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Distinct dietary risk factors for incident osteoporotic fractures in early and late postmenopausal phase women

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Abstract

Introduction

Available evidence on favorable nutritional factors for preventing osteoporosis remains controversial. Considering the recent increases in life expectancy, we investigated the relationship between incident osteoporotic fractures and dietary habits in early and late postmenopausal phase women.

Materials and methods

Subjects were Japanese postmenopausal outpatients recruited at a primary care institution in Nagano Prefecture (Nagano Cohort Study). Patients with critical or acute illness or secondary osteoporosis were not included in this study. In total, 1,071 participants were prospectively followed for a mean of 5.8 years. The cohort was divided into early (≤ 70 years) and late (> 70 years) postmenopausal phases based on median age. Dietary nutrient intake was estimated by the food frequency questionnaire method. According to baseline nutrient intake characteristics, we focused on protein/energy and Ca/NaCl intake ratios, which were also divided by the median values.

Results

Kaplan–Meier plots revealed a significantly higher occurrence of fractures for the high protein/energy intake group in early postmenopausal subjects (P = 0.009), whereas the low Ca/NaCl intake group in late postmenopausal subjects exhibited a significantly earlier occurrence of fractures (P = 0.002). Multivariate Cox regression uncovered significant independent risks of higher protein/energy (HR 1.35; 95% CI 1.04–1.74) and lower Ca/NaCl (HR 0.79; 95% CI 0.63–0.99) intake ratios for incident osteoporotic fractures in the early and late postmenopausal cohorts, respectively.

Conclusion

Distinct dietary risk factors for osteoporotic fractures were identified in early and late postmenopausal phase women. Appropriate nutritional guidance according to patient age will be important for maintaining bone health and quality of life.

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Availability of data and materials

The datasets generated during and/or analyzed during the current study are not publicly accessible but are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank all participants in this study as well as Mr. Trevor Ralph for his English language editing. The Nagano Cohort Study was funded by the Budget of Research Institute and Practice for Involutional Diseases, Japan. The authors declare that they have no conflict of interest regarding the present study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan

    Masaki Nakano, Yukio Nakamura & Jun Takahashi

  2. Division of Nutritional Physiology, Kagawa Nutrition University, Sakado, Saitama, 350-0288, Japan

    Kazuhiro Uenishi

  3. Research Institute and Practice for Involutional Diseases, Azumino, Nagano, 399-8101, Japan

    Masataka Shiraki

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  1. Masaki Nakano
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  2. Kazuhiro Uenishi
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Contributions

YN directed and designed the study. KU and MS developed the study. MN and KU analyzed the data and performed the statistical analysis. MN, KU, YN, JT, and MS interpreted the data. MN, YN, and MS drafted the manuscript. All authors approved the final version of the manuscript for publication. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

Corresponding author

Correspondence to Yukio Nakamura.

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Conflict of interest

All of the authors have no disclosures regarding the present study. The Nagano Cohort Study was funded by the Budget of Research Institute and Practice for Involutional Diseases, Japan. The authors declare that they have no conflict of interest.

Ethical approval

The protocol of this study was reviewed by the Ethics Committee of Research Institute and Practice for Involutional Diseases, Japan, prior to its commencement. The research procedure was carried out in accordance with the principles of the Declaration of Helsinki. Comprehensive written informed consent was provided by all participants enrolled in this investigation.

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Nakano, M., Uenishi, K., Nakamura, Y. et al. Distinct dietary risk factors for incident osteoporotic fractures in early and late postmenopausal phase women. J Bone Miner Metab 41, 227–238 (2023). https://doi.org/10.1007/s00774-023-01400-7

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  • DOI: https://doi.org/10.1007/s00774-023-01400-7

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