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41, 95% CI 0.79 to 2.52, I 2 = 54.1%). The results of five studies from four publications revealed no significant association between dietary PRAL score and femoral and spinal BMD (WMD femoral = -0.01, 95% confidence interval -0.02 to 0.01, I 2 = 76.5%; WMD spinal = -0.01, 95% CI -0.03 to 0.01, I 2 = 56.7%). However, being in the highest category of NEAP was significantly associated with a lower femoral and spinal BMD (WMD femoral = -0.01, 95% CI -0.02 to -0.00, I 2 = 82.1%; WMD spinal = -0.02, 95% CI -0.03 to -0.01, I 2 = 93%). It was s