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Zheng X, Li W, Yan Y, Su Z, Huang X. Association between the Dietary Inflammatory Index and fracture risk in older adults: a systematic review and meta-analysis. J Int Med Res 2024; 52:3000605241248039. [PMID: 38698503 PMCID: PMC11067643 DOI: 10.1177/03000605241248039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/02/2024] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVE We explored correlations between the Dietary Inflammatory Index (DII) and fracture risk in older adults. METHODS We systematically searched MEDLINE, PubMed, Science Direct, Scopus, and CNKI for all relevant epidemiological studies published through October 16, 2023. Because observational studies were included in the meta-analysis, we used a random-effects model to pool the study-specific effect sizes and 95% confidence intervals (CIs). We assessed study quality using the Newcastle-Ottawa scale. This meta-analysis was registered in PROSPERO. RESULTS Eight studies with 462,986 participants were included, with five cohort studies, two cross-sectional studies, and one case-control study. An analysis of heterogeneity among the eight included studies resulted in I2 = 87.1%, indicating significant between-study heterogeneity; hence, the random-effects model was adopted to generate the combined effect size. We found that the DII was positively associated with fracture (relative risk: 1.188, 95% CI: 1.043-1.354). This result was further confirmed in leave-one-out sensitivity analysis. CONCLUSIONS Our study provides evidence suggesting that diets high in pro-inflammatory components might increase the fracture risk among older people. Decreased consumption of pro-inflammatory foods and increased consumption of anti-inflammatory foods are suggested to prevent adverse fracture outcomes. More prospective studies involving both sexes are warranted to verify the results.
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Affiliation(s)
- Xiaojuan Zheng
- Department of Orthopedics, No. 910 Hospital of The Chinese People’s Liberation Army Joint Logistic Support Force, Quanzhou, China
| | - Wenhui Li
- Health Management Center, Xiang’an Hospital of Xiamen University, Xiamen, China
| | - Yonglong Yan
- Department of Rheumatology, Xiang’an Hospital of Xiamen University, Xiamen, China
| | - Zhaojie Su
- Organ Transplantation Clinical Medical Center of Xiamen University, Department of Organ Transplantation, Xiang’an Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Xuelin Huang
- Department of Orthopedics, No. 910 Hospital of The Chinese People’s Liberation Army Joint Logistic Support Force, Quanzhou, China
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Sotos-Prieto M, Rodriguez-Artalejo F, Fung TT, Meyer HE, Hu FB, Willett WC, Bhupathiraju SN. Plant-Based Diets and Risk of Hip Fracture in Postmenopausal Women. JAMA Netw Open 2024; 7:e241107. [PMID: 38421643 PMCID: PMC10905300 DOI: 10.1001/jamanetworkopen.2024.1107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 01/14/2024] [Indexed: 03/02/2024] Open
Abstract
Importance Previous research has found that vegetarian diets are associated with lower bone mineral density and higher risk of fractures, but these studies did not differentiate the quality of the plant-based foods. Objective To examine the association between the quality of plant-based diets (not necessarily vegan but also omnivorous) and hip fracture risk among postmenopausal women in the Nurses' Health Study. Design, Setting, and Participants This cohort study analyzed data from 70 285 postmenopausal women who participated in the US Nurses' Health Study from 1984 through 2014. Data were analyzed from January 1 to July 31, 2023. Main outcomes and Measures Hip fractures were self-reported on biennial questionnaires. Diet was assessed every 4 years using a validated semiquantitative food frequency questionnaire. Plant-based diet quality was assessed using 2 previously established indices: the healthful Plant-Based Diet Index (hPDI), for which healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, vegetable oils, and tea or coffee) received positive scores, whereas less healthy plant foods (fruit juices, sweetened beverages, refined grains, potatoes, and sweets or desserts) and animal foods received reversed scores; and the unhealthful Plant-Based Diet Index (uPDI), for which positive scores were given to less healthy plant foods and reversed scores to healthy plant and animal foods. Quintile scores of 18 food groups were summed, with a theoretical range for both indices of 18 to 90 (highest adherence). Cox proportional hazards regression with time-varying covariates was used to compute hazard ratios (HRs) and 95% CIs for hip fracture. Results In total, 70 285 participants (mean [SD] age, 54.92 [4.48] years; 100% White women) were included, and 2038 cases of hip fracture were ascertained during the study and for up to 30 years of follow-up. Neither the hPDI (HR for highest vs lowest quintile, 0.97 [95% CI, 0.83-1.14]) nor the uPDI (HR for highest vs lowest quintile, 1.02 [95% CI, 0.87-1.20]) for long-term diet adherence was associated with hip fracture risk. However, when examining recent intake for the highest vs lowest quintiles, the hPDI was associated with 21% lower risk of hip fracture (HR, 0.79 [95% CI, 0.68-0.92]; P = .02 for trend), and the uPDI was associated with 28% higher risk (1.28 [95% CI, 1.09-1.51]; P = .008 for trend). Conclusions and Relevance Findings of this cohort study indicated that long-term adherence to healthful or unhealthful plant-based diets as assessed by hPDI and uPDI scores was not associated with hip fracture risk. Future research should clarify whether the associations observed with recent dietary intake are due to short-term effects of these dietary patterns, reverse causality, or both.
