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Title: Adherence to the 2006 American Heart Association Diet and Lifestyle Recommendations for cardiovascular disease risk reduction is associated with bone health in older Puerto Ricans

Author
item BHUPATHIRAJU, SHILPA - Harvard School Of Public Health
item LICHTENSTEIN, ALICE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item DAWSON-HUGHES, BESS - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item HANNAN, MARIAN - Harvard Medical School
item TUCKER, KATHERINE - University Of Massachusetts

Submitted to: The American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 8/22/2013
Publication Date: 9/18/2013
Citation: Bhupathiraju, S.N., Lichtenstein, A.H., Dawson-Hughes, B., Hannan, M.T., Tucker, K. 2013. Adherence to the 2006 American Heart Association Diet and Lifestyle Recommendations for cardiovascular disease risk reduction is associated with bone health in older Puerto Ricans. American Journal of Clinical Nutrition. 98:1309-1316.

Interpretive Summary: Heart disease and osteoporosis are two major public health problems in the U.S. that may share common dietary origins. Hence, it is possible that strategies to promote heart health may also benefit bone health. The objective of the study was to test the hypothesis that adherence to the most current American Heart Association Diet and Lifestyle Recommendations (AHA-DLR) is associated with bone health. To address this issue we rated diets using our previously developed diet and lifestyle score (American Heart Association Diet and Lifestyle Score, AHA-DLS) instrument modified to test associations with bone health. The study population consisted of 933 Puerto Rican subjects aged 47-79 years. In addition to dietary intake, bone mineral density at four points in the body (femoral neck, trochanter, total hip, and lumbar spine (L2-L4)) was measured using dual energy X-ray absorptiometry. We found that for every 5 unit increase in the modified AHA-DLS, bone mineral density at these points was associated with a higher value. No single component of the AHA-DLR was responsible for the observed positive associations. For every 5 unit increase in the modified AHA-DLS, the odds for osteoporosis or osteopenia at the trochanter, total hip, and lumbar spine (L2-L4) were lower by 14%, 17%, and 9% respectively. These data indicate that dietary guidelines developed to promote heart health also promote bone health in this Hispanic cohort. Such synergism might positively influence efforts to encourage compliance with current Dietary Guidelines for Americans.

Technical Abstract: Cardiovascular disease (CVD) and osteoporosis are 2 major public health problems that share common pathophysiological mechanisms. It is possible that strategies to reduce CVD risk may also benefit bone health. We tested the hypothesis that adherence to the 2006 American Heart Association Diet and Lifestyle Recommendations We previously developed a unique diet and lifestyle score (American Heart Association Diet and Lifestyle Score; AHA-DLS) to assess adherence to the AHA-DLR. In a cross-sectional study of 933 Puerto Ricans aged 47–79 y, we modified the AHA-DLS to test associations with bone health. Bone mineral density (BMD) at the femoral neck, trochanter, total hip, and lumbar spine (L2–L4) was measured by using dual-energy X-ray absorptiometry. For every 5-unit increase in the modified AHA-DLS, BMD at the femoral neck, trochanter, total hip, and lumbar spine (L2–L4) was associated with a 0.005–0.008-g/cm2 (P, 0.05) higher value. No component of the AHA-DLR alone was responsible for the observed positive associations. For every 5-unit increase in the modified AHA-DLS, the odds for osteoporosis or osteopenia at the trochanter, total hip, and lumbar spine (L2–L4) were lower by 14% (OR: 0.86; 95% CI: 0.79, 0.92), 17% (OR: 0.83; 95% CI: 0.76, 0.92), and 9% (OR: 0.91; 95% CI: 0.84, 0.99), respectively. Dietary guidelines for CVD risk reduction may also benefit bone health in this Hispanic cohort. Synchronizing dietary guidelines for these 2 common diseases may provide a simplified public health message.