A posteriori dietary patterns are related to risk of fracture and low bone mineral density: findings from a systematic review and meta-analysis

Background: Observational studies suggest that dietary pattern intake plays an important role in the development of fracture and low bone mineral density (BMD). However, the association remains unclear. This systematic review was performed to evaluate the relationship between dietary patterns and fracture and BMD by pooling available data from existing studies. Methods: MEDLINE and EMBASE databases were searched up to January 2015 for eligible observational studies regarding the relationships between common dietary patterns and risk of fracture/ low BMD. Random-effects models were applied to pool the summary estimates for the highest versus the lowest category of dietary pattern. Sensitivity analyses were conducted and publication bias was assessed using Begg or Egger s tests. Results: A total of thirteen cross-sectional studies were included in the meta-analysis. There was evidence of inverse associations between the Healthy/Prudent dietary pattern and the risk of low BMD (OR: 0.75; 95% CI: 0.21 to 1.30; p =0.007) and a positive association between Unhealthy/Western dietary pattern and low BMD risk (OR: 1.21; 95% CI: 0.58 to 1.90; p 0.001) for the highest versus the lowest category. Moreover, the association between highest compared with lowest categories of intake of the Healthy/Prudent dietary pattern and the risk of fracture showed a significant inverse association (OR = 0.63; 95% CI: 0.53, 0.73; p 0.001) which was positive for Unhealthy/Western dietary patterns and fracture risk (OR = 1.08; 95% CI: 0.90, 1.26; p 0.001). Conclusion: There appears to be a beneficial effect of healthy dietary pattern on fracture and low BMD risk and adding a new direction toward prevention of fracture and low BMD level on population level.