Dietary Inflammatory Index and osteoporosis: the National Health and Nutrition Examination Survey, 2017–2018

Abstract Purpose: The dietary inflammatory index (DII) is a scoring system to quantify the inflammatory effects of nutrients and foods, while inflammation could affect osteoporosis. The purpose of this study was to further explore the relationships between DII and BMD and osteoporosis in both women and men. Methods: This study was involved 1070 women and 1136 men (age ≥ 50) in the US National Health and Nutrition Survey (NHANES) from 2017 to 2018. Multivariable linear regression models were used to estimate the associations between DII and BMD. And the correlations of DII and the risk of osteoporosis were estimated with multivariable logistic regression models. Results: In women, DII was negatively associated with lumbar spine, total hip and femoral neck BMD after adjusting for covariates in model 3, respectively ( P <0.05). In men, DII was negatively associated with lumbar spine BMD ( P <0.05). Multiple logistic regression analyses revealed that in women DII was positively associated with the risk of osteoporosis in models ( P <0.05). The significantly increased odds ratios (ORs) (95% CI) of the model 3 between the risk of osteoporosis and DII across quartiles 2, 3 and 4 compared with quartile 1 were 3.071 (95% CI 1.168,8.070), 5.631 (95% CI 2.808,11.293), and 6.169(95% CI 2.964,12.838), respectively. But no significant association was observed in men. Conclusions: This study revealed that higher DII score was associated with higher osteoporosis risk in women, while no association was found in men. more pro-inflammatory diets might be associated with lower BMD in both women and men.