Dietary Pattern-Based Differences in the Associations Between Weight Control, Bone Mineral Density, and the Risk of Fracture Among Iranian Postmenopausal Women With Osteoporosis: An Application of Theory of Planned Behavior

The aim of the present study was to investigate the relationships between cognitive factors, weight control behavior, bone mineral density (BMD), and the risk of bone fracture by the dietary pattern among Iranian postmenopausal women with osteoporosis.

In this cross-sectional study (2017), 240 postmenopausal women with osteoporosis referring to two densitometry clinics in Tabriz (Iran) were recruited to participate in the study using a convenience sampling technique. Then, nutrition survey, BMD, the risk of bone fracture, weight control behavior, and a framework-based weight control behavior questionnaire (Weight-CuRB) were applied to collect data.

Using factor analysis, three distinct dietary patterns were identified, including healthy, mixed, and western patterns, which accounted for 24.24% of the total variance in food intake. After adjustment for cognitive and socio-demographic variables, patients with a western dietary pattern and no control on weight showed the increased risk of major osteoporotic (odds ratio [OR]: 4.82, CI: 2.02-11.45, P = 0.000) and hip (OR: 3.13, CI: 1.36-7.19, P = 0.007) fractures (P<0.001). In addition, in the subjects with western dietary pattern and no control over their weight, results showed an increased risk of low BMD (OR: 0.451, CI: 0.199- 1.042, P = 0.044).

In general, the increased intake of fruits, nuts, the vegetable oil in a healthy dietary pattern, and adoption of appropriate weight control behaviors may reduce the risk of bone fracture in postmenopausal women with osteoporosis. Accordingly, health practitioners and healthcare providers should consider weight control in their risk assessment of bone fracture in postmenopausal women with osteoporosis