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  • Original Article
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Predictors of low bone mineral density in the elderly: the role of dietary intake, nutritional status and sarcopenia

European Journal of Clinical Nutrition volume 62, pages 802–809 (2008)Cite this article

Abstract

Objectives:

The aims of this study were to investigate the relationship between sarcopenia, dietary intake, nutritional indices and hip bone mineral density (BMD) in the elderly, and to estimate the risk of low BMD due to specific independent predictor thresholds.

Subjects and methods:

Body mass index (BMI), serum albumin, energy and protein intake were studied in 352 elderly outpatients (216 women aged 73.5±5.3 years and 136 men aged 73.9±5.6 years). BMD at different hip sites and appendicular skeletal muscle mass (ASMM) were assessed by dual-energy X-ray absorptiometry.

Results:

The prevalence of osteoporosis was 13% in men and 45% in women, while the prevalence of sarcopenia (50%) and hypoalbuminemia (5%) were similar in both genders. BMI, albumin and ASMM were significantly associated with BMD in both genders: so was protein intake, but only in men. By multiple regression analysis, the variables that retained their independent explanatory role on total hip BMD, were BMI and protein intake in men, and BMI and albumin in women. By logistic regression analysis, men risked having a low BMD with a BMI <22 (OR=12) and a protein intake <65.7 g/day (OR=3.7). Women carried some risk already in the BMI 25–30 class (OR=5), and a much greater risk in the BMI <22 class (OR=26). Albumin <40 g/l also emerged as an independent risk factor (OR=2.6).

Conclusions:

BMI in both genders, albumin in women and protein intake in men have an independent effect on BMD. BMI values <22 are normal for younger adults but carry a higher risk of osteoporosis in the elderly, particularly in women. Age-related sarcopenia does not seem to be involved in bone mass loss.

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Author information

Authors and Affiliations

  1. Department of Medical and Surgical Sciences, Geriatrics Unit, University of Padova, Italy

    A Coin, G Enzi, E M Inelmen, E Manzato, L Busetto & G Sergi

  2. Department of Environmental Medicine and Public Health, University of Padova, Italy

    E Perissinotto, A C Frigo & A Buja

  3. Geriatric Medicine Division, University of Verona, Italy

    M Zamboni

Authors
  1. A Coin
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  2. E Perissinotto
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  3. G Enzi
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  4. M Zamboni
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  5. E M Inelmen
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  6. A C Frigo
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  7. E Manzato
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  8. L Busetto
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  9. A Buja
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  10. G Sergi
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Corresponding author

Correspondence to G Sergi.

Additional information

Contributors: AC was the principal investigator, responsible for analyzing data and writing the manuscript; EP performed all statistical analyses using SAS Statistical Software; GE and EM were responsible for recruiting subjects in Padova; MZ was responsible for recruiting subjects in Verona; EMI and LB collected and analyzed nutritional data; ACF and AB organized the database and control data; GS helped with the study and supervised the work of the whole team.

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Coin, A., Perissinotto, E., Enzi, G. et al. Predictors of low bone mineral density in the elderly: the role of dietary intake, nutritional status and sarcopenia. Eur J Clin Nutr 62, 802–809 (2008). https://doi.org/10.1038/sj.ejcn.1602779

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  • DOI: https://doi.org/10.1038/sj.ejcn.1602779

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