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International Journal of Frontiers in Medicine, 2024, 6(5); doi: 10.25236/IJFM.2024.060511.

Association between Bone Mineral Density and Dietary Patterns in Elderly Women in Guangxi: A Cross-Sectional Study in China


Chaofan Xie1,2, Ziqi Chen1,2, Xu Tang3, Jiansheng Cai1,2, Tingyu Luo1,2, Tingyu Mai2, Yulu Chen1,2, Ruiying Li1,2, Xiashuang Zhang1,2, Zeyan Ye1,2, Liang Cao1,3, Jian Qin4, Zhiyong Zhang1,2, You Li1,2

Corresponding Author:
Zhiyong Zhang

1Department of Environmental Health and Occupational Medicine, School of Public Health, Guilin Medical University, Guilin, 541199, China

2Guangxi Health Commission Key Laboratory of Entire Lifecycle Health and Care (Guilin Medical University), Guilin, 541199, China

3Department of Experimental Teaching Center, School of Public Health, Guilin Medical University, Guilin, 541199, China

4Department of Environmental and Occupational Health, School of Public Health, Guangxi Medical University, Nanning, 530021, China


This study aimed to investigate the relationship between dietary patterns and bone mineral density (BMD) in elderly women, analyze potential risk factors and provide a reference for the prevention of osteoporosis (OP). The study was conducted from December 2018 to November 2019 in Gongcheng Yao Autonomous County, Guangxi, and a cross-sectional survey was conducted using the whole cluster random sampling method. In this study, older women ≥60 years old were selected for physical examination, baseline population survey and food frequency questionnaire (FFQ). Dietary patterns were analyzed using factor analysis, and the relationship between dietary patterns and the prevalence of OP was assessed using a binary logistic regression model. According to statistical analysis of data, a total of 666 elderly women were included in this study, and their prevalence of OP was 53.45%. The differences in ethnicity, education level, Body mass index (BMI), Age, Hipline (Hip), Waist circumference (WC), and High-density lipoprotein cholesterol (HDL-C) were statistically significant (P < 0.05) in the non-OP group compared with the OP group. The prevalence of OP was high among elderly women in a rural county in Guangxi, China. The analysis results show that a dietary pattern with relatively high intake of edible oil and salt may be a risk factor for developing OP. It is recommended that in daily life, elderly women should maintain a healthy weight, eat a balanced diet, and reduce the intake of oil and salt to promote bone health.


Dietary Patterns; Bone Mineral Density; Osteoporosis; Women

Cite This Paper

Chaofan Xie, Ziqi Chen, Xu Tang, Jiansheng Cai, Tingyu Luo, Tingyu Mai, Yulu Chen, Ruiying Li, Xiashuang Zhang, Zeyan Ye, Liang Cao, Jian Qin, Zhiyong Zhang, You Li. Association between Bone Mineral Density and Dietary Patterns in Elderly Women in Guangxi: A Cross-Sectional Study in China. International Journal of Frontiers in Medicine (2024), Vol. 6, Issue 5: 81-89. https://doi.org/10.25236/IJFM.2024.060511.


[1] He Y., Huang J., Jiang G., et al. (2021) Menarche age exceed 17 years and menopausal age smaller than 48 years may affect prevalence of osteoporosis for Chinese women. Arch Osteoporos, 16(1), 123.

[2] Melaku Y.A., Gill T.K., Adams R., et al. (2016) Association between dietary patterns and low bone mineral density among adults aged 50 years and above: findings from the North West Adelaide Health Study (NWAHS). Br J Nutr, 116(8), 1437-1446.

[3] Salari N., Ghasemi H., Mohammadi L., et al. (2021) The global prevalence of osteoporosis in the world: a comprehensive systematic review and meta-analysis. J Orthop Surg Res, 16(1), 609.

[4] Nourmohammadi H., Abdan Z., Amin Hashemipour S., et al. (2022) Prevalence of osteoporosis and osteopenia in people over 60 years in Iran: A systematic review and meta-analysis. International Journal of Preventive Medicine, 13(1), 11.

[5] Zeng Q., Li N., Wang Q., et al. (2019) The Prevalence of Osteoporosis in China, a Nationwide, Multicenter DXA Survey. J Bone Miner Res, 34(10), 1789-1797.

[6] Chen S.H., Wang X.L., Zheng L.Z., et al. (2016) Comparative study of two types of herbal capsules with different Epimedium species for the prevention of ovariectomised-induced osteoporosis in rats. J Orthop Translat, 4, 14-27.

[7] Leslie W.D., Seeman E., Morin S.N., et al. (2018) The diagnostic threshold for osteoporosis impedes fracture prevention in women at high risk for fracture: A registry-based cohort study. Bone, 114, 298-303.

[8] Ocke M.C. (2013) Evaluation of methodologies for assessing the overall diet: dietary quality scores and dietary pattern analysis. Proc Nutr Soc, 72(2), 191-199.

[9] Martiniakova M., Babikova M., Mondockova V., et al. (2022) The Role of Macronutrients, Micronutrients and Flavonoid Polyphenols in the Prevention and Treatment of Osteoporosis. Nutrients, 14(3), 523.

[10] Ratajczak A.E., Zawada A., Rychter A.M., et al. (2021) Milk and Dairy Products: Good or Bad for Human Bone? Practical Dietary Recommendations for the Prevention and Management of Osteoporosis. Nutrients, 13(4), 1329.

