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Published in: Osteoporosis International 11/2020

01-11-2020 | Osteoporosis | Original Article

Adherence to the dietary approaches to stop hypertension (DASH) dietary pattern and osteoporosis risk in postmenopausal Iranian women

Authors: Z. Shahriarpour, B. Nasrabadi, S.-E. Shariati-Bafghi, M. Karamati, B. Rashidkhani

Published in: Osteoporosis International | Issue 11/2020

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Abstract

Summary

This is the first study to examine the association of adherence to the dietary approaches to stop hypertension (DASH) dietary pattern and osteoporosis risk in postmenopausal Iranian women. Findings suggest the inverse association of adherence to the DASH dietary pattern and osteoporosis risk in postmenopausal Iranian women.

Introduction

This study was aimed to examine the association of adherence to the dietary approaches to stop hypertension (DASH) dietary pattern and osteoporosis risk in postmenopausal Iranian women, hypothesizing that higher adherence to this pattern is associated with lower risk of postmenopausal osteoporosis.

Methods

One hundred fifty-one postmenopausal Iranian women aged 50–85 years participated in this cross-sectional study. Lumbar spine and femoral neck bone mineral densities (BMDs) were measured via dual-energy X-ray absorptiometry. Postmenopausal osteoporosis was then defined using the WHO criteria as a BMD T-score of ≤ − 2.5 standard deviations. The usual past-year dietary intakes were assessed by a valid and reliable 168-item food frequency questionnaire. The DASH score was then calculated based on energy-adjusted intakes of eight major dietary components usually emphasized (i.e., fruits, vegetables, nuts and legumes, low-fat dairy products, and whole grains) or minimized (i.e., sodium, sweets, and red or processed meats) in the DASH diet. The higher the DASH score of a participant, the higher the adherence to the DASH dietary pattern.

Results

After adjusting for several potential covariates in the multivariable-adjusted binary logistic regression analysis, participants in the highest tertile of DASH score had lower risk of osteoporosis at lumbar spine than those in the lowest tertile (odds ratio = 0.28; 95% confidence interval, 0.09–0.88; p = 0.029). However, no significant association was observed between adherence to the DASH dietary pattern and risk of osteoporosis at femoral neck.