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Affiliation(s)
- Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, Campus of International Excellence and University of Madrid and Spanish National Research Council (CEI UAM-CSIC), Madrid, Spain
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Fernando Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, Campus of International Excellence and University of Madrid and Spanish National Research Council (CEI UAM-CSIC), Madrid, Spain
| | - Teresa T. Fung
- Department of Nutrition, Simmons University, Boston, Massachusetts
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Haakon E. Meyer
- Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Frank B. Hu
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Walter C. Willett
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Shilpa N. Bhupathiraju
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Al-Daghri NM, Hussain SD, Alnaami AM, Aljohani N, Sabico S. Dietary Calcium Intake and Osteoporosis Risk in Arab Adults. Nutrients 2023; 15:2829. [PMID: 37447157 DOI: 10.3390/nu15132829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/15/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Osteoporosis is a major public health concern in Saudi Arabia's aging population. There is particularly limited information on how diet affects bone loss in this ethnic group. The purpose of this study was to examine the association between dietary calcium (Ca) intake and osteoporosis risk in Saudi adults. A total of 1950 patients (416 males and 1534 females) with known risk factors for osteoporosis participated in this cross-sectional study. A short questionnaire (CaQ) was used to assess dietary Ca intakes in patients attending tertiary hospitals in Riyadh City. The prevalence of osteoporosis was 21.3% and was more common in females (93.5%). Patients with osteoporosis were older (p < 0.001) and had lower BMI (p < 0.001). Results showed that the overall mean Ca intake was only 445.1 mg/day (recommended dietary intake of 1300 mg/day). Tea intake (OR = 0.8 95%CI: 0.7-1.0; p = 0.02) and consumption of fish and eggs (OR = 0.9 95%CI: 0.8-1.0; p = 0.01) were significantly associated with a lower risk of osteoporosis. Furthermore, consumption of biscuits, cake and bread slices were significantly associated with higher incidence of osteoporosis (OR = 1.3 95%CI: 1.0-1.5; p = 0.02). In conclusion, extremely low dietary Ca intake was observed among Saudi adults already at risk of osteoporosis. A balanced diet including high amount of Ca, vitamin D and omega-3 fatty acids accompanied by limiting consumption of foods high in saturated fats and glycemic index may be helpful in reducing osteoporosis risk in the Saudi adult population.
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Affiliation(s)
- Nasser M Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Syed Danish Hussain
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Abdullah M Alnaami
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Naji Aljohani
- Obesity, Endocrine and Metabolism Center, King Fahad Medical City, Riyadh 12231, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
| | - Shaun Sabico
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
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Kwan ML, Lo JC, Laurent CA, Roh JM, Tang L, Ambrosone CB, Kushi LH, Quesenberry CP, Yao S. A prospective study of lifestyle factors and bone health in breast cancer patients who received aromatase inhibitors in an integrated healthcare setting. J Cancer Surviv 2023; 17:139-149. [PMID: 33565036 PMCID: PMC8349930 DOI: 10.1007/s11764-021-00993-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 01/15/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE Fracture and osteoporosis are known side effects of aromatase inhibitors (AIs) for postmenopausal hormone receptor positive (HR+) breast cancer (BC) patients. How modifiable lifestyle factors impact fracture risk in these patients is relatively unknown. METHODS We conducted a prospective cohort study to examine the association of lifestyle factors, focusing on physical activity, with risk of incident major osteoporotic fracture and osteoporosis in 2152 HR+ BC patients diagnosed from 2006 to 2013 at Kaiser Permanente Northern California and who received AIs. Patients self-reported lifestyle factors at study entry and at 6-month follow-up. Fracture and osteoporosis outcomes were prospectively ascertained by physician-adjudication and bone mineral density (BMD) values, respectively. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated from multivariable proportional hazards regression. Models were adjusted for age, menopausal status, race/ethnicity, body mass index (BMI), AJCC stage, breast cancer treatment, prior osteoporosis, and prior major fracture. RESULTS Over a median 6.1 years of follow-up after AI initiation, 165 women experienced an incident osteoporotic fracture and 243 women had osteoporosis. No associations were found between overall moderate-vigorous physical activity and fracture risk, although < 150 min/week of aerobic exercise in the 6 months after BC diagnosis was associated with increased fracture risk (HR=2.42; 95% CI: 1.34, 4.37) compared with ≥ 150 min/week (meeting physical activity guidelines). Risk was also higher for never or infrequently engaging in aerobic exercise (HR=1.90; 95% CI: 1.05, 3.44). None or infrequent overall moderate-vigorous physical activity in the 6 months before BC diagnosis was associated with increased risk of osteoporosis (HR=1.94; 95% CI: 1.11; 3.37). CONCLUSIONS Moderate-vigorous physical activity during the immediate period after BC diagnosis, particularly aerobic exercise, was associated with lower risk of major osteoporotic fractures in women on AI therapy. IMPLICATIONS FOR CANCER SURVIVORS Findings may inform fracture prevention in women on AI therapy through non-pharmacologic lifestyle-based strategies.
