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Dr. Susan E. Brown

Mediterranean diet a special help for those with osteoporosis

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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.

What makes this study different

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.



Mediterranean diet for osteoporosis: slowing key bone loss

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.

If you need support making changes to your diet and lifestyle to support your bones, learn more about our all-inclusive Better Bones, Better Body Program.

References

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.

Mediterranean diet and bones
Dr. Susan E. Brown

Is the Mediterranean diet good for bones?

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There is an amazing amount of research on the Mediterranean diet and its benefits for health, so naturally I get some questions about whether it’s good for bone health, too.

A brand new meta-analysis suggests that we can emphatically say it’s molto buoni [very good] for bones as well as the rest of the body (Benetou et al., 2018). The study looked at the relationship between adherence to a Mediterranean diet and hip fracture in over 140,000 US and European adults over age 60 (82% of whom were women). It found that those who have moderate to high adherence to a Mediterranean diet had a significant decrease in hip fracture risk compared to those with low adherence.

Mediterranean diet = Alkaline for Life® Diet

This finding is no surprise, because the Mediterranean diet is based on very similar principles as the Alkaline Diet — a focus on alkalizing plant foods and healthy fats, with limits on meat intake and simple carbohydrates. In many ways, the Mediterranean diet is simply one interpretation of Alkaline eating based on foods and meal patterns common to a certain part of the world.

A look at the extensive literature on Mediterranean diet and health highlights just a few important features:

• As a largely plant-based diet, it’s not only an alkaline option, it also offers health-supporting polyphenols that many studies agree are valuable in fighting cancer, inflammation, and oxidative stress — all factors that contribute to poor bone health (Estruch et al. 2013; Medina-Remon et al. 2017; Terra et al. 2009; Anderson & Nieman 2016; Martinez-Gonzalez et al. 2015).

• It contributes to maintenance of healthy weight and — important for bone health — muscle mass. One recent meta-analysis found that older adults who closely follow a Mediterranean diet had a lower risk of becoming frail and were better able to maintain muscle strength, activity, weight and energy levels (Kojima et al., 2018).

• A key component of the Mediterranean diet, olive oil, is associated with increased serum osteocalcin and P1NP concentrations, suggesting a protective effect on bone (Fernandez-Real et al., 2012) — and recent studies found higher consumption of olive oil corresponds to higher bone density (Savanelli et al., 2017).

More benefits to Mediterranean-style eating

It’s pretty clear that the this diet is beneficial to bones. So what other health benefits does it offer? Here are just a few:

• The Mediterranean Diet is specifically associated with improvements in blood pressure, insulin sensitivity, lipid profiles, inflammation, oxidative stress, and atherosclerosis (Martinez-Gonzalez et al. 2015).

• Researchers have found repeatedly that those eating a Mediterranean diet experienced about a 30–60% reduction in cardiovascular risk (Estruch et al. 2013; Bonaccio et al., 2017; Carlos et al. 2018).

• Individuals following the Mediterranean diet experienced half as much age-related brain shrinkage as those who did not (Luciano et al. 2017).

• A recent study of over 22,000 Spanish men and women noted benefits in terms of type 2 diabetes, weight gain, metabolic syndrome, depression, cognitive decline, and nephrolithiasis (Carlos et al., 2018).

So if you’ve been wondering if infusing your alkaline diet with more Mediterranean flavor and flair would help you support your bone health, wonder no more — it will do that and more!