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Nutritional Epidemiology

Predictors of Change in Calcium Intake in Postmenopausal Women after Osteoporosis Screening^1,2

³ Department of Exercise and Nutrition Science, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214; ⁴ Department of Epidemiology and Cancer Control, Division of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Buffalo, NY 14263; ⁵ Department of Social and Preventive Medicine, School of Public Health and Health Professions and ⁶ Department of Gynecology-Obstetrics, School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14214

^* To whom correspondence should be addressed. E-mail: jww{at}buffalo.edu.

Osteoporosis is a serious public health concern. Understanding the extent to which a bone density assessment affects change in dietary intake in postmenopausal women is needed. This study investigated whether results of bone density screening tests resulted in reported initiation or change in either dietary and/or supplemental calcium intake. Between 1997 and 2000, dual-energy X-ray absorptiometry (DXA) screening was conducted on 1468 postmenopausal women as part of an ancillary study of the Women's Health Initiative Observational Study in Buffalo, New York. One year after bone density testing, a questionnaire was sent to determine change in lifestyle behaviors and dietary intake. Participants included in this analysis were 923 Caucasian women who had not had a prior bone density screening test, reported no prior diagnosis of osteoporosis and were not taking medication (other than hormone therapy) for osteoporosis. Of these, according to WHO T-score criteria, 36% had osteoporosis, 48% had osteopenia, and 17% had normal bone density. Factors associated (P < 0.05) with increase in calcium intake in crude analyses included: BMI, follow-up consultation with a health care provider, and osteopenia or osteoporosis compared with normal T-score level. In multivariate adjusted analyses, both osteopenia [OR = 2.37, 95% CI (1.45–3.89); P = 0.001] and osteoporosis [OR = 3.86, 95% CI (2.30–6.46); P = <0.001] found on DXA were strong independent predictors of women's decision to start or increase calcium intake. This study provided evidence that the results of osteoporosis DXA screening influence postmenopausal women's decisions to increase calcium intake.