2. Materials and Methods
osteoporosis/osteopenia, Osteoporosis
SECONDARY, OSTEOPOROSIS
Study population: This study was a secondary cross-sectional analysis of data collected from the Heartland Osteoporosis Prevention Study (HOPS). HOPS was a randomized controlled trial (RCT) that evaluated the impact of risedronate versus exercise on bone outcomes in women within six years of menopause with a diagnosis of low bone mass (T-score of −1.0 to −2.49) [Diet Intake Assessment: In addition to the original study protocol, the need for complete dietary assessment was acknowledged. Therefore, a separate protocol was developed to capture these data after the initiation of the parent study. Screening for this ancillary study was performed at the time of eligibility screening after original enrollment began. The present study evaluated dietary intakes using the Harvard semi-quantitative food frequency questionnaire (FFQ), which has been previously validated and used in a variety of cohorts, including female populations [Calculation of the Dietary Inflammatory Index (DIIBone outcome measures: The outcome measures for this study included bone outcomes from DXA scans, which provide BMD and TBS, the latter being a measure of bone structure. BMD and TBS measurements were taken using a Hologic DXA instrument (Hologic QDR2000™ model, Hologic Inc., Waltham, MA, USA) [Other measures: Baseline demographic information and clinical data were obtained from the HOPS database and included age (years), education (some college or less, which includes less than a high school diploma, high school diploma or some college but no degree; college degree; master’s or doctorate degree), race/ethnicity (white/non-Hispanic; non-white/other), smoking history (ever/never), BMI (≤24.9 kg/mStatistical analysis: Baseline descriptive statistics were reported for all continuous and categorical variables (mean, standard deviation, counts and percentages). The baseline statistics were presented for the total population and by E-DII quartile, with quartile 1 representing the greatest anti-inflammatory potential and quartile 4 representing the least substantial pro-inflammatory potential. Differences in baseline characteristics were assessed by E-DII quartile, with analysis of variance (ANOVA) used for continuous data and chi-square tests applied to categorical data with pairwise adjustments for multiple comparisons. The differences in bone outcomes were assessed by E-DII quartile via ANCOVA, with pairwise adjustments used for multiple comparisons to explore the adjusted relationship addressing covariances of age, education, race/ethnicity, smoking history, family history of osteoporosis/osteopenia, BMI, physical activity, and calcium intake. Analysis was conducted using SAS, Version 9.4. For all analyses, a 