Dietary patterns in an elderly population and their relation with bone mineral density: the Rotterdam Study

Ester A. L. de Jonge, Fernando Rivadeneira, Nicole S. Erler, Albert Hofman, André G. Uitterlinden, Oscar H. Franco, Jessica C. Kiefte-de Jong

Our aim was to identify dietary patterns that are associated with bone mineral density (BMD) against a background of relatively high dairy intake in elderly Dutch subjects. Participants were 55 years of age and older (n = 5144) who were enrolled in The Rotterdam Study, a population-based prospective cohort study. Baseline intake of 28 pre-defined food groups was determined using a validated food frequency questionnaire. Dietary patterns were identified using principal component analysis. BMD was measured using dual-energy X-ray absorptiometry at baseline and at three subsequent visits (between 1993 and 2004). Linear mixed modelling was used to longitudinally analyse associations of adherence to each pattern with repeatedly measured BMD (both in Z scores). After adjustment for confounders, two dietary patterns were associated with high BMD: a "Traditional" pattern, characterized by high intake of potatoes, meat and fat (β = 0.06; 95 % CI 0.03, 0.09) and a "Health conscious" pattern, characterized by high intake of fruits, vegetables, poultry and fish (β = 0.06; 95 % CI 0.04, 0.08). The "Processed" pattern, characterized by high intake of processed meat and alcohol, was associated with low BMD (β = -0.03; 95 % CI -0.06, -0.01). Associations of adherence to the "Health conscious" and "Processed" pattern with BMD were independent of body weight and height, whereas the association between adherence to the "Traditional" pattern with BMD was not. Against a background of high dairy intake and independent of anthropometrics, a "Health conscious" dietary pattern may have benefits for BMD, whereas a "Processed" dietary pattern may pose a risk for low BMD.