Nutrient Intake in Postmenopausal Rheumatoid Arthritis Women with Osteoporosis: Results from the Korean National Health and Nutrition Examination Survey

ABSTRACT

OBJECTIVE: Osteoporosis (OP) is one of the principal comorbidities in women with rheumatoid arthritis (RA). Proper nutrition for these patients is required not only to improve bone health but to better manage their chronic illness. Thus, our aim was to assess the status of key nutrient intake in postmenopausal RA women with OP. METHODS: Using cross-sectional data of 4,933 postmenopausal women in the Korean National Health and Nutrition Examination Survey (K-NHANES IV, V) conducted between 2008 and 2011, we investigated the daily nutrient intake in RA subjects and their bone mineral density (BMD). We examined the association of nutrient intake and BMD after adjusting age, level of education, body mass index, family history, alcohol use, and total calorie intake in the osteoporosis, osteopenia, and normal BMD group using multivariable linear regression. RESULTS: We included 222 RA women and 320 controls whose BMD and T-score data were available. Low calcium and phosphorous intake were associated with reduced BMD T-scores in postmenopausal RA women. Additionally, β-carotene, potassium, riboflavin, and vitamin C intake were significantly lower in RA women with OP. Multivariable linear regression analysis showed a strong positive association of intake of β-carotene, potassium, riboflavin, and calcium with higher T-scores at the lumbar spine, femur neck, and total hip (all p<0.0001, respectively). CONCLUSION: We found insufficient intake of nutrients such as β-carotene, potassium, riboflavin, and vitamin C in Korean postmenopausal RA women with low BMD. Dietary counseling and recommendations are warranted for these subjects to attain better bone health.