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Affiliation(s)
- Marilyn L Kwan
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
| | - Joan C Lo
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | - Cecile A Laurent
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | - Janise M Roh
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | - Li Tang
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Christine B Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Lawrence H Kushi
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | - Charles P Quesenberry
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | - Song Yao
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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Hu H, Zhao Y, Feng Y, Yang X, Li Y, Wu Y, Yuan L, Zhang J, Li T, Huang H, Li X, Zhang M, Sun L, Hu D. Consumption of whole grains and refined grains and associated risk of cardiovascular disease events and all-cause mortality: a systematic review and dose-response meta-analysis of prospective cohort studies. Am J Clin Nutr 2023; 117:149-159. [PMID: 36789934 DOI: 10.1016/j.ajcnut.2022.10.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 10/10/2022] [Accepted: 10/28/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Although relationships between the intake of whole grains and refined grains and the incidence of cardiovascular disease (CVD) events and all-cause mortality have been investigated, the conclusions have been inconclusive. OBJECTIVES We aimed to comprehensively summarize the evidence about the correlation between consuming whole grains and refined grains and risks of CVD events and all-cause mortality and to evaluate the meta-evidence quality. METHODS We searched PubMed, Embase, and Web of Science until 15 March, 2022. Random-effects models were employed to calculate summary relative risks (RRs) and 95% confidence intervals (CIs). We explored potential linear or nonlinear relationships using restricted cubic splines. The NutriGrade tool was employed to rate meta-evidence quality. RESULTS Twenty-four articles (68 studies; 46 for whole grains and 22 for refined grains) with 1,624,407 participants were included. Per 30-g increase in daily whole grain consumption, the RRs and 95% CIs of stroke, coronary heart disease (CHD), heart failure (HF), CVD, and all-cause mortality were 0.98 (0.96, 1.00), 0.94 (0.92, 0.97), 0.97 (0.89, 1.07), 0.92 (0.88, 0.96), and 0.94 (0.92, 0.97), respectively. Whole grain consumption was linearly associated with CHD (Pnonlinearity = 0.231) and nonlinearly associated with CVD (Pnonlinearity = 0.002) and all-cause mortality (Pnonlinearity = 0.001). Except for a positive correlation between refined grain consumption and all-cause mortality in the restricted cubic spline, no significant influence of refined grain intake on stroke, CHD, HF, and CVD was detected. The meta-evidence quality for the association of whole grain consumption with stroke, CHD, HF, CVD, and all-cause mortality was moderate, moderate, low, high, and high, respectively. For refined grains, all meta-evidence was of low quality. CONCLUSIONS Consuming whole grains, rather than refined grains, can assist in preventing CHD, CVD, and all-cause mortality. Relationships between consumption of refined grains and health outcomes should be interpreted cautiously because of the low quality of meta-evidence.
