; 1995.

    Google Scholar 

  10. Holland B, Welch AA, Unwin ID, Buss DH, Paul AA, Southgate DAT, editors. McCance and Widdowson’s The Composition of Foods. 5th edition ed. Cambridge, UK: Royal Society of Chemistry; 1992.

    Google Scholar 

  11. Willett WC, Howe GR, Kushi LH. Adjustment for total energy intake in epidemiologic studies. Am J Clin Nutr. 1997;65:1220S–8. Discussion 1229S–1231S.

    CAS  PubMed  Google Scholar 

  12. Hardcastle AC, Aucott LS, Fraser WD, Reid DM, Macdonald HM. Dietary patterns, bone resorption, and bone mineral density in early post-menopausal Scottish women. Eur J Clin Nutr. 2010;65:378–85.

    Article  PubMed  Google Scholar 

  13. Karamati M, Jessri M, Shariati-Bafghi SE, Rashidkhani B. Dietary patterns in relation to bone mineral density among postmenopausal Iranian women. Calcif Tissue Int. 2012;91:40–9.

    Article  CAS  PubMed  Google Scholar 

  14. Whittle CR, Woodside JV, Cardwell CR, McCourt HJ, Young IS, Murray LJ, et al. Dietary patterns and bone mineral status in young adults: the Northern Ireland young hearts project. Br J Nutr. 2012;108:1494–504.

    Article  CAS  PubMed  Google Scholar 

  15. Fairweather-Tait SJ, Skinner J, Guile GR, Cassidy A, Spector TD, Macgregor AJ. Diet and bone mineral density study in postmenopausal women from the Twins UK registry shows a negative association with a traditional English dietary pattern and a positive association with wine. Am J Clin Nutr. 2011;94:1371–5.

    Article  CAS  PubMed  Google Scholar 

  16. McNaughton SA, Wattanapenaiboon N, Wark JD, Nowson CA. An energy dense nutrient poor dietary pattern is inversely associated with bone health in women. J Nutr. 2011;141:1516–23.

    Article  CAS  PubMed  Google Scholar 

  17. Sugiura M, Nakamura M, Ogawa K, Ikoma Y, Ando F, Shimokata H, et al. Dietary patterns of antioxidant vitamins and carotenoid intake associated with bone mineral density: findings from postmenopausal Japanese female subjects. Osteoporos Int. 2011;22:143–52.

    Article  CAS  PubMed  Google Scholar 

  18. Langsetmo L, Poliquin S, Hanley DA, Prior JC, Barr S, Anastassiades T, et al. Dietary patterns in Canadian men and women ages 25 and older: relationship to demographics, body mass index, and bone mineral density. BMC Musculoskelet Disord. 2010;11:20.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Kontogianni MD, Melistas L, Yannakoulia M, Malagaris I, Panagiotakos DB, Yiannakouris N. Association between dietary patterns and indices of bone mass in a sample of Mediterranean women. Nutrition. 2009;25:165–71.

    Article  PubMed  Google Scholar 

  20. Okubo H, Sasaki S, Horiguchi H, Oguma E, Miyamoto K, Hosoi Y, et al. Dietary patterns associated with bone mineral density in premenopausal farmwomen. Am J Clin Nutr. 2006;83:1185–92.

    CAS  PubMed  Google Scholar 

  21. Tucker KL, Chen H, Hannan MT, Cupples LA, Wilson PWF, Felson D, et al. Bone mineral density and dietary patterns in older adults: the Framingham Osteoporosis Study. Am J Clin Nutr. 2002;76:245–52.

    CAS  PubMed  Google Scholar 

  22. Zeng F, Wu B, Fan F, Xie H, Xue W, Zhu H, et al. Dietary patterns and the risk of hip fractures in elderly Chinese: a matched case-control study. J Clin Endocrinol Metab. 2013. doi:10.1210/jc.2013-1190.

    PubMed  Google Scholar 

  23. Samieri C, Ginder Coupez V, Lorrain S, Letenneur L, Alles B, Feart C, et al. Nutrient patterns and risk of fracture in older subjects: results from the three-city study. Osteoporos Int. 2013;24:1295–305.

    Article  CAS  PubMed  Google Scholar 

  24. Benetou V, Orfanos P, Pettersson-Kymmer U, Bergstrom U, Svensson O, Johansson I, et al. Mediterranean diet and incidence of hip fractures in a European cohort. Osteoporos Int. 2013;24(5):1587–98.

    Article  CAS  PubMed  Google Scholar 

  25. Langsetmo L, Hanley DA, Prior JC, Barr SI, Anastassiades T, Towheed T, et al. Dietary patterns and incidence of low trauma fractures in postmenopausal women and men aged ≥50 y: a population based cohort study. Am J Clin Nutr. 2011;93:192–9.

    Article  CAS  PubMed  Google Scholar 

  26. Monma Y, Niu K, Iwasaki K, Tomita N, Nakaya N, Hozawa A, et al. Dietary patterns associated with fall-related fracture in elderly Japanese: a population based prospective study. BMC Geriatr. 2010;10:31.

    Article  PubMed Central  PubMed  Google Scholar 

  27. McTiernan A, Wactawski-Wende J, Wu L, Rodabough RJ, Watts NB, Tylavsky F, et al. Low fat, increased fruit, vegetable, and grain dietary pattern, fractures and bone mineral density: the Women’s Health Initiative Dietary Modification Trial. Am J Clin Nutr. 2009;89:1864–76.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  28. Xu L, Dibley M, D’Este C, Phillips M, Porteous J, Attia J. Food groups and risk of forearm fractures in postmenopausal women in Chengdu, China. Climacteric. 2009;12(3):222–9.

    Article  CAS  PubMed  Google Scholar 

  29. Wachman A, Bernstein DS. Diet and osteoporosis. Lancet. 1968;1:958–9.

    Article  CAS  PubMed  Google Scholar 

  30. Darling AL, Millward DJ, Torgerson DJ, Hewitt CE, Lanham-New SA. Dietary protein and bone health: a systematic review and meta-analysis. Am J Clin Nutr. 2009;90:1674–92.

    Article  CAS  PubMed  Google Scholar 

  31. Schulze MB, Hoffman K. Methodological approaches to study dietary patterns in relation to risk of coronary heart disease and stroke. Br J Nutr. 2006;95(5):860–9.

    Article  CAS  PubMed  Google Scholar 

  32. Wosje KS, Khoury PR, Claytor RP, Copeland KA, Hornung RW, Daniels SR, et al. Dietary patterns associated with fat and bone mass in young children. Am J Clin Nutr. 2010;92:294–303.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Helen M. Macdonald .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer Science+Business Media New York

About this chapter

Cite this chapter

Wood, A.D., Macdonald, H.M. (2015). Dietary Pattern Analysis in Nutritional Science Research: A Review of Current Evidence Relating Dietary Patterns to Indices of Bone Health and Fracture Risk. In: Holick, M., Nieves, J. (eds) Nutrition and Bone Health. Nutrition and Health. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-2001-3_8

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-2001-3_8

  • Published:

  • Publisher Name: Humana Press, New York, NY

  • Print ISBN: 978-1-4939-2000-6

  • Online ISBN: 978-1-4939-2001-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics