Mediterranean Diet May Help Protect Bones in Postmenopausal Women

March 19, 2018

CHICAGO, Illinois — A small observational study suggests that following a Mediterranean diet may have a beneficial effect on bone mineral density (BMD) and muscle mass in women after menopause.

"We found that the Mediterranean diet could be a useful nonmedical strategy for the prevention of osteoporosis and fractures in postmenopausal women," said Thais Rasia Silva, PhD, of the Gynecological Endocrinology Unit at Hospital de Clinicas de Porto Alegre, Brazil, who reported the findings in a poster here at ENDO 2018: The Endocrine Society Annual Meeting.

Although many benefits of the Mediterranean diet have been reported, few studies have looked at the effects of this eating pattern on body composition after menopause, Silva told a press conference here.

This is important because of the decline in bone mass and subsequent increased risk of osteoporosis in women following the menopause and the accompanying decline in estrogen, she explained.

Study Details

Silva and her team recruited 103 healthy women from southern Brazil, who were an average age of 55 years and had gone through menopause a mean of 5.5 years earlier. They excluded anyone currently taking hormone replacement therapy.

BMD, percentage body fat, and skeletal muscle mass (as appendicular lean mass index [ALMI]) were assessed by dual-energy X-ray absorptiometry (DEXA), resting metabolic rate was calculated by indirect calorimetry, and habitual physical activity was measured using a pedometer. Dietary intake was assessed using a validated food frequency questionnaire.

Scoring of the Mediterranean diet was based on intake of the following: vegetables and legumes, fruits, cereals, fish, alcohol, olive oil, dairy products, and meat.

A higher Mediterranean dietary intake score was positively associated with better muscle mass vs a lower score (ALMI, 6.6 vs 6.3 kg/m2; P = .039) and greater lumbar spine BMD (1.076 vs 0.997; P = .07). Femoral neck and total femoral BMD were similar between groups. 

Adjustment for potential confounders including previous use of hormone replacement therapy (prior to the study), previous smoking behavior, and physical activity, did not alter the findings.

How Does the Diet Increase Muscle Mass, BMD? Studies Ongoing

Silva was asked during the press conference whether she thought there were any phytoestrogens in the Mediterranean diet that could have contributed to the findings. She said that she thought not.

Asked by Medscape Medical News how, then, the Mediterranean diet could be contributing to higher muscle mass and bone density, senior author Poli Mara Spritzer, MD, PhD, also of Hospital de Clinicas de Porto Alegre, said: "We believe protein in the diet, such as fish, can increase muscle mass, and that antioxidants play a role."

However, she cautioned that this was only an observational study that did not compare the Mediterranean diet with any other diet, and that more studies are necessary to clarify the effect of the Mediterranean diet on body composition during menopause. Her team is conducting further studies. 

Nevertheless, said Silva, this "emerging evidence suggests that a Mediterranean diet combined with other healthy lifestyle habits may be a useful nonpharmacological therapy for the primary prevention of osteoporosis and fractures postmenopause."

"Postmenopausal women, especially those with low bone mass, should ask their doctor whether they might benefit from consuming this dietary pattern," she concluded.

The authors have reported no relevant financial relationships.

ENDO 2018. March 19, 2018; Chicago, Illinois. Abstract MON-301

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