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Affiliation(s)
- Huifang Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yifei Feng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xingjin Yang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yang Li
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Yuying Wu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Lijun Yuan
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Jinli Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Tianze Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Hao Huang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Xi Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Ming Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China
| | - Liang Sun
- Department of Social Medicine and Health Service Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
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Dai Z, Hirani V, Sahni S, Felson DT, Naganathan V, Blyth F, Couteur DL, Handelsman D, Seibel MJ, Waite L, Kiel DP, Cumming R. Association of dietary fiber and risk of hip fracture in men from the Framingham Osteoporosis Study and the Concord Health and Ageing in Men Project. Nutr Health 2022; 28:229-238. [PMID: 33940973 PMCID: PMC10622166 DOI: 10.1177/02601060211011798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Data in the Offspring Framingham Osteoporosis Study (FOS) suggested that higher intake of dietary fiber was modestly protective against loss of bone mineral density at the femoral neck in men but not in women. AIM To examine the relationship of fiber intake with risk of hip fractures in men. METHODS We included 367 men from the FOS Original cohort, 1730 men from the FOS Offspring cohort, and 782 men from the Concord Health and Ageing in Men Project (CHAMP) in the analysis. Incident fractures were defined as medically confirmed first occurrence of osteoporotic fractures at the proximal femur. Fiber intake was estimated via a validated food frequency questionnaire (FFQ) or diet history. Cox proportional hazards models were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). A random-effects model was used to estimate the pooled relative risk in meta-analysis. RESULTS Seventy-two incident hip fractures were identified, of which 24 occurred in the FOS Original cohort [mean (SD): age 75.3 (5.1) years; follow-up time: 8.5 (6.2) years; dietary fiber: 19 (8) (g/d)], 19 in the FOS Offspring cohort [58.8 (9.8) years; 11.0 (5.9) years; 19 (8) (g/d)], and 29 in CHAMP [81.4 (4.5) years; 5.2 (1.5) years; 28 (10) (g/d)]. We did not find significant associations within each cohort between fiber intake and risk of hip fractures. The pooled HR (95% CI) was 0.80 (0.39, 1.66) comparing energy-adjusted dietary fiber at tertile 3 vs. tertile 1 (I2 = 0, p = 0.56). CONCLUSION These data suggested that dietary fiber was not associated with risk of incident hip fractures in men.
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Affiliation(s)
- Zhaoli Dai
- Charles Perkins Centre, School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, D17, The Hub, Camperdown, NSW, 2006, Australia
- Boston University School of Medicine, Department of Medicine, Rheumatology and Clinical Epidemiology, USA
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW 2109, Australia
| | - Vasant Hirani
- Centre for Education and Research on Aging, Concord Hospital, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- ARC Centre of Excellence in Population Aging Research, University of Sydney, Sydney, New South Wales, Australia
- School of Life and Environmental Sciences, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Shivani Sahni
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - David T. Felson
- Boston University School of Medicine, Department of Medicine, Rheumatology and Clinical Epidemiology, USA
- Central Manchester Foundation Trust and University of Manchester, Manchester UK
| | - Vasi Naganathan
- Centre for Education and Research on Aging, Concord Hospital, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Fiona Blyth
- Aging and Alzheimer’s Institute, Concord Hospital, Sydney, New South Wales, Australia
| | - David Le Couteur
- Centre for Education and Research on Aging, Concord Hospital, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- ARC Centre of Excellence in Population Aging Research, University of Sydney, Sydney, New South Wales, Australia
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - David Handelsman
- Centre for Education and Research on Aging, Concord Hospital, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- ARC Centre of Excellence in Population Aging Research, University of Sydney, Sydney, New South Wales, Australia
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- Aging and Alzheimer’s Institute, Concord Hospital, Sydney, New South Wales, Australia
| | - Markus J Seibel
- ANZAC Research Institute, Concord Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Louise Waite
- Bone Research Program, ANZAC Research Institute, and Department of Endocrinology and Metabolism, Concord Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Douglas P Kiel
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Robert Cumming
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW 2109, Australia
