No diet score exists that summarizes the features of a diet that is optimal for bone mineral density (BMD) in the elderly. Our aims were (a) to develop a BMD-Diet Score reflecting a diet that may be beneficial for BMD based on the existing literature, and (b) to examine the association of the BMD-Diet Score and the Healthy Diet Indicator, a score based on guidelines of the World Health Organization, with BMD in Dutch elderly participating in a prospective cohort study, the Rotterdam Study (n = 5144). Baseline dietary intake, assessed using a food frequency questionnaire, was categorized into food groups. Food groups that were consistently associated with BMD in the literature were included in the BMD-Diet Score. BMD was measured repeatedly and was assessed using dual energy X-ray absorptiometry. The BMD-Diet Score considered intake of vegetables, fruits, fish, whole grains, legumes/beans and dairy products as “high-BMD” components and meat and confectionary as “low-BMD” components. After adjustment, the BMD-Diet Score was positively associated with BMD (β (95% confidence interval) = 0.009 (0.005, 0.012) g/cm<sup>2</sup> per standard deviation). This effect size was approximately three times as large as has been observed for the Healthy Diet Indicator. The food groups included in our BMD-Diet Score could be considered in the development of future dietary guidelines for healthy ageing.

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Keywords BMD-Diet score, Bone mineral density, Dietary patterns, Healthy diet indicator
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Journal Nutrients
de Jonge, E.A.L, Kiefte-de Jong, J.C, de Groot, L.C.P.G.M, Voortman, R.G, Schoufour, J.D, Zillikens, M.C, … Rivadeneira Ramirez, F. (2015). Development of a food group-based diet score and its association with bone mineral density in the elderly: The Rotterdam study. Nutrients, 7(8), 6974–6990. doi:10.3390/nu7085317