Association between bone discordance and dietary pattern among Iranian postmenopausal women
-
Leila Khorrami-nezhad
,
Sajjad Moradi
,
Azadeh Dehghan
,
Zahra Veysi
,
Mir saeed Yekaninejad
,
Zhila Maghbooli
,
Khadijeh Mirzaei
Abstract
Background: Bone discordance considered a new challenge to a diagnosis of osteoporosis, especially among postmenopausal women, there are many causes have been proposed for the occurrence of this phenomenon. This study was conducted to investigate the relation between major dietary patterns and bone discordance in postmenopausal women.
Methods: In this cross-sectional study, 258 postmenopausal women completed demographic data from June 2015 to February 2016. Dietary intake was assessed with a validated food frequency questionnaire (FFQ). Dietary patterns were created by PCA method from 25 food groups. Dual-energy x-ray absorptiometry (DXA) was performed on lumbar (L2-L4) and hip for cases.
Results: Three major dietary patterns were identified by using factor analysis based on baseline intake data: Unhealthy, Mediterranean and Western diet. After analysis, we found 55.41% were concordance and 44.56% (4.26% were in the major discordance group of participants were discordance. We found participants who were in discordance group were younger, and obese participants were more talented to be in the major discordance group. We found an inversely relationship between unhealthy dietary pattern and hip and lumbar Z score, while there was a positive relationship between Mediterranean dietary pattern and hip BMD. No associations were found between dietary pattern and bone discordance.
Conclusion: This study concluded that bone discordance was directly related to obesity. Obese and younger women were at risk of bone discordance. Unhealthy and a Mediterranean dietary pattern were negatively and positively related to bone density among postmenopausal women
1. Moayyeri A, Soltani A, Tabari NK, Sadatsafavi M, Hossein-neghad A, Larijani B. Discordance in diagnosis of osteoporosis using spine and hip bone densitometry. BMC endocrine disorders. 2005;5(1):3.
2. Mounach A, Abayi DM, Ghazi M, Ghozlani I, Nouijai A, Achemlal L, et al., editors. Discordance between hip and spine bone mineral density measurement using DXA: prevalence and risk factors. Seminars in arthritis and rheumatism; 2009: Elsevier.
3. Faulkner KG, von Stetten E, Miller P. Discordance in patient classification using T-scores. Journal of Clinical Densitometry. 1999;2(3):343-50.
4. El Maghraoui A, Abayi DM, Rkain H, Mounach A. Discordance in diagnosis of osteoporosis using spine and hip bone densitometry. Journal of Clinical Densitometry. 2007;10(2):153-6.
5. Mounach A, Abayi DM, Ghazi M, Ghozlani I, Nouijai A, Achemlal L, et al., editors. Discordance between hip and spine bone mineral density measurement using DXA: prevalence and risk factors. Seminars in arthritis and rheumatism; 2009: Elsevier.
6. Tuchendler D, Bolanowski M. The influence of thyroid dysfunction on bone metabolism. Thyroid research. 2014;7(1):12.
7. Williams GR. Actions of thyroid hormones in bone. Endokrynol Pol. 2009;60(5):380-8.
8. Dennison EM, Compston JE, Flahive J, Siris ES, Gehlbach SH, Adachi JD, et al. Effect of co-morbidities on fracture risk: findings from the Global Longitudinal Study of Osteoporosis in Women (GLOW). Bone. 2012;50(6):1288-93.
9. Farhat GN, Cauley JA. The link between osteoporosis and cardiovascular disease. Clinical cases in mineral and bone metabolism. 2008;5(1):19-34.
10. Zhang Y, Min S. Analysis of clinical factors correlating with osteoporosis in patients with type 2 diabetes mellitus. Nan fang yi ke da xue xue bao= Journal of Southern Medical University. 2016;36(11):1546.
11. Zhou L, Song J, Yang S, Meng S, Lv X, Yue J, et al. Bone mass loss is associated with systolic blood pressure in postmenopausal women with type 2 diabetes in Tibet: a retrospective cross-sectional study. Osteoporosis International. 2017:1-6.
12. Vuolo L, Barrea L, Savanelli M, Savastano S, Rubino M, Scarano E, et al. Nutrition and Osteoporosis: Preliminary data of Campania Region of European PERsonalised ICT Supported Service for Independent Living and Active Ageing. Translational medicine@ UniSa. 2015;13:13.
