Fruit and vegetable consumption and the risk of postmenopausal osteoporosis: a meta-analysis of observational studies

The association of the consumption of fruit and vegetables (FV) and the risk of postmenopausal osteoporosis (PMOP) has been a controversial subject. Thus, we carried out a meta-analysis to evaluate the association of FV consumption and the risk of PMOP. PubMed, Web of Science and Wan Fang were searched for relevant articles published up to March 2018. To evaluate the association of FV intake and PMOP risk, combined odds ratio (OR) and 95% confidence intervals (CIs) were calculated with the fixed or random effects model. Eighteen studies involving 12643 participants were included in this meta-analysis. When comparing the highest with the lowest consumption, the pooled OR of PMOP was 0.68 (95% CI, 0.56-0.83; I-2 = 57.3%; REM) for fruit and 0.87 (95% CI, 0.65-1.16; I-2 = 68.9%; REM) for vegetables. For the intake of fruit and the risk of PMOP, subgroup analysis showed a significant association in case-control studies (OR, 0.52; 95% CI, 0.35-0.77; I-2 = 3.1%; FEM) and cross-sectional studies (OR, 0.73; 95% CI, 0.59-0.89; I-2 = 61.1%; REM). For the intake of vegetables and the risk of PMOP, subgroup analysis showed a significant association in case-control studies (OR, 0.62; 95% CI, 0.42-0.90; I-2 = 0.0%; FEM) but not in cross-sectional studies (OR, 0.95; 95% CI, 0.69-1.29; I-2 = 68.9%; REM). This meta-analysis indicates that fruit intake might be beneficial for the prevention of osteoporosis in postmenopausal women. The findings need to be confirmed by further investigations.