Conclusion

Findings suggest the inverse association of adherence to the DASH dietary pattern and osteoporosis risk in postmenopausal Iranian women.
Literature
1.
go back to reference Black DM, Rosen CJ (2016) Clinical practice: postmenopausal osteoporosis. N Engl J Med 374:254–262CrossRef Black DM, Rosen CJ (2016) Clinical practice: postmenopausal osteoporosis. N Engl J Med 374:254–262CrossRef
2.
go back to reference Fabiani R, Naldini G, Chiavarini M (2019) Dietary patterns in relation to low bone mineral density and fracture risk: a systematic review and meta-analysis. Adv Nutr 10:219–236CrossRef Fabiani R, Naldini G, Chiavarini M (2019) Dietary patterns in relation to low bone mineral density and fracture risk: a systematic review and meta-analysis. Adv Nutr 10:219–236CrossRef
3.
go back to reference Dempster DW (2011) Osteoporosis and the burden of osteoporosis-related fractures. Am J Manag Care 17(Suppl 6):S164–S169PubMed Dempster DW (2011) Osteoporosis and the burden of osteoporosis-related fractures. Am J Manag Care 17(Suppl 6):S164–S169PubMed
4.
go back to reference Rathnayake H, Lekamwasam S, Wickramatilake C, Lenora J (2019) Trabecular bone score and bone mineral density reference data for women aged 20-70 years and the effect of local reference data on the prevalence of postmenopausal osteoporosis: a cross-sectional study from Sri Lanka. Arch Osteoporos 14:91. https://doi.org/10.1007/s11657-019-0640-zCrossRefPubMed Rathnayake H, Lekamwasam S, Wickramatilake C, Lenora J (2019) Trabecular bone score and bone mineral density reference data for women aged 20-70 years and the effect of local reference data on the prevalence of postmenopausal osteoporosis: a cross-sectional study from Sri Lanka. Arch Osteoporos 14:91. https://​doi.​org/​10.​1007/​s11657-019-0640-zCrossRefPubMed
6.
go back to reference Hemmati F, Sarokhani D, Sayehmiri K, Motadayen M (2018) Prevalence of osteoporosis in postmenopausal women in Iran: a systematic review and meta-analysis. Iran J Obstet Gynecol Infertil 21:90–102 Hemmati F, Sarokhani D, Sayehmiri K, Motadayen M (2018) Prevalence of osteoporosis in postmenopausal women in Iran: a systematic review and meta-analysis. Iran J Obstet Gynecol Infertil 21:90–102
7.
go back to reference McGuigan FE, Murray L, Gallagher A, Davey-Smith G, Neville CE, Van’t Hof R, Boreham C, Ralston SH (2002) Genetic and environmental determinants of peak bone mass in young men and women. J Bone Miner Res 17:1273–1279CrossRef McGuigan FE, Murray L, Gallagher A, Davey-Smith G, Neville CE, Van’t Hof R, Boreham C, Ralston SH (2002) Genetic and environmental determinants of peak bone mass in young men and women. J Bone Miner Res 17:1273–1279CrossRef
8.
go back to reference Movassagh EZ, Vatanparast H (2017) Current evidence on the association of dietary patterns and bone health: a scoping review. Adv Nutr 8:1–16CrossRef Movassagh EZ, Vatanparast H (2017) Current evidence on the association of dietary patterns and bone health: a scoping review. Adv Nutr 8:1–16CrossRef
9.
go back to reference Hu FB (2002) Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 13:3–9CrossRef Hu FB (2002) Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 13:3–9CrossRef
10.
go back to reference Tucker KL (2010) Dietary patterns, approaches, and multicultural perspective. Appl Physiol Nutr Metab 35:211–218CrossRef Tucker KL (2010) Dietary patterns, approaches, and multicultural perspective. Appl Physiol Nutr Metab 35:211–218CrossRef
12.
go back to reference Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, Bray GA, Vogt TM, Cutler JA, Windhauser MM, Lin PH, Karanja N (1997) A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med 336:1117–1124CrossRef Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, Bray GA, Vogt TM, Cutler JA, Windhauser MM, Lin PH, Karanja N (1997) A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med 336:1117–1124CrossRef
13.
go back to reference Doyle L, Cashman KD (2004) The DASH diet may have beneficial effects on bone health. Nutr Rev 62:215–220CrossRef Doyle L, Cashman KD (2004) The DASH diet may have beneficial effects on bone health. Nutr Rev 62:215–220CrossRef
14.
go back to reference Monjardino T, Lucas R, Ramos E, Barros H (2014) Associations between a priori-defined dietary patterns and longitudinal changes in bone mineral density in adolescents. Public Health Nutr 17:195–205CrossRef Monjardino T, Lucas R, Ramos E, Barros H (2014) Associations between a priori-defined dietary patterns and longitudinal changes in bone mineral density in adolescents. Public Health Nutr 17:195–205CrossRef
15.
go back to reference Kanis JA, McCloskey EV, Johansson H, Oden A, Melton LJ III, Khaltaev N (2008) A reference standard for the description of osteoporosis. Bone 42:467–475CrossRef Kanis JA, McCloskey EV, Johansson H, Oden A, Melton LJ III, Khaltaev N (2008) A reference standard for the description of osteoporosis. Bone 42:467–475CrossRef
