The CHANCES project published a recent meta-analysis (1) that included 140,000 adults (over 60 years old, 82% women) from five cohorts from Europe and the USA to assess the association between adherence to Mediterranean diet and hip fracture incidence. The investigators found that participants with moderate or high adherence to the Mediterranean diet, compared to those with low adherence, showed a significant decrease in the risk of hip fracture. This finding was not surprising; first because the Mediterranean diet has many similarities with the Alkaline Diet, and second, because of its high content in polyphenols, which seems to be highly valuable in fighting cancer, inflammation and oxidative stress.

With regard to musculoskeletal health, a previous systematic review and meta-analysis (2) reported that adults better who followed the Mediterranean diet were at lower risk of becoming frail. Better ability to maintain body weight, muscle strength, physical activity and energy level has also been reported in association with a closer conformity with the traditional Mediterranean diet.

The Mediterranean dietary pattern as a whole, but also some particular items like extra virgin olive oil, which represents the hallmark of the Mediterranean diet and its principal culinary fat, fish and fruit, vegetables and fish have been associated with musculoskeletal health as well, in particular with higher bone density (3, 4).

A subgroup study nested in the PREDIMED trial also reported a reduced risk of osteoporotic fractures with extra-virgin olive oil (5). 

(1) Benetou V, Orfanos P, Feskanich D, Michaëlsson K, Pettersson-Kymmer U, Byberg L, Eriksson S, Grodstein F, Wolk A, Jankovic N, de Groot LCPGM, Boffetta P, Trichopoulou A. Mediterranean diet and hip fracture incidence among older adults: the CHANCES project. Osteoporos Int. 2018;29:1591-1599.

(2) Kojima G, Avgerinou C, Iliffe S, Walters K. Adherence to Mediterranean Diet Reduces Incident Frailty Risk: Systematic Review and Meta-Analysis. J Am Geriatr Soc. 2018;66:783-788.

(3) Savanelli MC, Barrea L, Macchia PE, Savastano S, Falco A, Renzullo A, Scarano E, Nettore IC, Colao A, Di Somma C. Preliminary results demonstrating the impact of Mediterranean diet on bone health. J Transl Med. 2017;15:81.

(4) Benetou V, Orfanos P, Feskanich D, et al. Fruit and Vegetable Intake and Hip Fracture Incidence in Older Men and Women: The CHANCES Project. J Bone Miner Res. 2016 Sep;31(9):1743-52.

(5) García-Gavilán JF, Bulló M, Canudas S, et al. Extra virgin olive oil consumption reduces the risk of osteoporotic fractures in the PREDIMED trial. Clin Nutr. 2018 Feb;37(1):329-335.