- Centre for Education and Research on Aging, Concord Hospital, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
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7
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Cao JJ, Roemmich JN, Sheng X, Jahns L. Increasing Vegetable Intake Decreases Urinary Acidity and Bone Resorption Marker in Overweight and Obese Adults: An 8-Week Randomized Controlled Trial. J Nutr 2021; 151:3413-3420. [PMID: 34386816 DOI: 10.1093/jn/nxab255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 05/18/2021] [Accepted: 07/08/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Controlled intervention trials are needed to confirm a positive association from epidemiological studies between vegetable consumption and bone health. OBJECTIVE We investigated whether providing vegetables at the Dietary Guidelines for Americans (DGA) recommended amount affects excretion of acid and calcium in urine and bone turnover markers in serum in adults with low vegetable intake. METHODS In total, 102 adults (19 males and 83 females, age 18-65 y, BMI ≥25 kg/m2) consuming ≤1 serving of vegetables (128 g raw leafy or 64 g cooked vegetables) per d were recruited in a 2-arm, parallel, randomized, controlled, and community-based 8-wk feeding intervention trial. The 2 arms included a vegetable intervention (VI) during which participants received extra vegetables (∼270 g/d) and an attention control (CON) group that conducted only the testing visits. Measurements included nutrient intake, plasma carotenoids, and bone-related markers in serum and urine. Differences between CON and VI at week 8 were tested using the ANCOVA with baseline values as a covariate. RESULTS Compared with CON, carotenoid intake (mean ± SD) was higher (6.4 ± 3.4 compared with 2.0 ± 1.2 mg/d) (P < 0.01) and dietary potential renal acid load was lower (20 ± 13 compared with 3.4 ± 14 mEq/d) (P < 0.01) in VI. Compared with CON at week 8, urine titratable acid and Mg were 24 and 26% lower, respectively, while urine pH was 3% greater (P < 0.05) and serum C-terminal telopeptide of type I collagen (CTX) was 19% lower in VI. There were no group differences in serum concentrations of propeptide of type 1 procollagen and tartrate-resistant acid phosphatase or urinary excretion of deoxypyridinoline and CTX. CONCLUSIONS Consumption of vegetables at the DGA-recommended amount by adults with low vegetable intake potentially benefits bone health. This trial was registered at clinicaltrials.gov as NCT02585102.
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Affiliation(s)
- Jay J Cao
- USDA, Agricultural Research Service, Grand Forks Human Nutrition Research Center, Grand Forks, ND, USA
| | - James N Roemmich
- USDA, Agricultural Research Service, Grand Forks Human Nutrition Research Center, Grand Forks, ND, USA
| | - Xiaoming Sheng
- Applied Statistics, University of Utah College of Nursing, Salt Lake City, UT, USA
| | - Lisa Jahns
- USDA, Agricultural Research Service, Grand Forks Human Nutrition Research Center, Grand Forks, ND, USA
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8
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Ding J, Zhang C, Guo Y. The association of OPG polymorphisms with risk of osteoporotic fractures: A systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e26716. [PMID: 34397809 PMCID: PMC8341286 DOI: 10.1097/md.0000000000026716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 07/02/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Subjects with low bone mineral density and osteoporosis are more likely to suffer osteoporotic fractures during their lifetime. Polymorphisms in osteoprotegerin (OPG) gene are found to be associated with low bone mineral density and osteoporosis risk but their association with fracture risk is inconclusive. Here, we performed a meta-analysis to investigate the relationship between OPG polymorphisms with susceptibility to osteoporotic fractures. METHODS Eligible studies investigating the association between common OPG polymorphisms (A164G, T245G, T950C, and G1181C) and risk of osteoporotic fracture were retrieved from PubMed, EMBASE, Web of Science, and the Cochrane Library. Odds ratio (OR) and the 95% confidence interval (CI) were calculated in the allelic, dominant, recessive, and homozygous model. Subgroup analyses of vertebral fractures, Caucasians, and postmenopausal women were also performed. RESULTS A total of 14 studies comprising 5459 fracture cases and 9860 non-fracture controls were included. A163G was associated with fracture risk in dominant (OR = 1.29, 95%CI 1.11-1.50), recessive (OR = 1.64, 95%CI 1.10-2.44), and homozygous model (OR = 1.73, 95%CI 1.16-2.59). T245G was significantly correlated with susceptibility to fractures in all genetic models. Subjects with CC genotype of T950C had a reduced risk of fracture compared to those with CT or TT genotypes (OR = 0.81, 95%CI 0.70-0.94, P = .004). Subgroup analysis showed that A163G and T245G but not T950C and G1181C were associated with vertebral fracture risk. CONCLUSION OPG A163G and T245G polymorphisms were risk factors of osteoporotic fractures while T950C had a protective role. These polymorphisms can be used as predictive markers of fractures.