16.
go back to reference Mirmiran P, Esfahani FH, Mehrabi Y, Hedayati M, Azizi F (2010) Reliability and relative validity of an FFQ for nutrients in the Tehran lipid and glucose study. Public Health Nutr 13:654–662CrossRef Mirmiran P, Esfahani FH, Mehrabi Y, Hedayati M, Azizi F (2010) Reliability and relative validity of an FFQ for nutrients in the Tehran lipid and glucose study. Public Health Nutr 13:654–662CrossRef
17.
go back to reference Esfahani FH, Asghari G, Mirmiran P, Azizi F (2010) Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the Tehran Lipid and Glucose Study. J Epidemiol 20:150–158CrossRef Esfahani FH, Asghari G, Mirmiran P, Azizi F (2010) Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the Tehran Lipid and Glucose Study. J Epidemiol 20:150–158CrossRef
18.
go back to reference Ghaffarpour M, Houshiar-Rad A, Kianfar H (1999) The manual for household measures, cooking yields factors, and edible portion of foods. Agriculture Sciences Press, Tehran Ghaffarpour M, Houshiar-Rad A, Kianfar H (1999) The manual for household measures, cooking yields factors, and edible portion of foods. Agriculture Sciences Press, Tehran
19.
go back to reference Willett W, Stampfer MJ (1986) Total energy intake: implications for epidemiologic analyses. Am J Epidemiol 124:17–27CrossRef Willett W, Stampfer MJ (1986) Total energy intake: implications for epidemiologic analyses. Am J Epidemiol 124:17–27CrossRef
20.
go back to reference Fung TT, Chiuve SE, McCullough ML, Rexrode KM, Logroscino G, Hu FB (2008) Adherence to a DASH-style diet and risk of coronary heart disease and stroke in women. Arch Intern Med 168:713–720CrossRef Fung TT, Chiuve SE, McCullough ML, Rexrode KM, Logroscino G, Hu FB (2008) Adherence to a DASH-style diet and risk of coronary heart disease and stroke in women. Arch Intern Med 168:713–720CrossRef
21.
go back to reference Perez-Cornago A, Sanchez-Villegas A, Bes-Rastrollo M, Gea A, Molero P, Lahortiga-Ramos F, Martinez-Gonzalez MÁ (2017) Relationship between adherence to dietary approaches to stop hypertension (DASH) diet indices and incidence of depression during up to 8 years of follow-up. Public Health Nutr 20:2383–2392CrossRef Perez-Cornago A, Sanchez-Villegas A, Bes-Rastrollo M, Gea A, Molero P, Lahortiga-Ramos F, Martinez-Gonzalez MÁ (2017) Relationship between adherence to dietary approaches to stop hypertension (DASH) diet indices and incidence of depression during up to 8 years of follow-up. Public Health Nutr 20:2383–2392CrossRef
23.
go back to reference Centers for Disease Control and Prevention (2007) National Health and Nutrition Examination Survey (NHANES) Anthropometry Procedures Manual. CDC, Atlanta Centers for Disease Control and Prevention (2007) National Health and Nutrition Examination Survey (NHANES) Anthropometry Procedures Manual. CDC, Atlanta
24.
go back to reference Kelishadi R, Rabiee K, Khosravi A, Famouri F, Sadeghi M, Roohafza H, Sh S (2001) Assessment of physical activity in adolescents of Isfahan. J Shahrekord Univ Med Sci 3:55–66 Kelishadi R, Rabiee K, Khosravi A, Famouri F, Sadeghi M, Roohafza H, Sh S (2001) Assessment of physical activity in adolescents of Isfahan. J Shahrekord Univ Med Sci 3:55–66
25.
go back to reference Aadahl M, Jorgensen T (2003) Validation of a new self-report instrument for measuring physical activity. Med Sci Sports Exerc 35:1196–1202CrossRef Aadahl M, Jorgensen T (2003) Validation of a new self-report instrument for measuring physical activity. Med Sci Sports Exerc 35:1196–1202CrossRef
26.
go back to reference Osterhoff G, Morgan EF, Shefelbine SJ, Karim L, McNamara LM, Augat P (2016) Bone mechanical properties and changes with osteoporosis. Injury 47(Suppl 2):S11–S20CrossRef Osterhoff G, Morgan EF, Shefelbine SJ, Karim L, McNamara LM, Augat P (2016) Bone mechanical properties and changes with osteoporosis. Injury 47(Suppl 2):S11–S20CrossRef
27.
go back to reference Ott SM (2018) Cortical or trabecular bone: what’s the difference? Am J Nephrol 47:373–375CrossRef Ott SM (2018) Cortical or trabecular bone: what’s the difference? Am J Nephrol 47:373–375CrossRef
28.
go back to reference Shariati-Bafghi SE, Nosrat-Mirshekarlou E, Karamati M, Rashidkhani B (2014) Higher dietary acidity is associated with lower bone mineral density in postmenopausal Iranian women, independent of dietary calcium intake. Int J Vitam Nutr Res 84:206–217CrossRef Shariati-Bafghi SE, Nosrat-Mirshekarlou E, Karamati M, Rashidkhani B (2014) Higher dietary acidity is associated with lower bone mineral density in postmenopausal Iranian women, independent of dietary calcium intake. Int J Vitam Nutr Res 84:206–217CrossRef
29.
