title: Increased inflammatory potential of diet is associated with bone mineral density among postmenopausal women in Iran.
abstract: OBJECTIVE
  Diet has been shown to be associated with bone mineral density (BMD); however, the inflammatory potential of diet in modulating BMD has not yet been studied.
  
  
  METHODS
  We examined the association between a newly developed dietary inflammatory index (DII) and BMD in a sample of postmenopausal Iranian women. In this cross-sectional study, 160 postmenopausal women aged 50-85 years were studied and their femoral neck and lumbar spine BMDs were measured by dual-energy X-ray absorptiometry. The DII was computed based on dietary intake assessed using a previously validated, 168-item semiquantitative food frequency questionnaire. Logistic and linear regression models were fit to derive beta estimates and odds ratios (ORs), with DII fit as continuous and as a dichotomous variable.
  
  
  RESULTS
  After adjusting for potential confounders, women with higher DII scores were more likely to have BMD below the median in the lumbar spine with the DII being used as both a continuous variable [ORcontinuous 1.64, 95 % confidence interval (CI) 1.11-2.43, p value = 0.01; one-unit increase corresponding to ≈17 % of its range in the current study] and a categorical variable (ORDII>-0.06/≤ 2.30, 95 % CI 1.05-5.07, p value = 0.04). Similar associations were observed when lumbar spine BMD was used as a continuous outcome. No significant association was observed with BMD in femoral neck, although the direction was along expected lines.
  
  
  CONCLUSIONS
  These data suggest a pro-inflammatory diet, as indicated by increasing DII score, may be a risk factor for lower BMD in lumbar spine in postmenopausal Iranian women.
authors.affiliation: Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA.|Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
authors.forename: Nitin
authors.initials: N
authors.lastname: Shivappa
authors.affiliation: Cancer Prevention and Control Program, University of South Carolina, Columbia, SC, 29208, USA.|Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Hébert
authors.affiliation: Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Karamati
authors.affiliation: Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran.
authors.forename: Seyedeh-Elaheh
authors.initials: SE
authors.lastname: Shariati-Bafghi
authors.affiliation: Community Nutrition Department, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Shahid Beheshti University of Medical Sciences, Tehran, Iran. rashidkhani@yahoo.com.
authors.forename: Bahram
authors.initials: B
authors.lastname: Rashidkhani
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D015519:Bone Density; D002253:Carbonated Beverages / Q000009:adverse effects; D003430:Cross-Sectional Studies; D004032:Diet; D004041:Dietary Fats / Q000008:administration & dosage / Q000009:adverse effects; D015444:Exercise; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging; D005638:Fruit; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000453:epidemiology*; D007492:Iran / Q000453:epidemiology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008875:Middle Aged; D015596:Nutrition Assessment; D064427:Nutritive Sweeteners / Q000008:administration & dosage / Q000009:adverse effects; D015663:Osteoporosis, Postmenopausal / Q000453:epidemiology* / Q000209:etiology; D017698:Postmenopause; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D014675:Vegetables
chemical_list: D004041:Dietary Fats; D064427:Nutritive Sweeteners
keywords: Bone mineral density; Dietary inflammatory index; Inflammation; Iran; Postmenopausal women