Income, Food Insecurity, and Osteoporosis among Older Adults in the 2007-2008 National Health and Nutrition Examination Survey (NHANES)

Background. Low SES is associated with risk and protective factors for osteoporosis. However, there has been little examination of SES and osteoporosis in the U.S. Methods. We conducted a cross-sectional study of adults aged 50 or older in 2007-2008 NHANES, examining two predictors of SES: income and food insecurity. Our outcome was osteoporosis assessed from bone scans. Adjusted regression models (overall and gender-stratified) controlled for age, gender, race/ethnicity, education, BMI, smoking, alcohol consumption, physical activity, calcium and vitamin D, and medication use. Results. Of 2403 participants, 5% had osteoporosis. In adjusted models, there was a higher risk of osteoporosis in low-income (OR; 95% CI: 1.90;1.07-3.37) and food-insecure populations (3.48;1.43-8.48). There was a stronger association with food insecurity among women (4.91;2.40-10.0) than men (0.46;0.07-3.01). Conclusions. Income and food insecurity may have significant implications not just for immediate nutritional outcomes, but also for conditions such as osteoporosis that develop over the lifespan.