Dietary Patterns of Greek Adults and Their Associations with Serum Vitamin D Levels and Heel Quantitative Ultrasound Parameters for Bone Health

Abstract

The aim of this study is to investigate the dietary patterns which indicate the nutritional habits of Greek adults and their effects on serum 25(OH)D levels and quantitative ultrasound (QUS) parameters for bone health. This study is part of OSTEOS, an observational cross-sectional study. In total, 741 adults from rural and urban areas throughout Greece were recruited. A validated food frequency questionnaire (FFQ) was used for assessment of the population's dietary habits. Serum 25(OH)D was measured by enzyme immunoassay; QUS parameters were assessed with an Achilles device. Principal component analysis (PCA) was carried out for dietary pattern determination, and univariate analysis of variance was used for the assessment of 25(OH)D, broadband ultrasound attenuation (BUA), speed of sound (SOS), and stiffness index (SI) determinants. Six dietary patterns explain 52.2% of the variability of Greek adults' nutritional habits. The 'vegetables-fruit' dietary pattern explains the biggest rate of variability. Determinants of serum 25(OH)D are body mass index (BMI), elderly status, summer sun exposure, organized physical activity, a 'healthy' pattern in winter months, and adherence to a 'sweet' pattern. Determinants of QUS parameters are age, BMI, sedentary time, organized physical activity participation, and adherence to a 'healthy' pattern.

Keywords: 25(OH)D; Greece; QUS parameters; dietary patterns; lifestyle.

Figure 1

Distribution of scores derived from PCA (principal component analysis) among; (A) sex, (B) age groups, (C) serum vitamin D status, (D) season of blood sampling, and (E) area of residence. * p < 0.05, ** p < 0.01, *** p < 0.001, • mean, ₋ median.