Hypertensive women consuming pro-inflammatory diets had lower lumbar vertebrae bone mineral density, with higher modified dietary inflammation index scores associated with increased risk of osteopenia, according to a recent study.

Researchers analyzed the association between the modified dietary inflammation index score (M-DIS) and lumbar vertebrae bone mineral density (BMD) in hypertensive patients. This cross-sectional study, published in Nutrition & Metabolism, utilized data from 3,864 participants aged ≥20 years with complete data across four National Health and Nutrition Examination Survey cycles (2007–2008, 2009–2010, 2013–2014, and 2017–2018). The study aimed to assess the inflammatory effects of dietary patterns on bone health, focusing on lumbar vertebrae (L1–L4) BMD measured by dual-energy X-ray absorptiometry.

Participants' dietary intake was evaluated using two 24-hour recall interviews, and M-DIS was calculated based on the inflammatory potential of 27 food parameters (adapted from a larger set of 45 parameters due to NHANES questionnaire limitations). Weighted multivariable linear regression and logistic regression models were employed to determine the relationship between M-DIS and lumbar BMD, with adjustments for age, race, body mass index, and other covariates.

The results revealed a significant negative correlation between M-DIS and average lumbar BMD. In the fully adjusted model (Model 3), the regression coefficient for mean lumbar BMD was −0.0103 (95% confidence interval [CI] −0.0160 to −0.0046, P < 0.001). Among individual vertebrae, L1 exhibited the strongest association (β = −0.0120, 95% CI −0.0172 to −0.0067, P < 0.001). The proportion of osteopenia in the lumbar spine was 7.2%. Higher M-DIS was positively correlated with the incidence of osteopenia (OR 0.595, 95% CI 0.371–0.965, P = 0.041).

Restricted spline analysis demonstrated a positive linear relationship between elevated M-DIS and osteopenia prevalence, although the non-linear correlation was not statistically significant (P for nonlinearity = 0.093). Stratified analyses indicated that elevated M-DIS in women was associated with lower lumbar BMD, while this trend was not significant in hypertensive men.

This study has several limitations. First, the cross-sectional design limits the ability to establish causation between M-DIS and bone health. Second, although the study used weighted and stratified sampling methods from NHANES, the use of two 24-hour dietary recalls may introduce recall bias, as they may not fully capture habitual dietary patterns. Additionally, the applicability of findings to other ethnic groups requires further investigation. Despite these limitations, the study's strengths include the use of a large, nationally representative dataset and adjustments for demographic, lifestyle, and dietary confounders.

These findings suggest that female hypertensive patients who prefer a pro-inflammatory diet may be at an increased risk of osteopenia, highlighting the necessity for tailored dietary recommendations. The researchers advocate for dietary interventions specific to this population, while future longitudinal studies are needed to establish causal relationships.

Full disclosures can be found in the published study.