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A pilot study on the correlation between dietary habits and osteoporosis in men living in the frigid regions of China
doi: 10.1515/fzm-2025-0023
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Abstract:
Objective To analyze the risk of osteoporosis among middle-aged men in the cold regions of China (Heilongjiang Province) and provide theoretical support for the early identification of high-risk populations. Methods Bone mineral density (BMD) data were collected from male subjects aged 50-65 who met the inclusion criteria at the physical examination center of a hospital in Harbin between August to December 2022. General clinical data and dietary information were obtained through face-to-face interviews using a dietary questionnaire survey. Results The prevalence of osteoporosis and osteopenia was 14.38% and 52.06%, respectively, while normal bone mass accounted for 33.56%. Significant differences were observed among groups in smoking habits, sunlight exposure, exercise levels, and dietary patterns at each bone mass level. The BMD of the lumbar spine, femoral neck, and hip showed a negative correlation with the Dietary Inflammatory Index (DII) score. Multivariate logistic regression analysis revealed that smoking and a diet high in oil and salt were positively associated with the risk of osteoporosis. A pro-inflammatory diet was also positively correlated with osteoporosis risk, with individuals in this group being 7.723 times more likely to develop osteoporosis compared to those in the anti-inflammatory diet group. Conclusion The high prevalence of osteoporosis and osteopenia observed in this study highlighted that osteoporosis is a significant and pressing issue among middle-aged men. Smoking, limited sunlight exposure, reduced physical activity, diets high in oil and salt, and pro-inflammatory diets were identified as major risk factors for bone loss. These factors are closely linked to the geography, climate, and cultural practices of cold regions in China. Primary healthcare in this region should focus on the screening and prevention of osteoporosis in middle-aged men by promoting smoking cessation, increased sunlight exposure, adequate vitamin D supplementation, regular physical activity, and adherence to a healthy diet to maintain bone health. -
Key words:
- osteoporosis /
- middle-aged men /
- dietary patterns /
- bone mineral density /
- frigid regions /
- risk factors
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Table 1. General clinical data of subjects
Item Group Number of people (N) Constituent ratio (%) Age (years) 50-54 62 42.47 55-59 55 37.67 60-65 29 19.86 Education Level Primary school and below 50 34.25 Middle school 56 38.36 High school 18 12.32 College and above 22 15.07 Occupation Civil servants or institutions 22 15.07 Administration, service 31 21.23 Workers 20 13.70 Farmers 6 4.11 Freelance 45 30.82 Retired, unemployment 22 15.07 Monthly household Income (million) < 0.3 17 11.65 0.3- < 0.6 47 32.19 0.6-1 59 40.41 > 1 23 15.75 
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Table 2. Comparison of education level, occupation, income, fracture history, smoking history, and alcohol consumption history in relation to bone density across different bone mass subgroups
Item Osteoporosis Osteopenia Normal P Age (year) 58.000 ± 3.655 55.000 ± 4.290 56.000 ± 3.784 0.059 Height (m) 1.730 ± 0.059 1.733 ± 0.061 1.739 ± 0.051 0.786 Weight (kg) 73.600 ± 15.118 76.500 ± 10.016 77.500 ± 9.972 3.900 Body mass index 24.472 ± 4.205 25.476 ± 10.857 25.620 ± 3.076 3.530 Education level, n (%) 0.466 Primary school and below 4(2.74) 25 (17.12) 21(14.38) Middle school 12 (8.21) 27 (18.49) 17(11.64) High school 2(1.37) 8(5.48) 4 (2.74) College and above 3(2.05) 16 (10.96) 7 (4.79) Occupation, n (%) 0.485 Civil servants or institutions 2(1.37) 15 (10.27) 5 (3.42) Administration, service 7(4.79) 15 (10.27) 9 (6.16) Workers 1(0.68) 9(6.16) 10(6.85) Farmers 2(1.37) 2(1.37) 2 (1.37) Freelance 7(4.79) 24 (16.44) 14(9.59) Retired, unemployment 2(1.37) 11 (7.53) 9 (6.16) Household income (million), n (%) 0.168 < 0.3 1(0.68) 8(5.48) 8 (5.48) 0.3- < 0.6 9(6.16) 19 (13.01) 19(13.01) 0.6-1 6(4.11) 38 (26.03) 15(10.27) > 1 5(3.42) 11 (7.53) 7 (4.79) Fracture history, n (%) 2(1.37) 1(0.68) 0 0.054 Family history, n (%) 1(0.68) 6(4.11) 3 (2.05) 1.000 Smoking history, n (%) 16 (10.96) 42 (27.70) 20(13.70) 0.022 Alcohol consumption, n (%) 16 (10.96) 46 (31.51) 28 (19.18) 0.310 Data were present as Mean ± SD or n (%).
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Table 3. Comparison of activity levels and sunlight exposure across different bone mass groups
Item Osteoporosis Osteopenia Normal χ2 P Activity 10.994 0.027 Low 10(6.85%) 31 (21.23%) 12(8.22%) Middle 6(4.11%) 29 (19.86%) 14(9.59%) High 5(3.42%) 16 (10.96%) 23(15.75%) Sunshine 11.572 0.021 < 30min 15(10.27%) 38 (26.03%) 16(10.96%) 30-60min 4(2.74%) 34 (23.29%) 26(17.81%) > 60min 2 (1.37%) 4 (2.74%) 7 (4.79%)
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Table 4. Correlation analysis between dietary pattern and bone mass level
Diet Osteoporosis Osteopenia Normal number of people (N) Constituent ratio (%) number of people (N) Constituent ratio (%) number of people (N) Constituent ratio (%) Vegetable, meat and egg 2 (-2.3) 1.370 26(0.9) 17.808 17(0.7) 11.644 Balanced 5 (-1.3) 3.425 31(1.2) 21.233 17(-0.3) 11.644 Heavy oil and high salt 14 (3.6) 9.589 19 (-2.1) 13.017 15 (-0.4) 10.274 Figures in brackets are adjusted residuals.
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Table 5. Comparison of bone mass levels between the pro-inflammatory diet group and the anti-inflammatory diet group
Bone mass level Pro-inflammatory diet Anti-inflammatory diet χ2 P Osteoporosis 19 (13.01%) 2 (1.27%) 19.385 < 0.001 Osteopenia 54 (36.97%) 22 (15.07%) Normal 20 (13.70%) 29 (19.86%)
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Table 6. Results of binary logistic regression analysis
Item β s.E. wald χ2 P OR 95%CI Smoking History No vs. Yes 1.388 0.616 5.085 0.024 4.008 1.199, 13.398 Sunshine 30-60 min vs. < 30 min -0.293 0.655 0.200 0.655 0.746 0.207, 2.694 > 60 min vs. < 30 min 0.092 0.717 0.017 0.897 1.097 0.269, 4.469 Activity Middle vs. Low -1.323 0.674 3.845 0.050 0.266 0.071, 0.999 High vs. Low -0.749 0.993 0.569 0.451 0.473 0.068, 3.310 Dietary pattern Heavy oil and salt diet vs. Vegetables, meat and eggs diet 2.254 0.850 7.031 0.008 9.526 1.800, 50.411 Balanced diet vs. Vegetables, meat and eggs diet 0.711 0.922 0.594 0.441 2.035 0.334, 12.401 Dietary inflammatory index Anti-inflammatory diet vs. Pro-inflammatory diet 1.984 0.825 5.784 0.016 7.273 1.444, 36.644
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