SAGE-Hindawi Access to Research Journal of Osteoporosis Volume 2011, Article ID 102686, 7 pages doi:10.4061/2011/102686 Research Article The Oslo Health Study: A Dietary Index Estimating Frequent Intake of Soft Drinks and Rare Intake of Fruit and Vegetables Is Negatively Associated with Bone Mineral Density Arne Torbjørn Høstmark,1 Anne Johanne Søgaard,1, 2 Kari Alvær,2 and Haakon E. Meyer1, 2 1 Section of Preventive Medicine and Epidemiology, University of Oslo, P.O. Box 1130, Blindern, 0318 Oslo, Norway 2 Division of Epidemiology, Norwegian Institute of Public Health, P.O. Box 4404, Nydalen, 0403 Oslo, Norway Correspondence should be addressed to Arne Torbjørn Høstmark, a.t.hostmark@medisin.uio.no Received 17 February 2011; Accepted 5 May 2011 Academic Editor: Harri Sieva¨nen Copyright © 2011 Arne Torbjørn Høstmark et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Since nutritional factors may aﬀect bone mineral density (BMD), we have investigated whether BMD is associated with an index estimating the intake of soft drinks, fruits, and vegetables. Methods. BMD was measured in distal forearm in a subsample of the population-based Oslo Health Study. 2126 subjects had both valid BMD measurements and answered all the questions required for calculating a Dietary Index = the sum of intake estimates of colas and non-cola beverages divided by the sum of intake estimates of fruits and vegetables. We did linear regression analyses to study whether the Dietary Index and the single food items included in the index were associated with BMD. Results. There was a consistent negative association between the Dietary Index and forearm BMD. Among the single index components, colas and non-cola soft drinks were negatively associated with BMD. The negative association between the Dietary Index and BMD prevailed after adjusting for gender, age, and body mass index, length of education, smoking, alcohol intake, and physical activity. Conclusion. An index reﬂecting frequent intake of soft drinks and rare intake of fruit and vegetables was inversely related to distal forearm bone mineral density. 1. Introduction It is generally agreed that nutritional factors are important for the development of osteoporosis. Among several negative factors for bone formation are sodium, protein, caﬀeine, ox- alate, ﬁbre, phytate, and increased acid load, whereas cal- cium, vitamin D, salads, herbs, and vegetables seem to be bone promoting factors. Also alkali buﬀers, whether bicar- bonate, vegetables, or fruits, can reverse the urinary calcium loss [1–4]. During the last decades consumption of soft drinks has increased in most Western countries. The consequences on bone health of this consumption have been relatively sparsely investigated. Some studies have reported an inverse asso- ciation between consumption of cola beverages/soft drinks and bone health [5, 6], and other studies found the same association only in females [7–10]. Finally, one study in older women concluded that moderate intake of carbonated bev- erages did not appear to have any adverse eﬀects on bone mineral density [11]. Thus, there are inconsistent results con- cerning the possible inﬂuence of soft drinks on bone health. In the present work, we have examined whether data of the Oslo Health Study would ﬁt the hypothesis that intake of some diet items would reduce, whilst intake of others would improve the bone mineral density. As potential negative diet items for bone health we have focused on soft drinks (colas and non-cola soft drinks); fruits and vegetables were chosen as positive diet factors [1]. We reasoned that a negative di- etary inﬂuence on BMD might be more easily detected by a Dietary Index calculated as the sum of intake estimates of colas and non-cola beverages divided by the sum of intake estimates of fruits and vegetables. Therefore, the aim of this work was to study the association between BMD and both the Dietary Index and its single components. 2. Materials/Subjects and Methods 2.1. Main Project. The Oslo Health Study (HUBRO) was car- ried out in 2000-2001 under the joint collaboration of the