The relationship between osteoporosis and socioeconomic
status has never been explored even though
income and education-related lifestyle factors, such as
diet and activity, are known to affect bone status. The
primary objectives of this study are to determine if an
association exists, and if bone density is higher among
the poor who participate in food assistance programs.
The authors used the National Health and Nutrition
Examination Survey (NHANES) III, 1988-94 for their
analysis. They limited their sample to nonpregnant
premenopausal women aged 20 years and older; postmenopausal
women; and men age 50 and older. Their
outcome variables were bone mineral density (BMD,
g/cm2) for the femoral neck and total body. They used
multiple linear regression to assess relationships
between participation in the Special Supplemental
Nutrition Program for Women, Infants, and Children
(WIC) and the Food Stamp Program, and bone density.
They also included age, nutrient intakes, physical
activity, oral contraceptive use, pregnancy history,
income, education, and cultural factors indicated by
language spoken at home and place of birth in the
regression models.
The authors found that education was a positive predictor
of BMD in all three groups—premenopausal
women, postmenopausal women, and men—but only
among whites. Participation in WIC was not related to
BMD. Participation in the Food Stamp Program was
associated with lower BMD in low-income Mexican
American men and African American postmenopausal
women. In premenopausal women, neither participation
in the Food Stamp Program nor in WIC was associated
with BMD. As in the Frongillo and Lee study,
these results are likely to derive from the participants’
reasons for entering the programs, rather than from
program impacts. Further research is needed to address
the potential impacts of length of participation in food
assistance programs on BMD.