Webster, J orcid.org/0000-0001-6999-6959, Greenwood, DC orcid.org/0000-0001-7035-3096 and Cade, JE orcid.org/0000-0003-3421-0121 (2022) Foods, nutrients and hip fracture risk: A prospective study of middle-aged women. Clinical Nutrition, 41 (12). pp. 2825-2832. ISSN 0261-5614
Abstract
Background and aims
Hip fracture affects 1.6 million people globally each year, and increases morbidity and mortality. There is potential for risk reduction through diet modification, but prospective evidence for associations between intake of several foods and nutrients and hip fracture risk is limited. This study aimed to investigate associations between food and nutrient intakes and hip fracture risk in the UK Women’s Cohort Study, and to determine the role of body mass index (BMI) as a potential effect modifier.
Methods
Dietary, lifestyle, anthropometric, and socio-economic information of UK women, ages 35–69 years, were collected in a survey at recruitment (1995-1998), and included a validated 217-item food frequency questionnaire. Hip fracture cases were identified by linking participant data at recruitment with their Hospital Episode Statistics (HES) up to March 2019. Cox regression models were used to estimate associations between standard portions of food and nutrient intakes and hip fracture risk over a median follow-up time of 22.3 years.
Results
Among 26,318 women linked to HES data (556,331 person-years), 822 hip fracture cases were identified. After adjustment for confounders, every additional cup of tea or coffee per day was associated with a 4% lower risk of hip fracture (HR (95% CI): 0.96 (0.92, 1.00)). A 25 g/day increment of dietary protein intake was also associated with a 14% lower risk of hip fracture (0.86 (0.73, 1.00)). In subgroup analyses, BMI modified linear associations between dietary intakes of protein, calcium, total dairy, milk, and tea and hip fracture risk (pinteraction = 0.02, 0.002, 0.003, 0.001, and 0.003, respectively); these foods and nutrients were associated with a reduced risk of hip fracture in underweight but not healthy or overweight participants. In particular, risk of hip fracture in underweight participants (28 cases, 545 participants) was 45% lower for every 25g/day protein consumed (0.55 (0.38, 0.78)).
Conclusions
This is the first prospective cohort study internationally of multiple food and nutrient intakes in relation to hip fracture risk by BMI using linkage to hospital records. Results suggest that the potential roles of some foods and nutrients in hip fracture prevention, particularly protein, tea and coffee in underweight women, merit confirmation.
Protocol registration
Clinicaltrials.gov NCT05081466.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2022 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
Keywords: | body mass index; cohort study; diet; epidemiology; hip fracture; nutrition |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Environment (Leeds) > School of Food Science and Nutrition (Leeds) > FSN Nutrition and Public Health (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Clinical & Population Science Dept (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 11 Nov 2022 12:43 |
Last Modified: | 09 Nov 2023 01:13 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.clnu.2022.11.008 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:193113 |
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