Mediterranean diet and hip fracture incidence among older adults: the CHANCES project

V. Benetou, P. Orfanos, D. Feskanich, K. Michaëlsson, U. Pettersson-Kymmer, L. Byberg, S. Eriksson, F. Grodstein, A. Wolk, N. Jankovic, L.C.P.G.M. de Groot, P. Boffetta, A. Trichopoulou

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Summary: The association between adherence to Mediterranean diet (MD) and hip fracture incidence is not yet established. In a diverse population of elderly, increased adherence to MD was associated with lower hip fracture incidence. Except preventing major chronic diseases, adhering to MD might have additional benefits in lowering hip fracture risk. Introduction: Hip fractures constitute a major public health problem among older adults. Latest evidence links adherence to Mediterranean diet (MD) with reduced hip fracture risk, but still more research is needed to elucidate this relationship. The potential association of adherence to MD with hip fracture incidence was explored among older adults. Methods: A total of 140,775 adults (116,176 women, 24,599 men) 60 years and older, from five cohorts from Europe and the USA, were followed-up for 1,896,219 person-years experiencing 5454 hip fractures. Diet was assessed at baseline by validated, cohort-specific, food-frequency questionnaires, and hip fractures were ascertained through patient registers or telephone interviews/questionnaires. Adherence to MD was evaluated by a scoring system on a 10-point scale modified to be applied also to non-Mediterranean populations. In order to evaluate the association between MD and hip fracture incidence, cohort-specific hazard ratios (HR), adjusted for potential confounders, were estimated using Cox proportional-hazards regression and pooled estimates were subsequently derived implementing random-effects meta-analysis. Results: A two-point increase in the score was associated with a significant 4% decrease in hip fracture risk (pooled adjusted HR 0.96; 95% confidence interval (95% CI) 0.92–0.99, pheterogeneity = 0.446). In categorical analyses, hip fracture risk was lower among men and women with moderate (HR 0.93; 95% CI 0.87–0.99) and high (HR 0.94; 95% CI 0.87–1.01) adherence to the score compared with those with low adherence. Conclusions: In this large sample of older adults from Europe and the USA, increased adherence to MD was associated with lower hip fracture incidence.
LanguageEnglish
Pages1591-1599
JournalOsteoporosis International
Volume29
Issue number7
Early online date14 Apr 2018
DOIs
Publication statusPublished - 2018

Fingerprint

Mediterranean Diet
Hip Fractures
Incidence
Confidence Intervals
Population
Meta-Analysis

Keywords

  • Aging
  • Bone health
  • CHANCES
  • Dietary patterns
  • Hip fractures
  • Mediterranean diet