13. Hirota T, Hirota K. [Bone and Nutrition. Nutritional management of osteoporosis]. Clinical calcium. 2014;25(7):1049-55.
14. Offord E, Karagounis L, Vidal K, Fielding R, Meydani S, Penninger J. Nutrition and the biology of human ageing: Bone health & osteoporosis/sarcopenia/immune deficiency. The journal of nutrition, health & aging. 2013;17(8):712-6.
15. Dai Z, Butler LM, van Dam RM, Ang L-W, Yuan J-M, Koh W-P. Adherence to a vegetable-fruit-soy dietary pattern or the Alternative Healthy Eating Index is associated with lower hip fracture risk among Singapore Chinese. The Journal of nutrition. 2014;144(4):511-8.
16. Zeng F-f, Wu B-h, Fan F, Xie H-l, Xue W-q, Zhu H-l, et al. Dietary patterns and the risk of hip fractures in elderly Chinese: a matched case-control study. The Journal of Clinical Endocrinology & Metabolism. 2013;98(6):2347-55.
17. Park S-J, Joo S-E, Min H, Park JK, Kim Y, Kim SS, et al. Dietary patterns and osteoporosis risk in postmenopausal Korean women. Osong Public Health and Research Perspectives. 2012;3(4):199-205.
18. Munger RG, Cerhan JR, Chiu BC. Prospective study of dietary protein intake and risk of hip fracture in postmenopausal women. The American journal of clinical nutrition. 1999;69(1):147-52.
19. Tucker KL, Chen H, Hannan MT, Cupples LA, Wilson PW, Felson D, et al. Bone mineral density and dietary patterns in older adults: the Framingham Osteoporosis Study. The American journal of clinical nutrition. 2002;76(1):245-52.
20. Samieri C, Coupez VG, Lorrain S, Letenneur L, Alles B, Feart C, et al. Nutrient patterns and risk of fracture in older subjects: results from the Three-City Study. Osteoporosis International. 2013;24(4):1295-305.
21. Chen G-d, Dong X-w, Zhu Y-Y, Tian H-y, He J, Chen Y-m. Adherence to the Mediterranean diet is associated with a higher BMD in middle-aged and elderly Chinese. Scientific reports. 2016;6.
22. Mirzaei K, Hossein-nezhad A, Keshavarz SA, Koohdani F, Saboor-Yaraghi AA, Hosseini S, et al. Crosstalk between circulating peroxisome proliferator-activated receptor gamma, adipokines and metabolic syndrome in obese subjects. Diabetology & metabolic syndrome. 2013;5(1):1.
23. Mirzaei K, Hossein-nezhad A, Aslani S, Emamgholipour S, Karimi M, Keshavarz S. Energy expenditure regulation via macrophage migration inhibitory factor in obesity and in vitro anti-macrophage migration inhibitory factor effect of Alpinia officinarum hance extraction. Endocrine Practice. 2011;18(1):39-48.
24. Mirmiran P, Esfahani FH, Mehrabi Y, Hedayati M, Azizi F. Reliability and relative validity of an FFQ for nutrients in the Tehran Lipid and Glucose Study. Public health nutrition. 2010;13(05):654-62.
25. Azar M, Sarkisian E. Food composition table of Iran: National Nutrition and Food Research Institute. Shaheed Beheshti University, Tehran. 1980.
26. Mirmiran P, Hosseini-Esfahani F, Jessri M, Mahan LK, Shiva N, Azizi F. Does dietary intake by Tehranian adults align with the 2005 dietary guidelines for Americans? Observations from the Tehran lipid and glucose study. Journal of Health, Population and Nutrition. 2011:39-52.
27. de França N, Camargo M, Lazaretti-Castro M, Peters B, Martini L. Dietary patterns and bone mineral density in Brazilian postmenopausal women with osteoporosis: a cross-sectional study. European journal of clinical nutrition. 2015.
28. Mahdaviroshan M, Ebrahimimameghani M. Assessments of dietary pattern and nutritional intake in osteoporotic patients in Tabriz. Journal of Paramedical Sciences. 2014;5(3).
29. http://www.stattutorials.com/SPSS/TUTORIAL-SPSS-Interrater-Reliability-Kappa.htm.
