title: Effects of dietary intake and life style on bone density in patients with diabetes mellitus type 2.
abstract: OBJECTIVE
  The aim of our study was to investigate the relation among glycemic control, lifestyle and dietary intake with bone mineral density in patients with diabetes mellitus type 2.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Tertiary care hospital.
  
  
  METHODS
  A cross-sectional study in a tertiary care hospital was performed. Ninety-two patients attending our diabetes service (56 females/36 males) with diabetes mellitus type 2 were enrolled in a consecutive way. The inclusion criteria were diabetes diagnosed >40 years of age, with type 2 diabetes defined in accordance with the criteria of the American Diabetes Association and no use of dietary supplements. Body mass index, waist-to-hip ratio, glucose level, and HbA1c levels were assessed in all patients. X-ray densitometry of the calcaneal region and a 3-days written food record keeping, and a qualitative questionnaire of lifestyle were also performed.
  
  
  RESULTS
  A total of 21.7% of patients had osteoporosis (T score <2.5 SD). Patients were overweight with a high BMI and a medium glucose control. Patients with osteoporosis were older than those without osteoporosis (67.8 +/- 6.9 vs. 62.1 +/- 9.2 years; p < 0.05). Significant differences were detected between patients without and with osteoporosis in calcium intake (1,219.37 +/- 387 vs. 839 +/- 251 mg/day; p < 0.05) and zinc intake (9.23 +/- 3.5 vs. 13.3 +/- 6.9 mg/day; p < 0.05), respectively. No differences were detected in other dietary dairy intakes. In correlation analysis age (r = -0.23; p < 0.05) and BMI (r = 0.48; p < 0.05) was correlated with BMD. In univariate analysis with dicotomic variables, only exercise was positive associated with osteoporotic status (87.5% exercise habit in patients without osteoporosis and 25% exercise habit in patients with osteoporosis; p < 0.05). In a logistic model with the dependent variable (osteoporosis), remained in the final model dietary dairy intake of calcium and zinc, BMI, age and exercise. Exercise, calcium intake and BMI were protective factors. Zinc intake, and age were risk factors.
  
  
  CONCLUSIONS
  Exercise, calcium intake, body mass index had a protective role in bone mineral density in patients with diabetes mellitus type 2. Zinc intake and age were risk factors in our population.
authors.affiliation: Secc. de Endocrinología y Nutrición Clínica Hospital u. Río Hortega, Medicina Interna Hurh, Valladolid, Spain.
authors.forename: D A
authors.initials: DA
authors.lastname: de Luis Román
authors.forename: R
authors.initials: R
authors.lastname: Aller
authors.forename: J L
authors.initials: JL
authors.lastname: Perez Castrillon
authors.forename: J
authors.initials: J
authors.lastname: De Luis
authors.forename: M
authors.initials: M
authors.lastname: Gonzalez Sagrado
authors.forename: O
authors.initials: O
authors.lastname: Izaola
authors.forename: E
authors.initials: E
authors.lastname: Romero
authors.forename: J C
authors.initials: JC
authors.lastname: Martín Escudero
authors.forename: V
authors.initials: V
authors.lastname: Herreros
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015519:Bone Density / Q000502:physiology*; D002136:Calcium, Dietary / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D004032:Diet; D015930:Diet Records; D015444:Exercise / Q000502:physiology; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D015032:Zinc / Q000008:administration & dosage
chemical_list: D002136:Calcium, Dietary; D015032:Zinc