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Nonlinear dose-response relationship between dietary niacin intake and osteoporosis in U.S. adults over 50 years of age: a cross-sectional study of the 2007-2018 National Health and Nutrition Examination Survey (NHANES)

Jia Bai, Botao Gao, Jinyang An, Lingling Li, Yangyang Zhang, Xinsai Li, Shuyun Li, Haihong Lv

Prepublicado: 2025-09-16

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Background and objectives: osteoporosis (OP) is prevalent among older adults, and nutritional factors significantly contribute to its development. Although some studies suggest niacin may influence bone health, the existing evidence remains inconclusive. This study investigates the dose-response relationship between dietary niacin intake and osteoporosis risk in US adults aged 50 years or older, using nationally representative data from the National Health and Nutrition Examination Survey (NHANES, 2007-2018). Methods and design: this cross-sectional study included 2308 adults aged ≥ 50 years from the NHANES. Dietary niacin intake was assessed using two non-consecutive 24-hour dietary recalls. Weighted multivariable logistic regression analyzed associations between niacin and OP, while restricted cubic spline (RCS) models evaluated potential nonlinear dose-response relationships. Results: the baseline analysis revealed significantly lower dietary niacin intake levels among OP patients. Multivariable logistic regression demonstrated that, after adjusting for confounders, participants in the highest percentile of dietary niacin intake exhibited a significantly reduced OP risk compared to those in the lowest percentile (OR: 0.81, 95 % CI: 0.68-0.84, p = 0.03), with a significant dose-response trend (p for trend = 0.04). Using RCS modeling, this study is the first to identify a nonlinear dose-response relationship (inverted U-shaped curve, overall p < 0.05, nonlinear p < 0.05) between niacin intake and OP risk. Subgroup analyses further revealed sex-specific differences in the association (p for interaction = 0.027), suggesting that niacin’s skeletal benefits may vary by biological sex. These findings provide novel insights into niacin’s role in OP prevention and inform personalized dietary recommendations. Conclusions: this study, based on NHANES data (2007-2018), first reveals a nonlinear inverted U-shaped association between dietary niacin intake and osteoporosis risk in a US population aged ≥ 50 years, filling the research gap in dose-response characteristics among middle-aged and elderly populations. It proposes a bone-protective threshold for niacin intake (18.62-50 mg/d), providing potential evidence for revising current dietary guidelines. Furthermore, the study innovatively employs RCS models to identify gender-specific inflection points, and is the first to demonstrate the significant moderating effect of gender on the niacin-osteoporosis association. These findings establish a scientific foundation for personalized nutritional interventions.

Palabras Clave: Dietary niacin intake. Osteoporosis. Cross-sectional study. Nonlinear dose-response.



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Trabajo Original: Impact of memory bias in the dietary estimation of older adults measured through a food frequency questionnaire and weighed food records: A cross-sectional study in older adults and primary caregivers

Marcos Galván , Laura Ivonne Arellano-Martínez , Ivonne Ramírez-Silva , Celina Ramírez Ramírez , Guadalupe López Rodríguez , Nely Isabel Cruz-Serrano , Vidalma del Rosario Bezares-Sarmiento , María Elena Rivera-Madrigal

Publicado: 2023-07-15 / http://dx.doi.org/10.20960/nh.04858
Resumen | PDF

Revisión: Alimentación para mantener una adecuada salud muscular y ósea

Liliana Guadalupe González-Rodríguez , Isabel Borrás Olivares , Yalda Ghazi , María Carmen Lozano Estevan , Rosa M. Ortega

Publicado: 2024-07-29 / http://dx.doi.org/10.20960/nh.05449
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Trabajo Original: NHANES data analysis of the cardiometabolic index in relation to lumbar spine bone mineral density

Rui Zhu , Chao-Ren Deng , Shao-Ping Wu

Publicado: 2024-09-29 / http://dx.doi.org/10.20960/nh.05548
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Trabajo Original: Higher frequency of adding salt to foods increases the risk of low bone mineral density in individuals over 60 - A Mendelian randomization study

Ying Li , Yuhan Wang , Lianying Guo , Ye Yu , Mengqi Jiang , Lili Deng , Qingyi Zhou , Lu Sun , Xu Feng , Zhuo Zhang

Publicado: 2024-08-22 / http://dx.doi.org/10.20960/nh.05492
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Trabajo Original: Association between Dietary Inflammatory Index and IL-17A level in a Mexican cross-sectional study

Mariela Vega-Cárdenas , Maribel Barragán , Margarita Terán-García , Juan Manuel Vargas-Morales , Diana Patricia Portales-Pérez , Celia Aradillas-García

Publicado: 2024-05-28 / http://dx.doi.org/10.20960/nh.05344
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Trabajo Original: Usefulness of the Mini-Nutritional Assessment in screening for sarcopenia in a sample of institutionalized older persons - A cross-sectional study

Ashuin Kammar-García , Esmeralda Garza-Santiago , Javier Mancilla-Galindo , Orietta Lizet Segura-Badilla , Martín Lazcano-Hernández , Obdulia Vera-López , Addi Rhode Navarro-Cruz

Publicado: 2024-08-22 / http://dx.doi.org/10.20960/nh.05491
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Trabajo Original: Home enteral nutrition - An Argentinian national cross-sectional study

Adriana Crivelli , Fabricio Pochettino , María Fernanda Cascarón , Gabriela Capurro , Marcelo Puga , Óscar Soria , Agustín Flores , Lucas Morando , Andrés Luciano Nicolás Martinuzzi

Publicado: 2024-12-13 / http://dx.doi.org/10.20960/nh.05669
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Trabajo Original: Association between the fat mass/fat-free mass ratio and muscle strength, static balance and exercise capacity in older adults: a cross-sectional study

Walter Sepúlveda-Loyola , Yshoner Antonio Silva-Díaz , Mário Molari , Erikson Alexander Jiménez Torres , Cintya Odar-Rojas , Denilson Teixeira , Vanessa Probst

Publicado: 2024-11-12 / http://dx.doi.org/10.20960/nh.05616
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