Abstract
BACKGROUND: The impact of dietary carbohydrate intake on bone health remains a subject of controversy, potentially influenced by individuals with diabetic osteoporosis who exhibit normal or elevated bone mineral density (BMD). The cross-sectional study was conducted to explore the association between carbohydrate intake and BMD, osteoporosis and fractures among adults without diabetes, based on the National health and nutrition examination survey (NHANES). METHODS: Participants were from the NHANES 2005-2010, excluding individuals with diabetes and those with incomplete data. The association between carbohydrate intake and BMD was analyzed using Spearman correlation, linear regression analysis and subgroup analysis, respectively. The association between carbohydrate intake and osteoporosis/fractures was analyzed using weighted logistic regression analysis. RESULTS: A total of 7275 adult participants were included and their dietary carbohydrate intake was inversely associated with BMD in the total femur [β = -0.20 95%CI (-0.30, -0.10); p < 0.001], femoral neck [β = -0.10 95%CI (-0.20, -0.00); p = 0.002], and lumbar spine [β = -0.10 95%CI (-0.20, -0.00); p = 0.004]. Stratified analysis indicated that individuals aged 65 and over, women, and non-Hispanic whites were more likely to have lower BMD. Furthermore, a higher intake of dietary carbohydrates was associated with an increased risk of osteoporosis [OR = 1.001 95%CI (1.001, 1.001); p < 0.001] and fractures at the hip [OR = 1.005 95%CI (1.005, 1.005); p < 0.001], wrist [OR = 1.001 95%CI (1.001, 1.001), p < 0.001], and spine [OR = 1.003 95%CI(1.003, 1.003); p < 0.001]. CONCLUSIONS: A higher carbohydrate diet is associated with lower BMD and a higher risk of osteoporosis and fractures among adults without diabetes, and a higher carbohydrate consumption show a stronger effect in individuals aged 65 and over, women, and non-Hispanic whites.