Study Suggests Adoption of the Mediterranean Diet is a Protective Factor Against Osteoporosis

Posted April 23, 2019

Adopting the so-called Mediterranean diet, a set of eating habits that in recent years has been associated with protection against diabetes and cardiovascular disease, can also have a positive impact on body composition and help preserve bones and muscles, especially in the lower back area. A study carried out at the National Institute of Science and Technology in Hormones and Women’s Health (INCT Hormona) investigated the association between bone and muscle mass with greater or lesser adherence to a Mediterranean-style diet by assessing the intake of food groups such as cereals, fruits and vegetables, dairy products, fish, meat, red wine, and olive oil. The results were published in the latest issue of Climacteric, the official journal of the International Menopause Society, in an article titled “Mediterranean diet is associated with bone mineral density and muscle mass in postmenopausal women”, authored by postdoctoral fellow Thaís Rasia da Silva, a dietitian and INCT investigator.

The study included 105 healthy women with a mean age of 55 years, living in Rio Grande do Sul, who had been in menopause for at least 1 year. The women completed questionnaires describing what they had eaten in the last month and underwent a series of tests to measure bone mineral density, total body fat, and appendicular lean mass; the results were then compared with the dietary pattern of each of the volunteers. “Women who had a Mediterranean-like diet had a better body composition, with higher muscle and bone mass, independently of other factors such as physical activity, duration of menopause, and history of hormone replacement therapy,” notes Thaís.

The study also found that women with better adherence to a Mediterranean diet reported higher intake of nutrients such as calcium and magnesium, which act directly on bone formation and resorption, as well as have a positive effect on muscle performance. “Other nutrients with antioxidant effects, such as vitamin A and selenium, were also consumed in greater quantity by these women, conferring protection against oxidative stress and reducing loss of both muscle and bone, which is common after menopause,” notes the author. The study was conducted under the supervision of Professor Poli Mara Spritzer (UFRGS), an endocrinologist and general coordinator of INCT Hormona, which is based at Hospital de Clínicas de Porto Alegre.

Professor Spritzer explains that menopause is characterized by a reduction in estrogen production by the ovaries and has been associated with the development of osteoporosis and a decline in bone and muscle mass, which increases the risk of trauma, muscle injury, and bone fractures, in addition to limiting autonomy and quality of life. “Osteoporosis is a chronic and silent disease, which can lead to decreased quality of life and increased risk of mortality. It is estimated that, in Brazil, 15 to 33% of postmenopausal women have osteoporosis, so it may be considered a public health issue”, warns the lead investigator and head of the hormones and women’s health research institute.

According to the scientists at INCT Hormona, the evidence presented at the Endocrine Society ENDO 2018 meeting in Chicago suggests that adherence to a Mediterranean diet may be an effective non-pharmacological strategy to prevent osteoporosis and falls in postmenopausal women. However, the investigators note that further studies are needed to more accurately verify the relationship observed in the study. “Even so, we can safely say that this dietary pattern, when combined with other healthy lifestyle habits, has a positive impact on health,” concludes Thaís.

What does a Mediterranean diet consist of?

Researcher Thais Rasia da Silva, author of the study associating adherence to a Mediterranean Diet with preservation of bone and muscle health, says that this dietary pattern is characterized by high intake of fruits, vegetables, whole grains, and seeds, as well as having olive oil as the main source of fat. In addition, it also includes moderate intake of fish, eggs, cheese, and yogurt, and allows small amounts of red meat and sugar.

Thais argues that adopting such an eating habit, or a pattern closer to what has been recommended as a healthy diet, can be a gradual process and can respect everyone’s individual socioeconomic and cultural conditions. “Our study was unable to evaluate intake of oilseeds among the participants, because these are more expensive foods and are thus not affordable to much of our population. However, no single dietary component was associated with bone or muscle mass in our analyses. Therefore, we believe that the dietary pattern as a whole is more important than any single food item alone”, she notes.

Finally, Thaís ponders that following a dietary pattern that ensures an adequate intake of nutrients and bioactive compounds, found mainly in fruits and vegetables, “in addition to ensuring an adequate intake of protein and calcium, are important steps toward obtaining a better body composition and thus improving quality of life after menopause”, says the INCT Hormona researcher.

Copy, photo, and editing: Luiz Sérgio Dibe