30. Derakhshan S, Shahsavari S. Discordance in diagnosis of osteoporosis using spine and femur bone densitometry: prevalence and related factors. Iranian Journal of Nuclear Medicine. 2012;20(2):14-9.
31. Moayyeri A, Soltani A, Tabari NK, Sadatsafavi M, Hossein-neghad A, Larijani B. Discordance in diagnosis of osteoporosis using spine and hip bone densitometry. BMC endocrine disorders. 2005;5(1):1.
32. Fairweather-Tait SJ, Skinner J, Guile GR, Cassidy A, Spector TD, MacGregor AJ. Diet and bone mineral density study in postmenopausal women from the TwinsUK registry shows a negative association with a traditional English dietary pattern and a positive association with wine. The American journal of clinical nutrition. 2011;94(5):1371-5.
33. Vokes TJ, Gillen DL, Lovett J, Favus MJ. Comparison of T-scores from different skeletal sites in differentiating postmenopausal women with and without prevalent vertebral fractures. Journal of Clinical Densitometry. 2005;8(2):206-15.
34. Pedone C, Napoli N, Pozzilli P, Lauretani F, Bandinelli S, Ferrucci L, et al. Quality of diet and potential renal acid load as risk factors for reduced bone density in elderly women. Bone. 2010;46(4):1063-7.
35. Hardcastle A, Aucott L, Fraser W, Reid D, Macdonald H. Dietary patterns, bone resorption and bone mineral density in early post-menopausal Scottish women. European journal of clinical nutrition. 2011;65(3):378-85.
36. Langsetmo L, Poliquin S, Hanley DA, Prior JC, Barr S, Anastassiades T, et al. Dietary patterns in Canadian men and women ages 25 and older: relationship to demographics, body mass index, and bone mineral density. BMC musculoskeletal disorders. 2010;11(1):1.
37. Lin P-H, Ginty F, Appel LJ, Aickin M, Bohannon A, Garnero P, et al. The DASH diet and sodium reduction improve markers of bone turnover and calcium metabolism in adults. The Journal of nutrition. 2003;133(10):3130-6.
38. Okubo H, Sasaki S, Horiguchi H, Oguma E, Miyamoto K, Hosoi Y, et al. Dietary patterns associated with bone mineral density in premenopausal Japanese farmwomen. The American journal of clinical nutrition. 2006;83(5):1185-92.
39. van den Hooven EH, Ambrosini GL, Huang R-C, Mountain J, Straker L, Walsh JP, et al. Identification of a dietary pattern prospectively associated with bone mass in Australian young adults. The American journal of clinical nutrition. 2015;102(5):1035-43.
40. Shin S, Sung J, Joung H. A fruit, milk and whole grain dietary pattern is positively associated with bone mineral density in Korean healthy adults. European journal of clinical nutrition. 2015;69(4):442-8.
41. Tucker KL, Hannan MT, Kiel DP. The acid-base hypothesis: diet and bone in the Framingham Osteoporosis Study. European journal of nutrition. 2001;40(5):231-7.
42. New SA, Robins SP, Campbell MK, Martin JC, Garton MJ, Bolton-Smith C, et al. Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable consumption and bone health? The American journal of clinical nutrition. 2000;71(1):142-51.
43. Rafferty K, Davies KM, Heaney RP. Potassium intake and the calcium economy. Journal of the American College of Nutrition. 2005;24(2):99-106.
44. Maurer M, Riesen W, Muser J, Hulter HN, Krapf R. Neutralization of Western diet inhibits bone resorption independently of K intake and reduces cortisol secretion in humans. American Journal of Physiology-Renal Physiology. 2003;284(1):F32-F40.
45. Jehle S, Zanetti A, Muser J, Hulter HN, Krapf R. Partial neutralization of the acidogenic Western diet with potassium citrate increases bone mass in postmenopausal women with osteopenia. Journal of the American Society of Nephrology. 2006;17(11):3213-22.
46. Krieger NS, Sessler NE, Bushinsky DA. Acidosis inhibits osteoblastic and stimulates osteoclastic activity in vitro. American Journal of Physiology-Renal Physiology. 1992;262(3):F442-F8.
47. Karamati M, Yousefian-Sanni M, Shariati-Bafghi S-E, Rashidkhani B. Major Nutrient Patterns and Bone Mineral Density among Postmenopausal Iranian Women. Calcified tissue international. 2014;94(6):648-58.
