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. Riboli & 1 others A. Trichopoulou

    Research output: Contribution to journalArticle

    68 Citations (Scopus)

    Abstract

    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
    Volume24
    Issue number5
    Early online date20 Oct 2012
    DOIs
    Publication statusPublished - May 2013

    Fingerprint

    Mediterranean Diet
    Hip Fractures
    Incidence
    Confidence Intervals
    Vegetables
    Meat
    Fruit
    Ethanol
    Public Health
    Prospective Studies
    Diet
    Lipids

    Keywords

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

    ASJC Scopus subject areas

    • Endocrinology, Diabetes and Metabolism

    Cite this

    Benetou, V., Orfanos, P., Pettersson-Kymmer, U., Bergström, U., Svensson, O., Johansson, I., ... Trichopoulou, A. (2013). Mediterranean diet and incidence of hip fractures in a European cohort. Osteoporosis International, 24(5), 1587-1598. https://doi.org/10.1007/s00198-012-2187-3

    Mediterranean diet and incidence of hip fractures in a European cohort. / Benetou, V.; Orfanos, P.; Pettersson-Kymmer, U.; Bergström, U.; Svensson, O.; Johansson, I.; Berrino, F.; Tumino, R.; Borch, K. B.; Lund, E.; Peeters, P. H M; Grote, V.; Li, K.; Altzibar, J. M.; Key, T.; Boeing, H.; Von Ruesten, A.; Norat, T.; Wark, P. A.; Riboli, E.; Trichopoulou, A.

    In: Osteoporosis International, Vol. 24, No. 5, 05.2013, p. 1587-1598.

    Research output: Contribution to journalArticle

    Benetou, V, Orfanos, P, Pettersson-Kymmer, U, Bergström, U, Svensson, O, Johansson, I, Berrino, F, Tumino, R, Borch, KB, Lund, E, Peeters, PHM, Grote, V, Li, K, Altzibar, JM, Key, T, Boeing, H, Von Ruesten, A, Norat, T, Wark, PA, Riboli, E & Trichopoulou, A 2013, 'Mediterranean diet and incidence of hip fractures in a European cohort' Osteoporosis International, vol. 24, no. 5, pp. 1587-1598. https://doi.org/10.1007/s00198-012-2187-3
    Benetou V, Orfanos P, Pettersson-Kymmer U, Bergström U, Svensson O, Johansson I et al. Mediterranean diet and incidence of hip fractures in a European cohort. Osteoporosis International. 2013 May;24(5):1587-1598. https://doi.org/10.1007/s00198-012-2187-3
    Benetou, V. ; Orfanos, P. ; Pettersson-Kymmer, U. ; Bergström, U. ; Svensson, O. ; Johansson, I. ; Berrino, F. ; Tumino, R. ; Borch, K. B. ; Lund, E. ; Peeters, P. H M ; Grote, V. ; Li, K. ; Altzibar, J. M. ; Key, T. ; Boeing, H. ; Von Ruesten, A. ; Norat, T. ; Wark, P. A. ; Riboli, E. ; Trichopoulou, A. / Mediterranean diet and incidence of hip fractures in a European cohort. In: Osteoporosis International. 2013 ; Vol. 24, No. 5. pp. 1587-1598.
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    abstract = "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.",
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    author = "V. Benetou and P. Orfanos and U. Pettersson-Kymmer and U. Bergstr{\"o}m and O. Svensson and I. Johansson and F. Berrino and R. Tumino and Borch, {K. B.} and E. Lund and Peeters, {P. H M} and V. Grote and K. Li and Altzibar, {J. M.} and T. Key and H. Boeing and {Von Ruesten}, A. and T. Norat and Wark, {P. A.} and E. Riboli and A. Trichopoulou",
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    T1 - Mediterranean diet and incidence of hip fractures in a European cohort

    AU - Benetou, V.

    AU - Orfanos, P.

    AU - Pettersson-Kymmer, U.

    AU - Bergström, U.

    AU - Svensson, O.

    AU - Johansson, I.

    AU - Berrino, F.

    AU - Tumino, R.

    AU - Borch, K. B.

    AU - Lund, E.

    AU - Peeters, P. H M

    AU - Grote, V.

    AU - Li, K.

    AU - Altzibar, J. M.

    AU - Key, T.

    AU - Boeing, H.

    AU - Von Ruesten, A.

    AU - Norat, T.

    AU - Wark, P. A.

    AU - Riboli, E.

    AU - Trichopoulou, A.

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    N2 - 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.

    AB - 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.

    KW - A priori methods

    KW - Bone health

    KW - Diet

    KW - Dietary patterns

    KW - Hip fractures

    KW - Mediterranean diet

    U2 - 10.1007/s00198-012-2187-3

    DO - 10.1007/s00198-012-2187-3

    M3 - Article

    VL - 24

    SP - 1587

    EP - 1598

    JO - Osteoporosis International

    JF - Osteoporosis International

    SN - 0937-941X

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