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Mediterranean Diet, Body Composition, and Activity Associated With Bone Health in Women With Fibromyalgia Syndrome

Correa-Rodríguez, María; El Mansouri-Yachou, Jamal; Tapia-Haro, Rosa María; Molina, Francisco; Rus, Alma; Rueda-Medina, Blanca; Aguilar-Ferrandiz, María Encarnación

doi: 10.1097/NNR.0000000000000361
FEATURE ARTICLES
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Background There is very little scientific literature on the potential relationships between modifiable factors, including body composition, dietary pattern and physical activity (PA), and bone status in patients with fibromyalgia—a musculoskeletal condition characterized by chronic, widespread pain that is often accompanied by a broad spectrum of symptoms.

Objectives The aim of the study was to investigate the impact of body composition parameters, adherence to the Mediterranean diet (Med Diet), and PA on bone health in a population of premenopausal and postmenopausal women with fibromyalgia syndrome (FMS).

Methods Ninety-five women diagnosed with FMS were included in this cross-sectional study. Body composition, including fat mass, percentage of fat mass, and lean mass (LM), were calculated using a body composition analyzer. Adherence to the Med Diet was measured through a validated 14-item questionnaire. The International Physical Activity Questionnaire was used to assess PA. Bone mass at the calcaneus was estimated through quantitative ultrasound.

Results Linear regression analysis revealed that LM had a significant association with broadband ultrasound attenuation (β = 0.211, 95% CI [0.046, 1.259], p = .035) and stiffness index parameters (β = 0.201, 95% CI [0.019, 1.654], p = .045) after adjusting for age and menopausal status. The Med Diet was also significantly associated with broadband ultrasound attenuation (β = 1.693, 95% CI [0.508, 2.879], p = .006).

Discussion LM and the Med Diet were consistently associated with calcaneal quantitative ultrasound parameters, supporting the hypothesis that LM and adherence to the Med Diet play determinant roles in bone health in FMS women. Training programs to maximize LM and strategies for promoting good adherence to the Med Diet should be considered in order to prevent the development of osteoporosis in FMS women. Because nurses are involved in implementing preventive programs, their roles in promoting this adherence to the Med Diet and maximizing LM in patients with FMS should help reduce the impact of osteoporosis.

María Correa-Rodríguez, PhD, RN, is Associate Professor, Instituto de Investigación Biosanitaria Granada, Department of Nursing, Faculty of Health Sciences, University of Granada, Spain.

Jamal El Mansouri-Yachou, MSOT, OT, is PhD Candidate, Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Spain.

Rosa María Tapia-Haro, MSPT, PT, OT, is PhD Candidate, Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Spain.

Francisco Molina, PhD, PT, is Associate Professor, Department of Health Sciences, University of Jaén, Paraje Las Lagunillas, Spain.

Alma Rus, PhD, BSc, is Associate Professor, Department of Cell Biology, University of Granada, Campus Fuentenueva, Spain.

Blanca Rueda-Medina, PhD, BSc, RN, is Professor, Instituto de Investigación Biosanitaria Granada, Department of Nursing, Faculty of Health Sciences, University of Granada, Spain.

María Encarnación Aguilar-Ferrandiz, PhD, PT, is Associate Professor, Instituto de Investigación Biosanitaria Granada, Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Spain.

Accepted for publication November 26, 2018.

The authors would like to thank AFIXA (Asociación de Fibromialgia de Jaén) and AGRAMFIM (Asociación Granadina de Fibromialgia) associations and especially all participants of this study for their insightful contribution. This article is part of the PhD thesis developed by Jamal El Mansouri-Yachou and is included in the Official PhD Program of Biomedicine from the University of Granada, Spain.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Written informed consent was obtained for all participants.

The authors have no conflicts of interest to report.

Corresponding author: Francisco Molina, PhD, PT, Department of Health Sciences, University of Jaén, Paraje Las Lagunillas s/n, 23071, Jaén, Spain (e-mail: fjmolina@ujaen.es).

Online date: April 2, 2019

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