48. Wachman A, Bernstein D. Diet and osteoporosis. The Lancet. 1968;291(7549):958-9.
49. New SA, Bolton-Smith C, Grubb DA, Reid DM. Nutritional influences on bone mineral density: a cross-sectional study in premenopausal women. The American journal of clinical nutrition. 1997;65(6):1831-9.
50. Eriksen E, Axelrod D, Melsen F. Bone histomorphometry Raven Press. New York. 1994.
51. Clarke B. Normal bone anatomy and physiology. Clinical journal of the American Society of Nephrology. 2008;3(Supplement 3):S131-S9.
2. Mounach A, Abayi DM, Ghazi M, Ghozlani I, Nouijai A, Achemlal L, et al., editors. Discordance between hip and spine bone mineral density measurement using DXA: prevalence and risk factors. Seminars in arthritis and rheumatism; 2009: Elsevier.
3. Faulkner KG, von Stetten E, Miller P. Discordance in patient classification using T-scores. Journal of Clinical Densitometry. 1999;2(3):343-50.
4. El Maghraoui A, Abayi DM, Rkain H, Mounach A. Discordance in diagnosis of osteoporosis using spine and hip bone densitometry. Journal of Clinical Densitometry. 2007;10(2):153-6.
5. Mounach A, Abayi DM, Ghazi M, Ghozlani I, Nouijai A, Achemlal L, et al., editors. Discordance between hip and spine bone mineral density measurement using DXA: prevalence and risk factors. Seminars in arthritis and rheumatism; 2009: Elsevier.
6. Tuchendler D, Bolanowski M. The influence of thyroid dysfunction on bone metabolism. Thyroid research. 2014;7(1):12.
7. Williams GR. Actions of thyroid hormones in bone. Endokrynol Pol. 2009;60(5):380-8.
8. Dennison EM, Compston JE, Flahive J, Siris ES, Gehlbach SH, Adachi JD, et al. Effect of co-morbidities on fracture risk: findings from the Global Longitudinal Study of Osteoporosis in Women (GLOW). Bone. 2012;50(6):1288-93.
9. Farhat GN, Cauley JA. The link between osteoporosis and cardiovascular disease. Clinical cases in mineral and bone metabolism. 2008;5(1):19-34.
10. Zhang Y, Min S. Analysis of clinical factors correlating with osteoporosis in patients with type 2 diabetes mellitus. Nan fang yi ke da xue xue bao= Journal of Southern Medical University. 2016;36(11):1546.
11. Zhou L, Song J, Yang S, Meng S, Lv X, Yue J, et al. Bone mass loss is associated with systolic blood pressure in postmenopausal women with type 2 diabetes in Tibet: a retrospective cross-sectional study. Osteoporosis International. 2017:1-6.
12. Vuolo L, Barrea L, Savanelli M, Savastano S, Rubino M, Scarano E, et al. Nutrition and Osteoporosis: Preliminary data of Campania Region of European PERsonalised ICT Supported Service for Independent Living and Active Ageing. Translational medicine@ UniSa. 2015;13:13.
13. Hirota T, Hirota K. [Bone and Nutrition. Nutritional management of osteoporosis]. Clinical calcium. 2014;25(7):1049-55.
14. Offord E, Karagounis L, Vidal K, Fielding R, Meydani S, Penninger J. Nutrition and the biology of human ageing: Bone health & osteoporosis/sarcopenia/immune deficiency. The journal of nutrition, health & aging. 2013;17(8):712-6.
15. Dai Z, Butler LM, van Dam RM, Ang L-W, Yuan J-M, Koh W-P. Adherence to a vegetable-fruit-soy dietary pattern or the Alternative Healthy Eating Index is associated with lower hip fracture risk among Singapore Chinese. The Journal of nutrition. 2014;144(4):511-8.
16. Zeng F-f, Wu B-h, Fan F, Xie H-l, Xue W-q, Zhu H-l, et al. Dietary patterns and the risk of hip fractures in elderly Chinese: a matched case-control study. The Journal of Clinical Endocrinology & Metabolism. 2013;98(6):2347-55.
