Perfil nutricional e saúde óssea de idosos: alimentação e sintomas gastrointestinais como fatores interferentes

Abstract

Introduction: Global population aging raises significant public health concerns, such as the increasing incidence of falls and fractures, which are strongly associated with higher morbidity and mortality rates. Factors such as diet and physical activity play a crucial role in fracture risk, with the BMD Diet Score being a tool developed to assess the influence of diet on bone mineral density (BMD). Age-related gastrointestinal changes may also impact nutrient absorption and bone health, with potential interactions between gut microbiota and bone metabolism. Objective: To analyze dietary patterns, gastrointestinal symptoms, and the applicability of the BMD Diet Score in relation to BMD in older adults. Methods: This quantitative, descriptive, and correlational study included 71 older adults (≥60 years) living in the community and registered at Primary Healthcare Units in Curitiba and surrounding regions. Data collection involved sociodemographic and health information, body composition analysis using DXA, frailty assessment with the IVCF-20, physical activity level using the short-form IPAQ, and gastrointestinal symptoms through the GSRS and complementary scales. Dietary intake was assessed using a 3-day food record, with nutrient analysis and calculation of the BMD Diet Score. Correlation analyses were performed using multiple linear regression and binary logistic regression (odds ratio). Results: Multiple linear regression analysis showed that protein intake (g/kg/body weight) was significantly negatively associated with BMD (β = -2.589911; p = 0.001), while calcium intake had a significant positive association (β = 0.0025391; p = 0.000). Regarding food groups, binary logistic regression revealed significant negative associations between the consumption of vegetables (OR = 0.9720; 95% CI [0.9477– 0.9970]; p = 0.0282) and fruits (OR = 0.9892; 95% CI [0.9790–0.9996]; p = 0.0411) with low BMD. Conversely, the consumption of red, processed, and pork meats was positively associated with low BMD (OR = 1.0313; 95% CI [1.0032–1.0602]; p = 0.0287). However, in multiple linear regression, only the “Red/Processed/Pork Meats” group maintained a significant negative relationship with BMD (β = -0.006741; p = 0.001). The BMD Diet Score was significantly positively associated with BMD in both multiple linear regression (β = 0.1132078; p = 0.000) and logistic regression analysis (OR = 0.6290; 95% CI [0.4942–0.8006]; p = 0.0002). No significant associations were found between gastrointestinal symptoms or physical activity levels and BMD. Among control variables, only “female gender” showed a significant negative correlation with BMD. Conclusion: This study identified significant associations between dietary patterns and bone mineral density (BMD) in older adults, highlighting the protective role of calcium intake and higher consumption of fruits and vegetables, as well as the negative impact of increased protein intake (g/kg body weight), particularly from red, processed, and pork meats. Furthermore, the positive association between higher BMD Diet Score values and BMD reinforces the applicability of this index as a practical tool to integrate dietary aspects into bone health strategies, contributing to more targeted and effective nutritional interventions.