Cite this

Benetou, V., Orfanos, P., Feskanich, D., Michaëlsson, K., Pettersson-Kymmer, U., Byberg, L., ... Trichopoulou, A. (2018). Mediterranean diet and hip fracture incidence among older adults: the CHANCES project. Osteoporosis International, 29(7), 1591-1599. https://doi.org/10.1007/s00198-018-4517-6
Benetou, V. ; Orfanos, P. ; Feskanich, D. ; Michaëlsson, K. ; Pettersson-Kymmer, U. ; Byberg, L. ; Eriksson, S. ; Grodstein, F. ; Wolk, A. ; Jankovic, N. ; de Groot, L.C.P.G.M. ; Boffetta, P. ; Trichopoulou, A. / Mediterranean diet and hip fracture incidence among older adults : the CHANCES project. In: Osteoporosis International. 2018 ; Vol. 29, No. 7. pp. 1591-1599.
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abstract = "Summary: The association between adherence to Mediterranean diet (MD) and hip fracture incidence is not yet established. In a diverse population of elderly, increased adherence to MD was associated with lower hip fracture incidence. Except preventing major chronic diseases, adhering to MD might have additional benefits in lowering hip fracture risk. Introduction: Hip fractures constitute a major public health problem among older adults. Latest evidence links adherence to Mediterranean diet (MD) with reduced hip fracture risk, but still more research is needed to elucidate this relationship. The potential association of adherence to MD with hip fracture incidence was explored among older adults. Methods: A total of 140,775 adults (116,176 women, 24,599 men) 60 years and older, from five cohorts from Europe and the USA, were followed-up for 1,896,219 person-years experiencing 5454 hip fractures. Diet was assessed at baseline by validated, cohort-specific, food-frequency questionnaires, and hip fractures were ascertained through patient registers or telephone interviews/questionnaires. Adherence to MD was evaluated by a scoring system on a 10-point scale modified to be applied also to non-Mediterranean populations. In order to evaluate the association between MD and hip fracture incidence, cohort-specific hazard ratios (HR), adjusted for potential confounders, were estimated using Cox proportional-hazards regression and pooled estimates were subsequently derived implementing random-effects meta-analysis. Results: A two-point increase in the score was associated with a significant 4{\%} decrease in hip fracture risk (pooled adjusted HR 0.96; 95{\%} confidence interval (95{\%} CI) 0.92–0.99, pheterogeneity = 0.446). In categorical analyses, hip fracture risk was lower among men and women with moderate (HR 0.93; 95{\%} CI 0.87–0.99) and high (HR 0.94; 95{\%} CI 0.87–1.01) adherence to the score compared with those with low adherence. Conclusions: In this large sample of older adults from Europe and the USA, increased adherence to MD was associated with lower hip fracture incidence.",
keywords = "Aging, Bone health, CHANCES, Dietary patterns, Hip fractures, Mediterranean diet",
author = "V. Benetou and P. Orfanos and D. Feskanich and K. Micha{\"e}lsson and U. Pettersson-Kymmer and L. Byberg and S. Eriksson and F. Grodstein and A. Wolk and N. Jankovic and {de Groot}, L.C.P.G.M. and P. Boffetta and A. Trichopoulou",
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Benetou, V, Orfanos, P, Feskanich, D, Michaëlsson, K, Pettersson-Kymmer, U, Byberg, L, Eriksson, S, Grodstein, F, Wolk, A, Jankovic, N, de Groot, LCPGM, Boffetta, P & Trichopoulou, A 2018, 'Mediterranean diet and hip fracture incidence among older adults: the CHANCES project', Osteoporosis International, vol. 29, no. 7, pp. 1591-1599. https://doi.org/10.1007/s00198-018-4517-6

Mediterranean diet and hip fracture incidence among older adults : the CHANCES project. / Benetou, V.; Orfanos, P.; Feskanich, D.; Michaëlsson, K.; Pettersson-Kymmer, U.; Byberg, L.; Eriksson, S.; Grodstein, F.; Wolk, A.; Jankovic, N.; de Groot, L.C.P.G.M.; Boffetta, P.; Trichopoulou, A.

In: Osteoporosis International, Vol. 29, No. 7, 2018, p. 1591-1599.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Mediterranean diet and hip fracture incidence among older adults

T2 - Osteoporis International

AU - Benetou, V.

AU - Orfanos, P.

AU - Feskanich, D.

AU - Michaëlsson, K.

AU - Pettersson-Kymmer, U.

AU - Byberg, L.

AU - Eriksson, S.

AU - Grodstein, F.

AU - Wolk, A.

AU - Jankovic, N.

AU - de Groot, L.C.P.G.M.

AU - Boffetta, P.

AU - Trichopoulou, A.