17. Park S-J, Joo S-E, Min H, Park JK, Kim Y, Kim SS, et al. Dietary patterns and osteoporosis risk in postmenopausal Korean women. Osong Public Health and Research Perspectives. 2012;3(4):199-205.
18. Munger RG, Cerhan JR, Chiu BC. Prospective study of dietary protein intake and risk of hip fracture in postmenopausal women. The American journal of clinical nutrition. 1999;69(1):147-52.
19. Tucker KL, Chen H, Hannan MT, Cupples LA, Wilson PW, Felson D, et al. Bone mineral density and dietary patterns in older adults: the Framingham Osteoporosis Study. The American journal of clinical nutrition. 2002;76(1):245-52.
20. Samieri C, Coupez VG, Lorrain S, Letenneur L, Alles B, Feart C, et al. Nutrient patterns and risk of fracture in older subjects: results from the Three-City Study. Osteoporosis International. 2013;24(4):1295-305.
21. Chen G-d, Dong X-w, Zhu Y-Y, Tian H-y, He J, Chen Y-m. Adherence to the Mediterranean diet is associated with a higher BMD in middle-aged and elderly Chinese. Scientific reports. 2016;6.
22. Mirzaei K, Hossein-nezhad A, Keshavarz SA, Koohdani F, Saboor-Yaraghi AA, Hosseini S, et al. Crosstalk between circulating peroxisome proliferator-activated receptor gamma, adipokines and metabolic syndrome in obese subjects. Diabetology & metabolic syndrome. 2013;5(1):1.
23. Mirzaei K, Hossein-nezhad A, Aslani S, Emamgholipour S, Karimi M, Keshavarz S. Energy expenditure regulation via macrophage migration inhibitory factor in obesity and in vitro anti-macrophage migration inhibitory factor effect of Alpinia officinarum hance extraction. Endocrine Practice. 2011;18(1):39-48.
24. Mirmiran P, Esfahani FH, Mehrabi Y, Hedayati M, Azizi F. Reliability and relative validity of an FFQ for nutrients in the Tehran Lipid and Glucose Study. Public health nutrition. 2010;13(05):654-62.
25. Azar M, Sarkisian E. Food composition table of Iran: National Nutrition and Food Research Institute. Shaheed Beheshti University, Tehran. 1980.
26. Mirmiran P, Hosseini-Esfahani F, Jessri M, Mahan LK, Shiva N, Azizi F. Does dietary intake by Tehranian adults align with the 2005 dietary guidelines for Americans? Observations from the Tehran lipid and glucose study. Journal of Health, Population and Nutrition. 2011:39-52.
27. de França N, Camargo M, Lazaretti-Castro M, Peters B, Martini L. Dietary patterns and bone mineral density in Brazilian postmenopausal women with osteoporosis: a cross-sectional study. European journal of clinical nutrition. 2015.
28. Mahdaviroshan M, Ebrahimimameghani M. Assessments of dietary pattern and nutritional intake in osteoporotic patients in Tabriz. Journal of Paramedical Sciences. 2014;5(3).
29. http://www.stattutorials.com/SPSS/TUTORIAL-SPSS-Interrater-Reliability-Kappa.htm.
30. Derakhshan S, Shahsavari S. Discordance in diagnosis of osteoporosis using spine and femur bone densitometry: prevalence and related factors. Iranian Journal of Nuclear Medicine. 2012;20(2):14-9.
31. Moayyeri A, Soltani A, Tabari NK, Sadatsafavi M, Hossein-neghad A, Larijani B. Discordance in diagnosis of osteoporosis using spine and hip bone densitometry. BMC endocrine disorders. 2005;5(1):1.
32. Fairweather-Tait SJ, Skinner J, Guile GR, Cassidy A, Spector TD, MacGregor AJ. Diet and bone mineral density study in postmenopausal women from the TwinsUK registry shows a negative association with a traditional English dietary pattern and a positive association with wine. The American journal of clinical nutrition. 2011;94(5):1371-5.
33. Vokes TJ, Gillen DL, Lovett J, Favus MJ. Comparison of T-scores from different skeletal sites in differentiating postmenopausal women with and without prevalent vertebral fractures. Journal of Clinical Densitometry. 2005;8(2):206-15.
34. Pedone C, Napoli N, Pozzilli P, Lauretani F, Bandinelli S, Ferrucci L, et al. Quality of diet and potential renal acid load as risk factors for reduced bone density in elderly women. Bone. 2010;46(4):1063-7.
