New Study Highlights Benefits of Energy-Reduced Mediterranean Diet for Bone Health in Older Women

A recent research study published in JAMA Network Open found that older women with metabolic syndrome who have overweight/obesity can increase their BMD substantially. This improvement is due to adopting a more low-energy Mediterranean diet and raising their level of physical activity. This version of the classic Mediterranean diet reduces calories without sacrificing healthy food preferences. It can be an important partner in tackling the health impacts of aging.

The traditional Mediterranean diet celebrates seasonal fruits, colorful vegetables, filling legumes, flavorful olive oil, and seafood. Together, these two complementary foods provide a wealth of unsaturated fats and lean protein. Ideal ingredients for a nutritious diet. Not surprisingly, for years it has received praise for contributing to better health and longer lives. Yet, it frequently fails to include clear portion size recommendations. The energy-controlled implementation changes this by focusing on smaller portion sizes to create an overall calorie deficit that supports weight loss.

Dr. Jesús F. García-Gavilán, a lecturer at Universitat Rovira i Virgili in Spain, who co-led the study. For example, he told us how this diet can directly improve the lives of older women in the U.S who are at high risk for osteoporosis and osteoporotic fractures. Osteoporosis is a silent disease that affects an estimated one in three women and one in five men over the age of 50. This puts them at an amplified risk for the health impacts related to deteriorating bone density.

Study participants adhered to an energy-reduced Mediterranean dietary pattern and an established physical activity regimen. Over the course of three years, these lifestyle changes proved highly effective in reversing and preventing osteoporosis. Those effects were most acute in the lumbar area of the lower back.

“A well-balanced, reduced-calorie Mediterranean diet combined with physical activity can assist older women not only in losing weight but also in protecting their bones, particularly in the spine, where bone loss can lead to serious fractures and disability.” – F. García-Gavilán, PhD

These findings highlight the need to combine dietary management with increased physical activity, especially with respect to medication use. Dr. Monique Richard, a registered dietitian nutritionist, underscored that keeping bones healthy takes more than one approach.

“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.” – Monique Richard, MS, RDN, LDN

The study focused exclusively on those with metabolic syndrome. The condition includes a group of metabolic disorders including increased blood pressure, blood sugar, excess body fat around the waist and low levels of high-density lipoprotein (HDL) cholesterol, and high triglycerides. Participants in this group are at a significantly increased risk of heart disease and diabetes. This situation puts them in the perfect place to undergo weight loss interventions that have positive effects on bone density.

Dr. García-Gavilán expanded on the reasoning behind targeting this demographic.

“We focused on this group because they are more likely to receive recommendations to lose weight for their health, and weight loss can influence bone density, making them a critical population for this type of research.” – F. García-Gavilán, PhD

The lat long term effects of bone mineral density loss can be dire. All of these factors contribute to the high risk of death following a fracture in older adults, which Dr. Mir Ali emphasized.

“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.” – Mir Ali, MD

The latest study underscores the importance of nutritional direction in achieving optimal bone health. Partnering with registered dietitian nutritionists helps equip Americans to be able to assess how their nutrition stacks up. This process increases critical nutrients including protein, vitamin D, calcium, potassium, magnesium and selenium.

“In addition to looking at the diet and exercise, other things we recommend are vitamin D and calcium supplements so comparing groups that took these supplements versus not taking these supplements I think would be helpful.” – Mir Ali, MD

This study provides strong evidence that an energy-reduced Med diet can have strong bone protective benefits. Especially when combined with regular physical activity, this approach is great—not just for everyone’s overall health, but especially for older women battling metabolic hurdles. Such an approach not only makes weight loss more attainable, but goes a long way toward addressing key factors involved in maintaining bone density.