Mediterranean diet may support both weight loss and bone health

 

According to the International Osteoporosis Foundation, about one in every three women and one in every five men over the age of 50 live with osteoporosis — a disease where bones weaken and become prone to fractures.

Due to rapidly aging global population, studies show that osteoporosis will likely become a bigger burden, with some estimating the amount of osteoporosis-related hip fractures to almost double in 2050, compared to 2018 statistics.

Past studies show there are some ways in which people can help reduce their risk of developing osteoporosis, such as eating a well-balanced diet rich in calcium and vitamin D, not smoking, participating in exercises that strengthen the muscles and bones and maintaining a healthy weight.

New research indicates that a Mediterranean diet may also help improve bone density as well as weight loss results.

The new study found that following a low-calorie Mediterranean diet coupled with physical activity may help reduce weight loss- and age-related bone mineral density decline in older women who have metabolic syndrome and who have obesity or overweight.

This energy-reduced Mediterranean diet is a variation of the traditional Mediterranean diet that contains fewer calories. It still emphasizes healthy foods such as fruits, vegetables, legumes, olive oil and fish, but with controlled portion sizes to support weight loss. The traditional Mediterranean diet is also a healthy dietary pattern, but it is typically food consumed without specific limits on portion sizes.

“As people age, especially women after menopause, BMD (bone mineral density) tends to decline, raising the risk of osteoporosis and fractures, which can significantly affect quality of life and the ability to live independently,” Jesús F. García-Gavilán, a lecturer in the Department of Biochemistry and Biotechnology at the Universitat Rovira i Virgili in Spain, said.

 “The Mediterranean diet has been associated with many health benefits; however, its specific effects on bone health during weight loss and aging have not been thoroughly investigated. Given that physical activity also contributes to maintaining bone strength, we aimed to explore whether combining both in a structured lifestyle intervention could protect against bone loss in older adults, particularly in the context of intentional weight reduction.”

“A reduced-energy Mediterranean diet involves participants consuming a modified version of the traditional Mediterranean diet with approximately 30% fewer calories than their usual intake.”

“Previous research has indicated that losing weight, particularly through diet alone, can lead to a reduction in bone density, which poses risks for older adults. Additionally, exercising alone does not always prevent this issue. What is new in this study is the finding that combining a well-balanced, reduced-calorie Mediterranean diet with physical activity can prevent bone loss in older women, even while they are losing weight,” García-Gavilán said.

“This emphasizes that the type of diet is important during weight loss, not just the calorie intake.”

The new diet was cut to about 30% fewer calories than they typically consumed and only from a Mediterranean-style eating plan.

Upon analysis, researchers found that study participants who followed an energy-reduced Mediterranean diet and increased their physical activity produced significant beneficial effects on BMD, especially at the lumbar level in the lower back, over three years, among women. And it is important to protect the spine, where bone loss can lead to serious fractures and disability.

“This finding is significant because it indicates that weight loss doesn’t have to compromise bone health,” García-Gavilán explained.

However, scientists did report there were no BMD changes observed in male participants.

Mir Ali, a board certified general surgeon, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, commented:

“Loss of bone mineral density, especially as you age, can make a person prone to fractures and weakness. And a fracture in older patients, like in their 70s and 80s, can be a very significant thing. Somebody fractures their hip in their 70s, there’s a 20-30% mortality associated with it. So it’s a serious thing, and it’s important to try to reduce that.”

The Mediterranean diet is full of good fats, vitamins, calcium and other minerals that support good bone health.

“The Mediterranean diet is rich in nutrients that promote bone health,” García-Gavilán said. “Nuts and dairy products provide essential calcium, magnesium, and vitamin D. Healthy fats, such as those found in olive oil, have been shown to reduce inflammation.”

Antioxidants such as vitamin C from fruits and vegetables may help protect and support bone cells, García-Gavilán added, while other important vitamins, like vitamin K found in vegetables such as spinach, play a role in bone formation.

“Together, these nutrients can lower the risk of bone loss and support bone maintenance, especially as we age,” García-Gavilán said. “Understanding this nutritional context is crucial for maintaining our long-term quality of life.”

Monique Richard, a registered dietitian nutritionist, recommended:

Mimicking dietary patterns, as culturally appropriate, and accessible, rich in fruits and vegetables, unsaturated fats, lean protein and herbs and spices, such as the DASH diet and Mediterranean Diet, have strong evidence in contributing to overall health and longevity.

Gauging additional dietary and lifestyle behaviors may impact bone health, including soft drink intake, sugar, caffeine, and alcohol intake, as well as whether a person is a smoker, has a genetic predisposition to osteoporosis, osteopenia, and/or specific nutrient pathways affecting absorption and the bone matrix in addition to their current health status.

Moreover, we need to incorporate foods rich in nutrients associated with bone density, such as leafy greens, fruits rich in fiber, fish like sardines, salmon, tuna, tofu, and dairy.

Richard also recommended regularly incorporating weight-bearing movement two to three times a week, such as resistance training using free weights, weight machines, or your own body weight (plyometrics), pilates, yoga and tai chi, in addition to regular aerobic-cardio activity such as walking, running, dancing, or swimming.

“As we age, continued activity and quality of diet remain important priorities. Bone health is an inside-out-outside-in job with adequate nutrition needed as a foundation to keep that skeleton strong and vibrant.”