{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:55:03Z","timestamp":1791266103354,"version":"4.1.0"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Gut microbiota has been implicated in bone metabolism, but whether a diet supporting gut microbial health is associated with fracture prevalence in older women remains unclear. This study aimed to examine the association between the dietary index for gut microbiota (DI-GM) and fracture prevalence in women aged 50 years and older.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed cross-sectional data from five NHANES cycles, including 6,318 women aged 50 years and older (mean age 63.8 \u00b1 9.6 years). DI-GM scores were derived from 24-h dietary recalls based on 13 dietary components. Self-reported hip, wrist, or spine fracture was the outcome (863 women, 13.7%). Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry. Weighted logistic regression and exploratory mediation analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Higher DI-GM scores were associated with lower odds of fragility fracture (OR = 0.93, 95% CI: 0.88\u20131.00,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.035) and any fracture (Model 3: OR = 0.96, 95% CI: 0.92\u20130.99,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.045). Neither femoral neck nor spinal BMD significantly mediated these associations. In a small exploratory pilot cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f12), DI-GM scores were positively correlated with spinal BMD (\n                      <jats:italic>R<\/jats:italic>\n                      \u202f=\u202f0.82,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.0011).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Higher DI-GM scores were associated with lower fracture prevalence in women aged 50 years and older, although BMD did not significantly mediate this association. Given the cross-sectional design and the small pilot sample, these findings should be considered exploratory and require confirmation in larger prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1933908","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:21:12Z","timestamp":1791264072000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between the dietary index for gut microbiota and fracture prevalence among women aged 50\u202fyears and older: a NHANES-based study with a preliminary exploratory pilot analysis"],"prefix":"10.3389","volume":"14","author":[{"given":"Ji","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Cervicodynia\/Omalgia\/Lumbago\/Sciatica, Sichuan Province Orthopedic Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunping","family":"Liu","sequence":"additional","affiliation":[{"name":"College of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zihao","family":"Huang","sequence":"additional","affiliation":[{"name":"College of Pharmacy, Chengdu University of Traditional Chinese Medicine","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingming","family":"Ning","sequence":"additional","affiliation":[{"name":"Department of Foot and Ankle Surgery, Sichuan Province Orthopedic Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Cervicodynia\/Omalgia\/Lumbago\/Sciatica, Sichuan Province Orthopedic Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiongxia","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Cervicodynia\/Omalgia\/Lumbago\/Sciatica, Sichuan Province Orthopedic Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Cervicodynia\/Omalgia\/Lumbago\/Sciatica, Sichuan Province Orthopedic Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luming","family":"Qi","sequence":"additional","affiliation":[{"name":"College of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhangmeng","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Cervicodynia\/Omalgia\/Lumbago\/Sciatica, Sichuan Province Orthopedic Hospital","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1001\/jamainternmed.2021.2617","article-title":"Risk of subsequent fractures in postmenopausal women after nontraumatic vs. traumatic fractures","volume":"181","author":"Crandall","year":"2021","journal-title":"JAMA Intern Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e068033","DOI":"10.1136\/bmj-2021-068033","article-title":"Fracture risk reduction and safety by osteoporosis treatment compared with placebo or active comparator in postmenopausal women: systematic review, network meta-analysis, and meta-regression analysis of randomised clinical 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