Mediterranean diet is associated with bone mineral density and muscle mass in postmenopausal women

Purpose: This study aimed to investigate the association between the Mediterranean diet (MD), body composition, and bone mineral density (BMD) in postmenopausal women. Methods: In this cross-sectional study, 105 apparently healthy postmenopausal women aged between 45 and 65 years were included. BMD, percentage body fat, and appendicular lean mass index (ALMI, appendicular lean mass/height squared) were assessed by dual-energy X-ray absorptiometry. Dietary intake was assessed by a validated food frequency questionnaire. Assessment of MD adherence was based on intake of cereals, vegetables, fruits, meats, dairy products, fish, red wine, and olive oil, and expressed as the Mediterranean diet score (MDS). Results: Women with higher adherence to the MD had higher ALMI (6.6 +/- 0.8 kg/m(2) vs. 6.3 +/- 0.7 kg/m(2); p = 0.039) and lumbar spine BMD (1.076 +/- 0.149 vs. 0.997 +/- 0.143 g/cm(2); p = 0.007) compared to those with lower MDS. Linear regression analysis adjusted for previous hormone therapy, previous smoking behavior, and habitual physical activity showed an independent positive contribution of MDS to lumbar spine BMD (mean difference 0.088 g/cm(2), 95% confidence interval 0.028-0.147; p = 0.004) and ALMI (mean difference 0.296 kg/m(2), 95% confidence interval 0.020-0.591; p = 0.049). Conclusion: Bone mineral density at the lumbar spine and ALMI were positively associated with the MDS in a sample of postmenopausal women from a non-Mediterranean region.