I mentioned a while back that the Mediterranean diet is an excellent alkaline diet option for people concerned about bone health. So I was really excited to read about a new clinical trial that specifically tested the Mediterranean diet as a nutritional therapy for bone loss and osteoporosis. If you have been wondering if following a Mediterranean diet for osteoporosis is worthwhile, I think you will find these results particularly encouraging.
This trial is interesting because it’s unusually robust in terms of how it was conducted. It’s the first trial I’ve ever seen where they actually provided people with food — including the olive oil and grains — instead of simply asking them to record what they ate and determining from there if it could be categorized as a Mediterranean diet. The fact that they provided extra virgin olive oil to their subjects is important because other studies have found that positive effects on bone only happen with high-quality extra virgin olive oil (most of the olive oil we get in the US is cut with other oils, so we don’t get those benefits).
Also, the study followed over 1000 participants, age 65–79, for a full year. One problem with so many studies is that they’re too small or too short, so I was really pleased to see the researchers went the extra mile. It is really the first large, long-term trial that took the step of controlling (somewhat) the foods people ate before looking at the effects on bone density.
By conducting the trial this way, researchers greatly strengthened their results by ensuring that their participants routinely ate foods consistent with a Mediterranean diet for osteoporosis. Unfortunately, the participants didn’t get all the Mediterranean diet foods — key components like fish or wine weren’t provided, so only people who already ate those items got them — but I see it as a really good try at unraveling a very difficult problem, and it did have some positive results.
We find that a lot of lifestyle interventions work better on people who are worse off to begin with their bone density, and that seems to be true in this study: People with normal bone density got little benefit, but the dietary intervention did help those with osteoporosis.
Participants with osteoporosis who followed the Mediterranean diet using the foods supplied by the researchers saw a lower rate of loss of bone density in the femoral neck — the location most likely to break in a hip fracture — compared to those with osteoporosis in the control group. It confirms earlier studies that noticed lower hip fracture incidence in those following a Mediterranean diet of their own accord.
As I’ve mentioned before about the Mediterranean diet for osteoporosis, not all fractures are the same in terms of seriousness, and if following a Mediterranean diet for osteoporosis can affect bone density in the hip in this way, it potentially offers protection against the most serious fracture older adults can face.
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Mediterranean diet for osteoporosis – references
Benetou V, Orfanos P, Feskanich D, et al. Mediterranean diet and hip fracture incidence among older adults: The CHANCES Project. [Published online ahead of print April 14, 2018]. Osteoporos Int. doi:10.1007/s00198-018-4517-6.
García-Gavilán JF, Bulló M, Canudas S, et al. Extra virgin olive oil consumption reduces the risk of osteoporotic fractures in the PREDIMED trial. Clin Nutr.2018:37;329–335.
Jennings A, Cashman KD, Gillings R, et al. A Mediterranean-like dietary pattern with vitamin D3 (10 μg/d) supplements reduced the rate of bone loss in older Europeans with osteoporosis at baseline: results of a 1-y randomized controlled trial. Am J Clin Nutr. 2018;108:633–640.