title: Income, food insecurity, and osteoporosis among older adults in the 2007-2008 National Health and Nutrition Examination Survey (NHANES).
abstract: BACKGROUND
  Low SES is associated with risk and protective factors for osteoporosis. However, there has been little examination of SES and osteoporosis in the U.S. Methods: We conducted a cross-sectional study of adults aged 50 or older in 2007–2008 NHANES, examining two predictors of SES: income and food insecurity. Our outcome was osteoporosis assessed from bone scans. Adjusted regression models (overall and gender-stratified) controlled for age, gender, race/ethnicity, education, BMI, smoking, alcohol consumption, physical activity, calcium and vitamin D, and medication use.
  
  
  RESULTS
  Of 2403 participants, 5% had osteoporosis. In adjusted models, there was a higher risk of osteoporosis in low-income (OR; 95% CI: 1.90;1.07–3.37) and food-insecure populations (3.48;1.43–8.48). There was a stronger association with food insecurity among women (4.91;2.40–10.0) than men (0.46;0.07–3.01).
  
  
  CONCLUSIONS
  Income and food insecurity may have significant implications not just for immediate nutritional outcomes, but also for conditions such as osteoporosis that develop over the lifespan.
authors.forename: Courtney R
authors.initials: CR
authors.lastname: Lyles
authors.forename: Anne L
authors.initials: AL
authors.lastname: Schafer
authors.forename: Hilary K
authors.initials: HK
authors.lastname: Seligman
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys / Q000706:statistics & numerical data*; D010024:Osteoporosis / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D014481:United States / Q000453:epidemiology