Adherence to a Mediterranean-style diet and incident fractures: pooled analysis of observational evidence

Setor K. Kunutsor*, Jari A. Laukkanen, Michael R. Whitehouse, Ashley W. Blom

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

6 Citations (Scopus)
338 Downloads (Pure)

Abstract

PURPOSE: The Mediterranean diet is associated with decreased morbidity and mortality from various chronic diseases. Adherence to a Mediterranean-style diet has been suggested to have protective effects on bone health and decreases the incidence of bone fractures, but the evidence is not clear. We conducted a systematic review and meta-analysis of available observational studies to quantify the association between adherence to a Mediterranean-style diet, as assessed by the Mediterranean Diet Score (MDS), and the risk of fractures in the general population.

METHODS: Relevant studies were identified in a literature search of MEDLINE, EMBASE, Web of Science, and reference lists of relevant studies to October 2016. Relative risks (RRS) with 95% confidence intervals (CIs) were aggregated using random-effects models.

RESULTS: Five observational studies with data on 353,076 non-overlapping participants and 33,576 total fractures (including 6,881 hip fractures) were included. The pooled fully adjusted RR (95% CI) for hip fractures per 2-point increment in adherence to the MDS was 0.82 (0.71-0.96). Adherence to the MDS was not associated with the risk of any or total fractures based on pooled analysis of only two studies.

CONCLUSION: Limited observational evidence supports a beneficial effect of adherence to a Mediterranean-style diet on the incidence of hip fractures. Well-designed intervention studies are needed to elucidate the relationship between adherence to a Mediterranean-style diet and the risk of adverse bone health outcomes such as fractures.

Original languageEnglish
Pages (from-to)1687-1700
Number of pages14
JournalEuropean Journal of Nutrition
Volume57
Issue number4
Early online date22 Mar 2017
DOIs
Publication statusPublished - Jun 2018

Structured keywords

  • Centre for Surgical Research

Keywords

  • Bone
  • Fractures
  • Mediterranean diet
  • Nutrition

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