35. Hardcastle A, Aucott L, Fraser W, Reid D, Macdonald H. Dietary patterns, bone resorption and bone mineral density in early post-menopausal Scottish women. European journal of clinical nutrition. 2011;65(3):378-85.
36. Langsetmo L, Poliquin S, Hanley DA, Prior JC, Barr S, Anastassiades T, et al. Dietary patterns in Canadian men and women ages 25 and older: relationship to demographics, body mass index, and bone mineral density. BMC musculoskeletal disorders. 2010;11(1):1.
37. Lin P-H, Ginty F, Appel LJ, Aickin M, Bohannon A, Garnero P, et al. The DASH diet and sodium reduction improve markers of bone turnover and calcium metabolism in adults. The Journal of nutrition. 2003;133(10):3130-6.
38. Okubo H, Sasaki S, Horiguchi H, Oguma E, Miyamoto K, Hosoi Y, et al. Dietary patterns associated with bone mineral density in premenopausal Japanese farmwomen. The American journal of clinical nutrition. 2006;83(5):1185-92.
39. van den Hooven EH, Ambrosini GL, Huang R-C, Mountain J, Straker L, Walsh JP, et al. Identification of a dietary pattern prospectively associated with bone mass in Australian young adults. The American journal of clinical nutrition. 2015;102(5):1035-43.
40. Shin S, Sung J, Joung H. A fruit, milk and whole grain dietary pattern is positively associated with bone mineral density in Korean healthy adults. European journal of clinical nutrition. 2015;69(4):442-8.
41. Tucker KL, Hannan MT, Kiel DP. The acid-base hypothesis: diet and bone in the Framingham Osteoporosis Study. European journal of nutrition. 2001;40(5):231-7.
42. New SA, Robins SP, Campbell MK, Martin JC, Garton MJ, Bolton-Smith C, et al. Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable consumption and bone health? The American journal of clinical nutrition. 2000;71(1):142-51.
43. Rafferty K, Davies KM, Heaney RP. Potassium intake and the calcium economy. Journal of the American College of Nutrition. 2005;24(2):99-106.
44. Maurer M, Riesen W, Muser J, Hulter HN, Krapf R. Neutralization of Western diet inhibits bone resorption independently of K intake and reduces cortisol secretion in humans. American Journal of Physiology-Renal Physiology. 2003;284(1):F32-F40.
45. Jehle S, Zanetti A, Muser J, Hulter HN, Krapf R. Partial neutralization of the acidogenic Western diet with potassium citrate increases bone mass in postmenopausal women with osteopenia. Journal of the American Society of Nephrology. 2006;17(11):3213-22.
46. Krieger NS, Sessler NE, Bushinsky DA. Acidosis inhibits osteoblastic and stimulates osteoclastic activity in vitro. American Journal of Physiology-Renal Physiology. 1992;262(3):F442-F8.
47. Karamati M, Yousefian-Sanni M, Shariati-Bafghi S-E, Rashidkhani B. Major Nutrient Patterns and Bone Mineral Density among Postmenopausal Iranian Women. Calcified tissue international. 2014;94(6):648-58.
48. Wachman A, Bernstein D. Diet and osteoporosis. The Lancet. 1968;291(7549):958-9.
49. New SA, Bolton-Smith C, Grubb DA, Reid DM. Nutritional influences on bone mineral density: a cross-sectional study in premenopausal women. The American journal of clinical nutrition. 1997;65(6):1831-9.
50. Eriksen E, Axelrod D, Melsen F. Bone histomorphometry Raven Press. New York. 1994.
51. Clarke B. Normal bone anatomy and physiology. Clinical journal of the American Society of Nephrology. 2008;3(Supplement 3):S131-S9.
| Files | ||
| Issue | Vol 2, No 3 (Summer 2016) | |
| Section | Original Article(s) | |
| Keywords | ||
| dietary pattern bone discordance unhealthy pattern Mediterranean pattern postmenopausal women | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Khorrami-nezhad L, Moradi S, Dehghan A, Veysi Z, Yekaninejad M saeed, Maghbooli Z, Mirzaei K. Association between bone discordance and dietary pattern among Iranian postmenopausal women. J Nutr Sci & Diet. 2017;2(3).
