A community-based cross-sectional study for relationship of frequency of vegetables intake and osteoporosis in a Chinese postmenopausal women sample

Healthy plant-based diet index as a determinant of bone mineral density in osteoporotic postmenopausal women: A case-control study

Introduction

The association between plant-based diet indices and bone mineral density (BMD) of women with osteoporosis have not been studied in Iranian women. This study aimed to evaluate the association between plant-based diet indices and BMD in postmenopausal women with osteopenia/osteoporosis.

Materials and methods

The present research was a case-control study conducted on 131 postmenopausal women with osteoporosis/osteopenia and 131 healthy women. The BMD of the femoral neck and lumbar vertebrae was measured by the Dual-energy X-ray absorptiometry (DXEA) method. Participants were asked to complete a validated semi-quantitative food frequency questionnaire (FFQ). We used three versions of plant-based diet indices, including plant-based diet index (PDI), healthy plant-based diet index (hPDI), and unhealthy plant-based diet index (uPDI). Two different multivariable logistic regression was used for the crude and adjusted model to assess the relationship between PDI, hPDI, and uPDI with odds of femoral and lumbar BMD.

Results

There was a reverse association between last tertile of hPDI with femoral BMD abnormality in the both adjusted model [Model 1: odds ratio (OR): 0.33; 95% confidence interval (CI): 0.19-0.63 and Model 2: OR: 0.30; 95% CI: 0.15-0.58, respectively]. Furthermore, we found a reverse relationship between hPDI with lumbar BMD abnormality in the first adjusted model (OR: 0.36; 95% CI: 0.19-0.67). On the other hand, a negative association was observed in the second and last tertile of hPDI with lumbar BMD abnormality (OR: 0.47; 95% CI: 0.24-0.90 and OR: 0.34; 95% CI: 0.17-0.64, respectively). According to the results, the association of femoral BMD abnormality in the last tertile of uPDI compared to the first tertile in the both adjusted models (Model 1: OR: 2.85; 95% CI: 1.52-5.36 and Model 2: OR: 2.63; 95% CI: 1.37-5.06) were significant. Also, we observed a positive relationship between the last tertile of uPDI with lumbar BMD abnormality compared to the lowest tertile in the both adjusted models (Model 1; OR: 4.16; 95% CI: 2.20-7.85, Model 2; OR: 4.23; 95% CI: 2.19-8.19).

Conclusion

Overall, the findings indicated that in postmenopausal women with osteoporosis, a healthy plant-based diet could prevent bone loss, and an unhealthy plant-based diet might have detrimental effects on BMD.

Veganism, vegetarianism, bone mineral density, and fracture risk: a systematic review and meta-analysis

Context

The numbers of vegans and vegetarians have increased in the last decades. However, the impact of these diets on bone health is still under debate.

Objective

This systematic review and meta-analysis sought to study the impact of vegetarian and vegan diets on bone mineral density (BMD) and fracture risk.

Data Sources

A systematic search was conducted of PubMed, Scopus, and Science Direct, covering the period from the respective start date of each database to November 2017.

Data Extraction

Two investigators evaluated 275 studies against the inclusion criteria (original studies in humans, written in English or Spanish and including vegetarian or vegan diets and omnivorous diets as factors with BMD values for the whole body, lumbar spine, or femoral neck and/or the number of fractures as the outcome) and exclusion criteria (articles that did not include imaging or studies that included participants who had suffered a fracture before starting the vegetarian or vegan diet). The quality assessment tool for observational cohort and cross-sectional studies was used to assess the quality of the studies.

Results

Twenty studies including 37 134 participants met the inclusion criteria. Compared with omnivores, vegetarians and vegans had lower BMD at the femoral neck and lumbar spine and vegans also had higher fracture rates.

Conclusions

Vegetarian and vegan diets should be planned to avoid negative consequences on bone health.

Systematic Review Registration

PROSPERO registration no. CRD42017055508.

Dyslipidemia associated with body constitution in Traditional Chinese Medicine

Objective: This study aimed at investigating the association between dyslipidemia and body constitution of traditional Chinese medicine (BCTCM) may be clinically meaningful for the early diagnosis and treatment of dyslipidemia.

Methods: More than 4,000 participants were invited to a screening visit between 2011 and 2014, and 3,748 participants were available for data analysis. All study subjects underwent complete clinical baseline characteristics evaluation. Differences were determined using one-way analysis and [Formula: see text] analysis. Univariate regression analyses and multiple-variable logistic regressions (MLRs) determined the association between BCTCM variables and outcomes.

Results: In the dyslipidemia group, the Qi-deficient and Yang-deficient types accounted for more participants than others, and these two types were significantly associated with the outcome ([Formula: see text]). MLRs detected significant associations between the Qi-deficient and Yang-deficient types with dyslipidemia ([Formula: see text] for the two), and their odds ratios (ORs) for dyslipidemia were 1.211 and 1.234, respectively.

Conclusion: Qi-deficient and Yang-deficient types are independently and significantly associated with dyslipidemia. Participants with Qi-deficient and Yang-deficient constitutions have a higher incidence of dyslipidemia.

Association study of diabetes mellitus and body constitution of traditional Chinese medicine

Objective: We report on the association between traditional Chinese medicine (TCM) constitution and diabetes mellitus (DM) and provide epidemiological evidence for the theory of correlation between constitution and disease.