PY - 2018

Y1 - 2018

N2 - Summary: The association between adherence to Mediterranean diet (MD) and hip fracture incidence is not yet established. In a diverse population of elderly, increased adherence to MD was associated with lower hip fracture incidence. Except preventing major chronic diseases, adhering to MD might have additional benefits in lowering hip fracture risk. Introduction: Hip fractures constitute a major public health problem among older adults. Latest evidence links adherence to Mediterranean diet (MD) with reduced hip fracture risk, but still more research is needed to elucidate this relationship. The potential association of adherence to MD with hip fracture incidence was explored among older adults. Methods: A total of 140,775 adults (116,176 women, 24,599 men) 60 years and older, from five cohorts from Europe and the USA, were followed-up for 1,896,219 person-years experiencing 5454 hip fractures. Diet was assessed at baseline by validated, cohort-specific, food-frequency questionnaires, and hip fractures were ascertained through patient registers or telephone interviews/questionnaires. Adherence to MD was evaluated by a scoring system on a 10-point scale modified to be applied also to non-Mediterranean populations. In order to evaluate the association between MD and hip fracture incidence, cohort-specific hazard ratios (HR), adjusted for potential confounders, were estimated using Cox proportional-hazards regression and pooled estimates were subsequently derived implementing random-effects meta-analysis. Results: A two-point increase in the score was associated with a significant 4% decrease in hip fracture risk (pooled adjusted HR 0.96; 95% confidence interval (95% CI) 0.92–0.99, pheterogeneity = 0.446). In categorical analyses, hip fracture risk was lower among men and women with moderate (HR 0.93; 95% CI 0.87–0.99) and high (HR 0.94; 95% CI 0.87–1.01) adherence to the score compared with those with low adherence. Conclusions: In this large sample of older adults from Europe and the USA, increased adherence to MD was associated with lower hip fracture incidence.

AB - Summary: The association between adherence to Mediterranean diet (MD) and hip fracture incidence is not yet established. In a diverse population of elderly, increased adherence to MD was associated with lower hip fracture incidence. Except preventing major chronic diseases, adhering to MD might have additional benefits in lowering hip fracture risk. Introduction: Hip fractures constitute a major public health problem among older adults. Latest evidence links adherence to Mediterranean diet (MD) with reduced hip fracture risk, but still more research is needed to elucidate this relationship. The potential association of adherence to MD with hip fracture incidence was explored among older adults. Methods: A total of 140,775 adults (116,176 women, 24,599 men) 60 years and older, from five cohorts from Europe and the USA, were followed-up for 1,896,219 person-years experiencing 5454 hip fractures. Diet was assessed at baseline by validated, cohort-specific, food-frequency questionnaires, and hip fractures were ascertained through patient registers or telephone interviews/questionnaires. Adherence to MD was evaluated by a scoring system on a 10-point scale modified to be applied also to non-Mediterranean populations. In order to evaluate the association between MD and hip fracture incidence, cohort-specific hazard ratios (HR), adjusted for potential confounders, were estimated using Cox proportional-hazards regression and pooled estimates were subsequently derived implementing random-effects meta-analysis. Results: A two-point increase in the score was associated with a significant 4% decrease in hip fracture risk (pooled adjusted HR 0.96; 95% confidence interval (95% CI) 0.92–0.99, pheterogeneity = 0.446). In categorical analyses, hip fracture risk was lower among men and women with moderate (HR 0.93; 95% CI 0.87–0.99) and high (HR 0.94; 95% CI 0.87–1.01) adherence to the score compared with those with low adherence. Conclusions: In this large sample of older adults from Europe and the USA, increased adherence to MD was associated with lower hip fracture incidence.

KW - Aging

KW - Bone health

KW - CHANCES

KW - Dietary patterns

KW - Hip fractures

KW - Mediterranean diet

U2 - 10.1007/s00198-018-4517-6

DO - 10.1007/s00198-018-4517-6

M3 - Article

VL - 29

SP - 1591

EP - 1599

JO - Osteoporis International

JF - Osteoporis International

SN - 0937-941X

IS - 7

ER -

Benetou V, Orfanos P, Feskanich D, Michaëlsson K, Pettersson-Kymmer U, Byberg L et al. Mediterranean diet and hip fracture incidence among older adults: the CHANCES project. Osteoporosis International. 2018;29(7):1591-1599. https://doi.org/10.1007/s00198-018-4517-6