Pro-inflammatory dietary pattern is associated with fractures in women: an eight-year longitudinal cohort study

N. Veronese, B. Stubbs, A. Koyanagi, J. R. Hébert, C. Cooper, M. G. Caruso, G. Guglielmi, J. Y. Reginster, R. Rizzoli, S. Maggi, N. Shivappa

Research output: Contribution to journalArticlepeer-review


Summary: In this study, during 8 years of follow-up, we reported that higher dietary inflammatory index values were associated with a higher risk of incident fractures in women, but not in men, after adjusting for potential confounders. Introduction: Inflammation is a key risk factor for many adverse outcomes in older people. While diet is a potential source of inflammation, little is known about the impact of inflammatory diet on fractures. Thus, we investigated whether higher Dietary Inflammatory Index (DII)™ ® scores are associated with fractures in a cohort of North American people. Methods: This longitudinal study with a follow-up of 8 years included 3648 participants (1577 males and 2071 females; mean age = 60.6 years) with/at risk of knee osteoarthritis participating with in the Osteoarthritis Initiative. DII scores were calculated using the validated Block Brief 2000 Food Frequency Questionnaire, categorized into sex-specific quintiles. Information on fractures was obtained through self-reported history of fractures at hip, spine, and forearm. The relationship between baseline DII score and incident fracture was assessed through a Cox’s regression analysis, adjusted for potential baseline confounders, and reported as hazard ratios (HRs). Results: During 8 years of follow-up, 560 individuals developed fractures (15.4%). Adjusting for 10 potential confounders, women in the highest DII score quintile (i.e., most pro-inflammatory diet) had a significantly higher risk for fractures (HR = 1.46; 95% CI = 1.02–2.11) compared to women in the lowest quintile. An increase in one standard deviation of DII scores significantly predicted fracture onset in women (adjusted HR = 1.14; 95% CI = 1.02–1.27). The association between DII score and fractures was not significant among men or in the sample as whole. Conclusion: Pro-inflammatory diet is associated with a higher incidence of fractures in women but not men.

Original languageEnglish
Pages (from-to)143-151
Number of pages9
JournalOsteoporosis International
Issue number1
Publication statusPublished - Jan 1 2018


  • Aged
  • Dietary Inflammatory Index
  • Fracture
  • Inflammation
  • Osteoporosis

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism


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