go back to reference Doyle L, Cashman KD (2003) The effect of nutrient profiles of the dietary approaches to stop hypertension (DASH) diets on blood pressure and bone metabolism and composition in normotensive and hypertensive rats. Br J Nutr 89:713–724CrossRef Doyle L, Cashman KD (2003) The effect of nutrient profiles of the dietary approaches to stop hypertension (DASH) diets on blood pressure and bone metabolism and composition in normotensive and hypertensive rats. Br J Nutr 89:713–724CrossRef
30.
go back to reference Lin PH, Ginty F, Appel LJ, Aickin M, Bohannon A, Garnero P, Barclay D, Svetkey LP (2003) The DASH diet and sodium reduction improve markers of bone turnover and calcium metabolism in adults. J Nutr 133:3130–3136CrossRef Lin PH, Ginty F, Appel LJ, Aickin M, Bohannon A, Garnero P, Barclay D, Svetkey LP (2003) The DASH diet and sodium reduction improve markers of bone turnover and calcium metabolism in adults. J Nutr 133:3130–3136CrossRef
31.
go back to reference Nowson CA, Patchett A, Wattanapenpaiboon N (2009) The effects of a low-sodium base-producing diet including red meat compared with a high-carbohydrate, low-fat diet on bone turnover markers in women aged 45-75 years. Br J Nutr 102:1161–1170CrossRef Nowson CA, Patchett A, Wattanapenpaiboon N (2009) The effects of a low-sodium base-producing diet including red meat compared with a high-carbohydrate, low-fat diet on bone turnover markers in women aged 45-75 years. Br J Nutr 102:1161–1170CrossRef
32.
go back to reference Tucker KL, Hannan MT, Kiel DP (2001) The acid-base hypothesis: diet and bone in the Framingham Osteoporosis Study. Eur J Nutr 40:231–237CrossRef Tucker KL, Hannan MT, Kiel DP (2001) The acid-base hypothesis: diet and bone in the Framingham Osteoporosis Study. Eur J Nutr 40:231–237CrossRef
33.
go back to reference Bushinsky DA (1996) Metabolic alkalosis decreases bone calcium efflux by suppressing osteoclasts and stimulating osteoblasts. Am J Phys 271:F216–F222 Bushinsky DA (1996) Metabolic alkalosis decreases bone calcium efflux by suppressing osteoclasts and stimulating osteoblasts. Am J Phys 271:F216–F222
35.
36.
go back to reference Shivappa N, Steck SE, Hurley TG, Hussey JR, Hebert JR (2014) Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr 17:1689–1696CrossRef Shivappa N, Steck SE, Hurley TG, Hussey JR, Hebert JR (2014) Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr 17:1689–1696CrossRef
37.
go back to reference Shivappa N, Hebert JR, Karamati M, Shariati-Bafghi SE, Rashidkhani B (2016) Increased inflammatory potential of diet is associated with bone mineral density among postmenopausal women in Iran. Eur J Nutr 55:561–568CrossRef Shivappa N, Hebert JR, Karamati M, Shariati-Bafghi SE, Rashidkhani B (2016) Increased inflammatory potential of diet is associated with bone mineral density among postmenopausal women in Iran. Eur J Nutr 55:561–568CrossRef
38.
go back to reference Sahni S, Mangano KM, McLean RR, Hannan MT, Kiel DP (2015) Dietary approaches for bone health: lessons from the Framingham Osteoporosis Study. Curr Osteoporos Rep 13:245–255CrossRef Sahni S, Mangano KM, McLean RR, Hannan MT, Kiel DP (2015) Dietary approaches for bone health: lessons from the Framingham Osteoporosis Study. Curr Osteoporos Rep 13:245–255CrossRef
41.
go back to reference Heaney RP (2006) Role of dietary sodium in osteoporosis. J Am Coll Nutr 25:271S–276SCrossRef Heaney RP (2006) Role of dietary sodium in osteoporosis. J Am Coll Nutr 25:271S–276SCrossRef
42.
go back to reference Corwin RL, Hartman TJ, Maczuga SA, Graubard BI (2006) Dietary saturated fat intake is inversely associated with bone density in humans: analysis of NHANES III. J Nutr 136:159–165CrossRef Corwin RL, Hartman TJ, Maczuga SA, Graubard BI (2006) Dietary saturated fat intake is inversely associated with bone density in humans: analysis of NHANES III. J Nutr 136:159–165CrossRef
44.
go back to reference You L, Z-y S, C-l T, Chen L, Pan L, J-y C (2011) High cholesterol diet increases osteoporosis risk via inhibiting bone formation in rats. Acta Pharmacol Sin 32:1498–1504CrossRef You L, Z-y S, C-l T, Chen L, Pan L, J-y C (2011) High cholesterol diet increases osteoporosis risk via inhibiting bone formation in rats. Acta Pharmacol Sin 32:1498–1504CrossRef
45.
go back to reference Livingstone M (1995) Assessment of food intakes: are we measuring what people eat? Br J Biomed Sci 52:58–67PubMed Livingstone M (1995) Assessment of food intakes: are we measuring what people eat? Br J Biomed Sci 52:58–67PubMed
Metadata
Title
Adherence to the dietary approaches to stop hypertension (DASH) dietary pattern and osteoporosis risk in postmenopausal Iranian women
Authors
Z. Shahriarpour
B. Nasrabadi
S.-E. Shariati-Bafghi
M. Karamati
B. Rashidkhani
Publication date
01-11-2020
Publisher
Springer London
Published in
Osteoporosis International / Issue 11/2020
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-020-05450-9

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