A Sweets, Sugared Drink and Dairy Desserts and a Meat, Processed Meat Dietary Pattern is Associated with Higher Odds of Osteoporosis in Puerto Rican Men and Postmenopausal Women

OBJECTIVES: To examine associations between empirically derived dietary patterns and osteoporosis among Puerto Rican adults. METHODS: Participants from the Boston Puerto Rican Osteoporosis Study, an ancillary study to the Boston Puerto Rican Heath Study, were included if they presented with complete bone and dietary data (n = 955, mean age = 59.9 ± 7.6 y, 71.3% female). Dual energy x-ray absorptiometry was used to measure BMD at the hip and spine. Diet was estimated from a food frequency questionnaire and dietary patterns were derived using principal components analysis. Logistic regression was used to examine associations between patterns and odds of osteoporosis adjusting for age, height, BMI, smoking status, alcohol use, physical activity, and total energy intake (model 1) and model 1 plus diabetes status (model 2). Interactions by estrogen status (premenopausal or using HRT; postmenopausal and no HRT; men) were observed; however, only 4 pre-menopausal women had osteoporosis. Therefore, final models were stratified by men and postmenopausal/no HRT women. RESULTS: Prevalence of osteoporosis was 10.6%. The Meat, Processed Meat, French Fries pattern was associated with higher odds of osteoporosis among postmenopausal women only in model 1 (OR: 1.39, 95% CI: 1.01–1.91, P = 0.05). Associations were attenuated after adjusting for diabetes status (OR: 1.35, 95% CI: 0.98–1.87, P = 0.07). The Sweets, Sugared Beverages, Dessert's pattern was associated with higher odds of osteoporosis in men in model 1 (OR: 1.97, 95% CI: 1.05–3.69, P = 0.04) and remained significant after additional adjustment for diabetes status (OR: 2.1, 95% CI: 1.09–4.03, P = 0.03). This pattern was not significantly associated with osteoporosis in postmenopausal women (OR: 1.21, 95% CI; 0.89–1.65, P = 0.22). The Traditional, Rice, Beans and Oils pattern was not associated with osteoporosis. CONCLUSIONS: Dietary patterns with high intakes of Sweets, Sugared Beverages and Dairy Desserts pattern (in men) and with Meat, Processed Meat and French Fries (in postmenopausal women) were associated with higher odds of osteoporosis in this Puerto Rican population. Findings suggest that recommendations to optimize bone health in this group should include messaging to limit added sugar, processed meats and fast food. FUNDING SOURCES: National Institutes of Health (P01 AG023394, P50 HL105185, R01 AG027087, K01 AR067894).