Association of dietary oxidative balance score, dietary inflammatory potential and fractures among adults aged ≥ 40 years in the United States in 1999-2018.

BACKGROUND AND OBJECTIVES: The Dietary Oxidative Balance Score (DOBS) and Dietary Inflammatory Index (DII) reflect dietary oxidative and inflammatory status. This study investigated their associations with the prevalence of wrist, hip, and spine fractures. METHODS AND STUDY DESIGN: DOBS and DII were scored based on 16 and 28 dietary factors, respectively. Multivariate logistic regression models and restricted cubic spline (RCS) models were used to assess the associations of DOBS and DII with the prevalence of wrist, hip, and spine fractures. Temporal trends of DOBS and DII and their associations with fracture trends were also analyzed, with subgroup analyses for robustness. RESULTS: Compared with the lowest DOBS tertile, the highest DOBS tertile was associated with lower prevalence of hip and spine fractures [OR = 0.57 (0.32, 0.72); OR = 0.79 (0.48, 1.00)]. In contrast, the highest DII tertile was associated with an increased prevalence of hip and spine fractures compared with the lowest DII tertile [OR = 1.85 (1.49, 2.72); OR = 1.75 (1.18, 2.58)]. Anti-inflammatory and antioxidant diets were associated with lower prevalence of hip and spine fractures compared with pro-inflammatory and pro-oxidative diets [OR = 0.45 (0.24, 0.85); OR = 0.66 (0.44, 0.84)]. No significant associations were observed for wrist fractures. The overall DOBS trended upward among U.S. adults, while the DII showed opposite trend during the same period, with consistent results observed in subgroup analyses. CONCLUSION: Higher DOBS and/or lower DII were significantly associated with lower hip and spine fracture prevalence, but not with wrist fracture prevalence.