Journal of Mazandaran University of Medical Sciences (Jul 2024)
The Relationship between Dietary Inflammatory Potential and Osteoporosis in Mazandaran Adult Women: Cross-Sectional Results of the Tabari Cohort Study
Abstract
Background and purpose: Osteoporosis is one of the main public health concerns worldwide, which imposes a significant economic burden on the healthcare system. Chronic inflammation might play a role as one of the possible risk factors for osteoporosis and fractures. Also, previous studies have reported that dietary factors are effective in controlling and modulating inflammation. Recently, an index was designed to determine the dietary inflammatory potential (DIP), which estimates the inflammatory potential of diet on a continuous spectrum from anti-inflammatory to pro-inflammatory. There are limited studies investigating the relationship between dietary inflammatory potential (DIP) and the risk of osteoporosis in the Middle East. The present study aimed to explore the relationship between DIP and the risk of osteoporosis in a large population of Iranian adult women. Materials and methods: This study was conducted cross-sectionally using the basic data of the Tabari Cohort Study (TCS). Dietary information of study participants, which included 5417 adult women aged 35-70 living in Mazandaran, was collected using a validated semi-quantitative 119-item food frequency questionnaire. Dietary inflammatory potential was calculated using the method proposed by Shivappa et al. Data on osteoporosis was collected using the self-report method. Information on other variables was collected using standard questionnaires. A binary logistic regression test was used to assess the relationship between DIP and osteoporosis in crude and adjusted models. Results: The mean ± standard deviation of the age of the study participants was 49.20±9.14 years. The prevalence of osteoporosis in the participants was 9.8% (n=529). The mean±standard deviation dietary inflammatory potential of the study participants was 2.29±0.36. Individuals who were in the highest quartile of the DIP score were older and had higher physical activity than those in the lowest quartile of the DIP score (P<0.001). Moreover, the poor socio-economic status and menopause in these subjects were greater than women in the lowest quartile of the DIP score (P<0.001). In the crude model, no significant relationship was found between DIP and the risk of osteoporosis (OR: 1.19; 95% CI: 0.91-1.55). When this analysis was adjusted for age and energy intake, the association remained non-significant (OR: 0.85; 95% CI: 0.62-1.18). Even after further adjustment for other potential confounding factors, this association remained non-significant (OR: 1.29; 95% CI: 0.87-1.92). When these analyses were done stratified by age, in women under 50 years of age, no significant relationship was found between DIP and risk of osteoporosis either in the crude model (OR: 1.46; 95% CI: 0.80-2.68) or after adjusting for possible confounding factors (OR: 1.69; 95% CI: 0.75-3.81). Similar results were obtained for women over or equal to 50 years. So no significant association was observed between DIP and osteoporosis in the crude model (OR: 0.92; 95% CI: 0.68-1.25). Even after adjusting for potential confounders, this association remained non-significant (OR: 1.11; 95% CI: 0.71-1.73). Conclusion: In the current study among adult women, no significant association was observed between DIP score and the risk of osteoporosis neither in the crude model nor after controlling for potential confounders. In addition, after stratified analysis by age, no significant relationship was found between DIP and the risk of osteoporosis either in women under 50 years or in women over or equal to 50 years. Further prospective studies are required to elucidate these associations.
