Differences in Bone Mineral Density between Adult Vegetarians and Nonvegetarians Become Marginal when Accounting for Differences in Anthropometric Factors
Differences in Bone Mineral Density between Adult Vegetarians and Nonvegetarians Become Marginal when Accounting for Differences in Anthropometric Factors
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DOI：
10.1093/jn/nxaa018
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发表时间：
2020-05-01
影响因子：
4.2
通讯作者：
Kuehn, Tilman
中科院分区：
文献类型：
--
作者：
Karavasiloglou, Nena;Selinger, Eliska;Kuehn, Tilman
背景资料：以植物为基础的饮食的人具有较低的骨矿物质密度（BMD）和较高的骨折风险，可能是由于次优的营养供应。然而，人体测量的措施并没有被认为是潜在的混杂因素，在许多以前的研究，和身体质量指数（BMI）是正相关的BMD，但也普遍较低的素食者和vegetarians.Objectives：我们的目的是调查，如果BMD测量值之间的差异，素食者和非素食者从成人一般人群时，占重要的决定因素的BMD，特别是BMI和腰围。使用NHANES（2007-2008和2009-2010周期）的数据，我们评估了成年素食者和非素食者之间BMD（股骨颈、全股骨和全腰椎）的差异。线性回归模型被用来确定BMD和饮食之间的关系。对统计模型进行重要因素调整，即，年龄、性别、种族/民族、吸烟状况、饮酒情况、血清维生素D和钙浓度、腰围和BMI。结果：在调整年龄、性别、种族/民族、绝经状况和教育水平的统计模型中，素食者的BMD值显著低于非素食者（P < 0.001）。调整生活方式因素后，这些差异减弱，调整人体测量变量（BMI和腰围）后，股骨颈（素食者与非素食者之间0.77与0.79 g/cm（2），P = 0.10）和股骨总BMD（0.88与0.90 g/cm（2），P = 0.12）的差异在统计学上不显著。一个小的，但有统计学意义的差异仍然为腰椎BMD总量（1.01与1.04 g/cm（2），P = 0.005）。结论：这些研究结果表明，较低的BMD在成年素食者在很大程度上解释了较低的BMI和腰围。
Background: Persons following plant-based diets have lower bone mineral density (BMD) and higher fracture risk, possibly due to suboptimal nutrient supply. However, anthropometric measures were not considered as potential confounders in many previous studies, and body mass index (BMI) is positively associated with BMD but also generally lower among vegans and vegetarians.Objectives: Our objective was to investigate if BMD measurements differ between vegetarians and nonvegetarians from the adult general population when accounting for important determinants of BMD, especially BMI and waist circumference.Methods: Using data from the NHANES (cycles 2007-2008 and 2009-2010), we evaluated the differences in BMD (femoral neck, total femoral, and total lumbar spine) between adult vegetarians and nonvegetarians. Linear regression models were used to determine the associations between BMD and diet. Statistical models were adjusted for important factors, i.e., age, sex, race/ethnicity, smoking status, alcohol consumption, serum vitamin D and calcium concentrations, waist circumference, and BMI.Results: In statistical models adjusted for age, sex, race/ethnicity, menopausal status, and education level, BMD values were significantly lower among vegetarians than among nonvegetarians (P < 0.001). These differences were attenuated upon adjustment for lifestyle factors, and became statistically nonsignificant upon adjustment for anthropometric variables (BMI and waist circumference) for femoral neck (0.77 compared with 0.79 g/cm(2) among vegetarians versus nonvegetarians, P = 0.10) and total femoral BMD (0.88 compared with 0.90 g/cm(2), P = 0.12). A small but statistically significant difference remained for total lumbar spine BMD (1.01 compared with 1.04 g/cm(2), P = 0.005).Conclusions: These findings suggest that lower BMD among adult vegetarians is in larger parts explained by lower BMI and waist circumference.