title: Development of a Food Group-Based Diet Score and Its Association with Bone Mineral Density in the Elderly: The Rotterdam Study.
abstract: No diet score exists that summarizes the features of a diet that is optimal for bone mineral density (BMD) in the elderly. Our aims were (a) to develop a BMD-Diet Score reflecting a diet that may be beneficial for BMD based on the existing literature, and (b) to examine the association of the BMD-Diet Score and the Healthy Diet Indicator, a score based on guidelines of the World Health Organization, with BMD in Dutch elderly participating in a prospective cohort study, the Rotterdam Study (n = 5144). Baseline dietary intake, assessed using a food frequency questionnaire, was categorized into food groups. Food groups that were consistently associated with BMD in the literature were included in the BMD-Diet Score. BMD was measured repeatedly and was assessed using dual energy X-ray absorptiometry. The BMD-Diet Score considered intake of vegetables, fruits, fish, whole grains, legumes/beans and dairy products as "high-BMD" components and meat and confectionary as "low-BMD" components. After adjustment, the BMD-Diet Score was positively associated with BMD (β (95% confidence interval) = 0.009 (0.005, 0.012) g/cm(2) per standard deviation). This effect size was approximately three times as large as has been observed for the Healthy Diet Indicator. The food groups included in our BMD-Diet Score could be considered in the development of future dietary guidelines for healthy ageing.
authors: Department of Epidemiology, Erasmus MC, University Medical Centre, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands. e.a.l.dejonge@erasmusmc.nl.|Department of Internal Medicine, Erasmus MC, University Medical Centre, P.O. box 2040, 3000 CA Rotterdam, The Netherlands. e.a.l.dejonge@erasmusmc.nl.
authors: Ester A L
authors: EA
authors: de Jonge
authors: Department of Epidemiology, Erasmus MC, University Medical Centre, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands. j.c.kiefte-dejong@erasmusmc.nl.|Department of Global Public Health, Leiden University College The Hague, P.O. box 13228, 2501 EE, The Hague, The Netherlands. j.c.kiefte-dejong@erasmusmc.nl.
authors: Jessica C
authors: JC
authors: Kiefte-de Jong
authors: Department of Human Nutrition, Wageningen University, P.O. box 8129, 6700 EV, Wageningen, The Netherlands. Lisette.deGroot@wur.nl.
authors: Lisette C P G M
authors: LC
authors: de Groot
authors: Department of Epidemiology, Erasmus MC, University Medical Centre, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands. trudy.voortman@erasmusmc.nl.
authors: Trudy
authors: T
authors: Voortman
authors: Department of Epidemiology, Erasmus MC, University Medical Centre, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands. j.schoufour@erasmusmc.nl.
authors: Josje D
authors: JD
authors: Schoufour
authors: Department of Internal Medicine, Erasmus MC, University Medical Centre, P.O. box 2040, 3000 CA Rotterdam, The Netherlands. m.c.zillikens@erasmusmc.nl.
authors: M Carola
authors: MC
authors: Zillikens
authors: Department of Epidemiology, Erasmus MC, University Medical Centre, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands. a.hofman@erasmusmc.nl.
authors: Albert
authors: A
authors: Hofman
authors: Department of Epidemiology, Erasmus MC, University Medical Centre, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands. a.g.uitterlinden@erasmusmc.nl.|Department of Internal Medicine, Erasmus MC, University Medical Centre, P.O. box 2040, 3000 CA Rotterdam, The Netherlands. a.g.uitterlinden@erasmusmc.nl.
authors: André G
authors: AG
authors: Uitterlinden
authors: Department of Epidemiology, Erasmus MC, University Medical Centre, P.O. box 2040, 3000 CA, Rotterdam, The Netherlands. o.franco@erasmusmc.nl.
authors: Oscar H
authors: OH
authors: Franco
authors: Department of Internal Medicine, Erasmus MC, University Medical Centre, P.O. box 2040, 3000 CA Rotterdam, The Netherlands. f.rivadeneira@erasmusmc.nl.
authors: Fernando
authors: F
authors: Rivadeneira
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D000818:Animals; D015519:Bone Density; D003611:Dairy Products; D004032:Diet; D058620:Elder Nutritional Physiological Phenomena; D002149:Energy Intake; D005260:Female; D005399:Fishes; D005638:Fruit; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008460:Meat; D008875:Middle Aged; D009043:Motor Activity; D009426:Netherlands; D015596:Nutrition Assessment; D018673:Nutrition Policy; D011446:Prospective Studies; D017747:Seafood; D014675:Vegetables
keywords: BMD-Diet score; bone mineral density; dietary patterns; healthy diet indicator