Mediterranean diet and incidence of hip fractures in a European cohort

V. Benetou, P. Orfanos, U. Pettersson-Kymmer, U. Bergström, O. Svensson, I. Johansson, F. Berrino, R. Tumino, K. B. Borch, E. Lund, P. H M Peeters, V. Grote, K. Li, J. M. Altzibar, T. Key, H. Boeing, A. Von Ruesten, T. Norat, P. A. Wark, E. RiboliA. Trichopoulou

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    115 Citations (Scopus)


    Prevention of hip fractures is of critical public health importance. In a cohort of adults from eight European countries, evidence was found that increased adherence to Mediterranean diet, measured by a 10-unit dietary score, is associated with reduced hip fracture incidence, particularly among men. Introduction: Evidence on the role of dietary patterns on hip fracture incidence is scarce. We explored the association of adherence to Mediterranean diet (MD) with hip fracture incidence in a cohort from eight European countries. Methods: A total of 188,795 eligible participants (48,814 men and 139,981 women) in the European Prospective Investigation into Cancer and nutrition study with mean age 48.6 years (±10.8) were followed for a median of 9 years, and 802 incident hip fractures were recorded. Diet was assessed at baseline through validated dietary instruments. Adherence to MD was evaluated by a MD score (MDs), on a 10-point scale, in which monounsaturated were substituted with unsaturated lipids. Association with hip fracture incidence was assessed through Cox regression with adjustment for potential confounders. Results: Increased adherence to MD was associated with a 7 % decrease in hip fracture incidence [hazard ratio (HR) per 1-unit increase in the MDs 0.93; 95 % confidence interval (95 % CI) = 0.89-0.98]. This association was more evident among men and somewhat stronger among older individuals. Using increments close to one standard deviation of daily intake, in the overall sample, high vegetable (HR = 0.86; 95 % CI = 0.79-0.94) and high fruit (HR = 0.89; 95 % CI = 0.82-0.97) intake was associated with decreased hip fracture incidence, whereas high meat intake (HR = 1.18; 95 % CI = 1.06-1.31) with increased incidence. Excessive ethanol consumption (HR high versus moderate = 1.74; 95 % CI = 1.32-2.31) was also a risk factor. Conclusions: In a prospective study of adults, increased adherence to MD appears to protect against hip fracture occurrence, particularly among men.

    Original languageEnglish
    Pages (from-to)1587-1598
    Number of pages12
    JournalOsteoporosis International
    Issue number5
    Early online date20 Oct 2012
    Publication statusPublished - May 2013


    • A priori methods
    • Bone health
    • Diet
    • Dietary patterns
    • Hip fractures
    • Mediterranean diet

    ASJC Scopus subject areas

    • Endocrinology, Diabetes and Metabolism


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