[11] Song Xiao, Ziqi Chen, Tingyu Mai, Jiansheng Cai, Yulu Chen, Xu Tang., et al. (2023) Analysis of the association between dietary patterns and nonalcoholic fatty liver disease in a county in Guangxi. BMC Gastroenterology, 23, 309.

[12] Muschitz C., Feichtinger X., Haschka J., et al. (2017) Diagnosis and treatment of Paget's disease of bone : A clinical practice guideline. Wien Med Wochenschr, 167(1-2), 18-24.

[13] Chen C., Lu F.C. (2004) The guidelines for prevention and control of overweight and obesity in Chinese adults. Biomed Environ Sci, 17 Suppl, 1-36.

[14] Xudong L., Xiaorong W., Sihao L., et al. (2015) Reproducibility and Validity of a Food Frequency Questionnaire for Assessing Dietary Consumption via the Dietary Pattern Method in a Chinese Rural Population. PLoS ONE, 10(7), e134627.

[15] Qiao D., Liu X., Tu R., et al. (2020) Gender-specific prevalence and influencing factors of osteopenia and osteoporosis in Chinese rural population: the Henan Rural Cohort Study. BMJ Open, 10(1), e28593.

[16] Hyassat D., Alyan T., Jaddou H., et al. (2017) Prevalence and Risk Factors of Osteoporosis Among Jordanian Postmenopausal Women Attending the National Center for Diabetes, Endocrinology and Genetics in Jordan. Biores Open Access, 6(1), 85-93.

[17] Kim Y., Kim H.Y., Kim J.H. (2017) Associations Between Reported Dietary Sodium Intake and Osteoporosis in Korean Postmenopausal Women: The 2008-2011 Korea National Health and Nutrition Examination Survey. Asia Pac J Public Health, 29(5), 430-439.

[18] Park S.M., Joung J.Y., Cho Y.Y., et al. (2015) Effect of high dietary sodium on bone turnover markers and urinary calcium excretion in Korean postmenopausal women with low bone mass. European journal of clinical nutrition, 69(3), 361-366.

[19] Dar H.Y., Singh A., Shukla P., et al. (2018) High dietary salt intake correlates with modulated Th17-Treg cell balance resulting in enhanced bone loss and impaired bone-microarchitecture in male mice. Sci Rep, 8(1), 2503.

[20] Liu Q., Wang X., Huang Z., et al. (2018) Ketogenic diet delays spinal fusion and decreases bone mass in posterolateral lumbar spinal fusion: an in vivo rat model. Acta Neurochir (Wien), 160(10), 1909-1916.

[21] Shu L., Beier E., Sheu T., et al. (2015) High-fat diet causes bone loss in young mice by promoting osteoclastogenesis through alteration of the bone marrow environment. Calcif Tissue Int, 96(4), 313-323.

[22] Qiao J., Wu Y., Ren Y. (2021) The impact of a high fat diet on bones: potential mechanisms. Food Funct, 12(3), 963-975.

[23] Hosohata K. (2021) Biomarkers of high salt intake. Adv Clin Chem, 104, 71-106.

[24] Ohta Y., Kimura Y., Kitaoka C., et al. (2017) Blood pressure control status and relationship between salt intake and lifestyle including diet in hypertensive outpatients treated at a general hospital. Clin Exp Hypertens, 39(1), 29-33.

[25] Muñoz-Garach A., García-Fontana B., Muñoz-Torres M. (2020) Nutrients and Dietary Patterns Related to Osteoporosis. Nutrients, 12(7), 1986.

[26] Rizzoli R., Biver E., Brennan-Speranza T.C. (2021) Nutritional intake and bone health. Lancet Diabetes Endocrinol, 9(9), 606-621.

[27] Hardcastle A.C., Aucott L., Fraser W.D., et al. (2011) Dietary patterns, bone resorption and bone mineral density in early post-menopausal Scottish women. Eur J Clin Nutr, 65(3), 378-385.

[28] Shin S., Joung H. (2013) A dairy and fruit dietary pattern is associated with a reduced likelihood of osteoporosis in Korean postmenopausal women. Br J Nutr, 110(10), 1926-1933.

[29] Shin S., Hong K., Kang S.W., et al. (2013) A milk and cereal dietary pattern is associated with a reduced likelihood of having a low bone mineral density of the lumbar spine in Korean adolescents. Nutr Res, 33(1), 59-66.

[30] Leder B.Z. (2017) Parathyroid Hormone and Parathyroid Hormone-Related Protein Analogs in Osteoporosis Therapy. Curr Osteoporos Rep, 15(2), 110-119.

[31] Perna S., Avanzato I., Nichetti M., et al. (2017) Association between Dietary Patterns of Meat and Fish Consumption with Bone Mineral Density or Fracture Risk: A Systematic Literature. Nutrients, 9(9), 1029.

[32] Fan Y., Ni S., Zhang H. (2022) Association between Healthy Eating Index-2015 total and component food scores with osteoporosis in middle-aged and older Americans: a cross-sectional study with U.S. National Health and Nutrition Examination Survey. Osteoporos Int, 33(4), 921-929.

[33] Cheraghi Z., Doosti-Irani A., Almasi-Hashiani A. et al. (2019) The effect of alcohol on osteoporosis: A systematic review and meta-analysis. Drug Alcohol Depend, 197, 197-202.

[34] Cho Y., Choi S., Kim K., et al. (2018) Association between alcohol consumption and bone mineral density in elderly Korean men and women. Arch Osteoporos, 13(1), 46.