(P23-058-23) Ultra-Processed Food Intake and Osteoporosis Among Puerto Rican Adults

Objectives: Emerging evidence from animal studies suggests that ultra-processed food (UPF) intake may be a risk factor for bone health. To our knowledge, there are few studies on UPF and bone outcomes in human populations, and none among Puerto Rican adults. Understanding risk factors for osteoporosis is important as this population is at increased risk. This study aimed to examine the cross-sectional association between UPF intake and osteoporosis among Puerto Rican adults aged 47 to 79 y.

Methods: A total of 830 participants with complete dietary and bone data from the Boston Puerto Rican Osteoporosis Study were included. Bone mineral density was measured using dual-energy X-ray absorptiometry and osteoporosis at the femoral neck or lumbar spine was defined as T-score, ≤ 2.5. Diet was collected using a FFQ and UPF was characterized using the NOVA classification grouping system including 1) unprocessed and minimally processed foods, 2) processed culinary ingredients, 3) processed foods, and 4) ultra-processed foods. Percentage of total energy intake from UPF was calculated. Multivariable logistic regressions were used to model associations between % energy from UPF and osteoporosis. Model 1 was adjusted for age, sex/estrogen status (male, female w/es, post-menopausal no es), BMI, height, total energy; model 2 additionally for smoking status; and model 3 for alcohol consumption, fruit and vegetable intake and 25(OH)D concentration.

Results: Prevalence of osteoporosis was 10.6% and mean %energy from UPF was 34%. Participants were primarily female (71.3%) and 59.9± 7.6 y old. Greater intake of % energy from UPF was associated with significantly higher odds of osteoporosis in models 1 (OR: 7.9, 95%CI: 1.2, 52.2) and 2 (OR: 7.5, 95%CI: 1.1, 50.2). Associations were attenuated after adjusting for alcohol intake, total fruit and vegetable intake and vitamin D concentration (OR: 3.6, 95%CI: 0.42, 31.5), although the OR remained high.

Conclusions: Greater intake of UPF was associated with osteoporosis among Puerto Rican adults. Further research is warranted to determine if UPF intake is associated with bone loss and bone quality, particularly in high-risk populations, as this may serve as an important public health strategy for prevention and management of osteoporosis.

Funding Sources: NIH