How your diet makes you a fall risk and a risk for bone fractures

Marion Hauser, MS, RD

Bone destruction is of course a major factor in both osteoarthritis and osteoporosis. Fractures of course, are of great concern to everyone, especially aging patients. In this article we will target bad diet and bone loss that can lead to frailty and fall risk.

Postmenopausal women (average age 61) with knee osteoarthritis, who eat foods high in inflammatory factors not only make their knees worse, but increase their risk for frailty, fall risk and fractures.

In a recent study, an international team of researchers writing in the medical journal Osteoporosis international (1) found that women who were already at high risk for advanced knee osteoarthritis (due to wear and tear factors) and who continued to eat a diet of foods with high pro-inflammatory factors, also made themselves a higher risk for bone fractures. (These are diets rich in refined foods, sugars, flour or starch.)

Women were highly impacted by bad diet and the risk of future fractures.

Lead by Italian university researchers and including researchers from the University of South Carolina, this study followed men and women for 8 years of follow-up. Here is what they found.

  • Women were highly impacted by bad diet and the risk of future fractures.
  • During 8 years of follow-up, 560 individuals enrolled in the study developed fractures, representing 15.4% or about 1 in 6.5 women.
  • Even a small change in diet helped women significantly reduce their risk fracture for falling and fractures.

Here are the summary learning points from the researchers:

  • While high pro-inflammatory diets can cause bone health problems and frailty other studies have shown that healthy dietary patterns (such as Mediterranean diet – please see my article The Mediterranean diet and osteoarthritis) are associated with a lower risk of fracture, particularly hip fractures. Encouraging people (particularly women) to eat healthier to prevent fractures is important

A December 2018 study in the journal Nutrients (2)  also suggested that “A more pro-inflammatory diet was significantly associated with higher osteoporosis risk in women.”

American and German researchers combined to publish their data on: “Dietary Patterns and Fractures in Postmenopausal Women.” (3) Here the German team joined with researchers from UCLA, University of Alabama at Birmingham, the Medical College of Georgia at Georgia Regents University, Ohio State University, Albert Einstein College of Medicine, among others leading centers found that women, average age 63 and a half years old, who had higher adherence to a Mediterranean diet (low inflammatory diet) had a lower risk for hip fractures. Further, that these results support a healthy dietary pattern may play a role in maintaining bone health in postmenopausal women.

A small change in diet helps a lot – no change is dangerous

As you can see researchers from around the world are tackling this problem of prevention of falling and broken bones because of the significant impact caring for aging people with a broken hip can cause. It does not take much imagination to speculate on how much a broken hip will impact your life or the lives of your loved ones.

This article is not meant to frighten you. It is meant to help inspire a small change of your diet to preserve bone health. If you want to be frightened into eating better, listen to this research: It is in the August 2019 issue of Clinical Nutrition (4). It comes from medical university researchers in Italy.

Learning points:

  • Hip fractures are strongly associated with mortality in the elderly.
  • Poor nutritional status, increased cognitive and functional impairment were all associated with death 3 months after hip fracture, 6 months after hip fracture, and 12 months after hip fracture.
  • Both cognitive and functional impairment were associated with poor nutritional status .
  • In hip fracture elderly patients (over age 65), poor nutritional status strongly predicts 1 year mortality

A small change in diet helps a lot

Confirming that even a small change in diet, away from inflammatory foods, a study in the Journal of bone and mineral research,(5) doctors lead by a team from Ohio State University, and contributed to by researchers at the University of South Carolina, University of Massachusetts, University of Pittsburgh, Albert Einstein College of Medicine, University of Tennessee, Harvard Medical School, and the University of  Buffalo made these observations using over 160,000 study participants from data from the National Institutes of Health’s Women’s Health Initiative Observational Study and Clinical Trials.

  • Previous studies suggest that bone loss and fracture risk are associated with higher inflammatory milieu, potentially modifiable by diet.
  • A less inflammatory dietary pattern was associated with less Bone Mineral Density loss in postmenopausal women.
  • Benefits for the high risk group. Caucasian (white) women under the age of 63 were shown to be at the highest risk for bone fractures as it relates to a more inflammatory diet. Moving to a less inflammatory dietary lifestyle decreased this risk.

A small change – The simple learning point of this article is to recognize that avoiding these obvious bad food choices can lessen the risk of bone loss and fractures.

  • Sugar
  • Processed and refined foods
  • Alcohol
  • Artificial anything

Also read my article on “inflammaging,” a recently coined term to describe the consequences on an inflammatory diet on aging joints.

If this article has helped you understand the problems of obesity and joint pain and you would like to explore Prolotherapy as a possible remedy for your joint pain, ask for help and information from our specialists

1 Veronese N, Stubbs B, Koyanagi A, Hébert JR, Cooper C, Caruso MG, Guglielmi G, Reginster JY, Rizzoli R, Maggi S, Shivappa N. Pro-inflammatory dietary pattern is associated with fractures in women: an eight-year longitudinal cohort study. Osteoporosis International. 2017:1-9. [Google Scholar]
2 Kim HS, Sohn C, Kwon M, Na W, Shivappa N, Hébert JR, Kim MK. Positive association between dietary inflammatory index and the risk of osteoporosis: Results from the KoGES_Health Examinee (HEXA) cohort study. Nutrients. 2018 Dec;10(12):1999. [Google Scholar]

2 Haring B, Crandall CJ, Wu C, LeBlanc ES, Shikany JM, Carbone L, Orchard T, Thomas F, Wactawaski-Wende J, Li W, Cauley JA. Dietary patterns and fractures in postmenopausal women: results from the Women’s Health Initiative. JAMA internal medicine. 2016 May 1;176(5):645-52. [Google Scholar]

3 Zanetti M, Cappellari GG, Ratti C, Ceschia G, Murena L, De Colle P, Barazzoni R. Poor nutritional status but not cognitive or functional impairment per se independently predict 1 year mortality in elderly patients with hip-fracture. Clinical Nutrition. 2019 Aug 1;38(4):1607-12. [Google Scholar]

4 Orchard T, Yildiz V, Steck SE, Hébert JR, Ma Y, Cauley JA, Li W, Mossavar‐Rahmani Y, Johnson KC, Sattari M, LeBoff M. Dietary Inflammatory Index, Bone Mineral Density, and Risk of Fracture in Postmenopausal Women: Results From the Women’s Health Initiative. Journal of Bone and Mineral Research. 2017 May 1;32(5):1136-46. [Google Scholar]


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