Methods: A total of 3748 participants were used for data analysis, and all study subjects underwent a complete clinical baseline characteristics evaluation to collect related information. DM was determined by an oral glucose tolerance test. Multiple logistic regression (MLR) models were employed to detect the associations.

Results: In total, 16.84% of the participants had DM in the total sample. Significant differences were found in age, height, weight, and heart rate, between the DM and non-DM groups. Univariate linear regression analyses indicated that the variables Qi_Deficient and Yang_Deficient were significantly associated with the outcome, and a negative correlation between TCM constitution and DM was found. After adjustment for relevant potential confounding factors, the MLR detected significant associations between both the Qi_Deficient and Yang_Deficient variables and DM ([Formula: see text]-value [Formula: see text] 0.015 for Qi_Deficient and [Formula: see text]-value [Formula: see text] for Yang_Deficient). In Qi_Deficient and Yin_Deficient participants, the odds ratios (ORs) for DM were 0.778 and 0.646, respectively.

Conclusion: Qi_Deficient and Yang_Deficient were significantly associated with DM. These findings may provide insights for clinical practice for the prevention and diagnosis of DM.

Can increasing the prevalence of vegetable-based diets lower the risk of osteoporosis in postmenopausal subjects? A systematic review with meta-analysis of the literature

OBJECTIVES

Several epidemiological investigations have assessed the association between vegetable-based diet intake (VDI) and risk of osteoporosis in postmenopausal subjects (OPS), but the outcomes have been inconsistent. We performed a review of the updated literature to evaluate this correlation.

METHODS

We searched for relevant studies published in September 2018 or earlier. Two researchers conducted eligibility assessment and data extraction. Discrepancies were resolved through consultation with a third expert. Pooled odds ratios (ORs) were calculated with 95% confidence intervals (CIs).

RESULTS

Ten studies, which included 14,247 subjects, were identified. On comparing the highest category of VDI consumption with the lowest category of VDI consumption, the pooled OR for OPS was 0.73 (95% CI = 0.57-0.95), i.e., participants with a higher intake of vegetables had a 27% (95% CI = 5-43%) lower risk of OPS. Significant benefits were found on subgroup analyses of case-control studies (OR, 0.61 [95% CI, 0.48-0.78]), but not on subgroup analyses of cross-sectional studies (OR, 0.82 [95% CI, 0.57-1.16]). The synthesized effect estimates were in the direction of decreased risk of OPS on subgroup analyses of the femoral region (OR, 0.57, 95% CI = 0.41-0.80) and the lumbar spine (OR = 0.55, 95% CI = 0.38-0.81), but not on subgroup analyses of the calcaneus (OR = 0.85, 95% CI = 0.33-2.16) and the lumbar and/or femoral region (OR = 1.04, 95%CI = 0.79-1.38). Positive results were observed on pooled analyses of the Dual energy X-ray absorptiometry (DEXA) measurement method (OR, 0.72 [95% CI, 0.54-0.95]), but not on pooled analyses of the Standardized Quantitative Ultrasound (QUS) measurement method (OR, 0.85 [95% CI, 0.33-2.16]). This might have resulted from a type II error due to wide confidence intervals and less number of included studies.

CONCLUSION

This meta-analysis seemingly confirms that higher consumption of VDI was associated with a lower risk of OPS. Taken together, these results highlight the need for future high-quality design-based trials on quantified vegetable intake and OPS.

Calcium supplementation from dairy products in the diet of women over the age of 55 from Zabrze (the Silesian Osteoactive Study - nutritional part)

Objectives

The primary goal of the study was to assess calcium intake among women over the age of 55.

Material and methods

The study participants were randomly selected from the female population of Zabrze, a town in the Upper Silesia Region in Poland, making use of the framework of the Silesia Osteoactive Study Project. The Semi-Quantitative Food Frequency Questionnaire (sFFQ) was used for nutritional assessment. A total of 388 women at the median age of 65.2 years responded to written and mailed invitations and decided to participate in the study.

Results

The mean calcium intake in the group of enrolled post-menopausal women was 886.9 ±615.1 mg/day. Only 32.9% of the participants met the daily calcium intake criterion of > 1000 g/day (the Estimated Average Requirement of 1000 mg according to the Nutrition Standards from 2017 for women in the age group of 51–65 years). Calcium supplementation, identified among women over the age of 55 years in Zabrze, was not sufficient and significantly differed from indicated nutrition standards. Fermented dairy products were the main source of calcium for the studied women. The quantity of calcium provided from yoghurts, kefirs and buttermilk was 338.3 mg/day. The level of consumption of fortified plant products, e.g., soy milk, was found to be very low. Some of the study participants (approximately 32%) reported the intake of calcium supplements or OTC medicinal products with calcium.

Conclusions

Summing up, the studied women reported low calcium intake levels, which calls for appropriate adjustments, including either dietary modifications or proper supplementation programmes with calcium containing agents.

Fruit and vegetable consumption and the risk of postmenopausal osteoporosis: a meta-analysis of observational studies

The association of the consumption of fruit and vegetables (FV) and the risk of postmenopausal osteoporosis (PMOP) has been a controversial subject.