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Sheng B, Li X, Nussler AK, Zhu S. The relationship between healthy lifestyles and bone health: A narrative review. Medicine (Baltimore) 2021; 100:e24684. [PMID: 33663079 PMCID: PMC7909112 DOI: 10.1097/md.0000000000024684] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/14/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Bone health, especially osteoporosis among ageing populations, has become an important topic for both clinical and basic researchers. The relationship between bone health and healthy lifestyles has been frequently discussed. The present study focuses on the relationship between bone health and healthy lifestyles among older adults, based on a global comparison. METHODS This narrative review was performed by collecting clinical trials, basic research and reviews on lifestyle and bone health in PubMed database. RESULTS Positive effects of physical activity and negative effects of malnutrition, alcohol abuse, and cigarette smoking on bone health were revealed. The relationship between bone health and drinking coffee and tea is still inconclusive. Moreover, the diversity of each region should be aware when considering healthy lifestyles to improve bone health. CONCLUSION Healthy lifestyles are highly related to bone health, and different lifestyles may have different influences on regions with a high risk of bone diseases. It is practical to acknowledge the diversity of economic, religious, environmental and geological conditions in each region when providing suitable and effective recommendations for healthy lifestyles that can improve overall bone health.
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Affiliation(s)
- Bin Sheng
- The First Affiliated Hospital of Hunan Normal University, Hunan Provincial People's Hospital, Changsha, PR China
| | - Xin Li
- The First Affiliated Hospital of Hunan Normal University, Hunan Provincial People's Hospital, Changsha, PR China
| | - Andreas K. Nussler
- Siegfried Weller Institute for Trauma Research, Eberhard Karls University Tuebingen, Department of Trauma and Reconstructive Surgery, BG Trauma Center Tuebingen, Tuebingen, Germany
| | - Sheng Zhu
- Siegfried Weller Institute for Trauma Research, Eberhard Karls University Tuebingen, Department of Trauma and Reconstructive Surgery, BG Trauma Center Tuebingen, Tuebingen, Germany
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10
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Ferro Y, Pujia R, Maurotti S, Mare R, Arturi F, Montalcini T, Pujia A, Mazza E. Relationship between osteoporosis, multiple fractures, and egg intake in healthy elderly. J Midlife Health 2021; 12:287-293. [PMID: 35264835 PMCID: PMC8849143 DOI: 10.4103/jmh.jmh_118_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 11/14/2021] [Accepted: 12/06/2021] [Indexed: 11/29/2022] Open
Abstract
Context: The role of dietary patterns in the prevention of osteoporosis has been investigated in many studies, but few have examined the association between consumption of specific food and whole-body (WB) bone mineral density (BMD). Recent evidence suggests that whole eggs contain bioactive compounds that could have beneficial effects on BMD. BMD is also expressed as the T-score, which is used for the clinical diagnosis of osteoporosis and to evaluate the effectiveness of drugs. Aims: We conducted a study to assess the association between eggs consumption and bone density in a population of the elderly. Settings and Design: This cross-sectional study included 176 individuals of both genders and aged ≥65 years. Subjects and Methods: Egg intake was ascertained by a combination of dietary intake assessment, and a dual X-ray absorptiometry scan was performed to measure WB T-score. Results: In our study, among all the food groups and nondietary factors evaluated, we find a positive association between the WB T-score and egg consumption (B = 0.02; P = 0.02), gender (B = 0.85; P < 0.001), and body mass index (B = 0.04; P = 0.03). Multiple fractures were associated with the daily intake of eggs (B = ‒0.26; P = 0.02) and high-density lipoprotein-cholesterol (B = 0.09; P = 0.03). Conclusions: This study provides novel evidence of a positive link between whole egg consumption and bone health. If results observed in this study will be confirmed through future randomized controlled trials, whole eggs may represent a viable strategy to prevent osteoporosis and reduce the risk of fractures in the elderly.
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11
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Associations between dietary patterns and osteoporosis-related outcomes in older adults: a longitudinal study. Eur J Clin Nutr 2020; 75:792-800. [PMID: 33190142 DOI: 10.1038/s41430-020-00806-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 08/29/2020] [Accepted: 10/31/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES To describe the associations of baseline dietary pattern scores with falls risk, bone mineral density (BMD), and incident fractures measured over 10 years in older adults. SUBJECTS/METHODS Dietary patterns were identified using exploratory factor analysis. Femoral neck (FN), hip, and lumbar spine (LS) BMD were measured using dual-energy X-ray absorptiometry, falls risk z-score using the Physiological Profile Assessment, and incident fractures by self-report. Linear mixed-effects models and log-binomial regression were used to estimate associations between baseline dietary pattern z-scores and outcomes. RESULTS Of 1098 participants at baseline, 567 were retained over 10 years. Four dietary patterns were derived: fruit and vegetable (FV), animal protein (AP), snack, and Western. FV pattern reduced falls risk at baseline by β = 0.05-0.08/SD and the annual decreases of FN and hip BMD were less for higher Western or AP pattern scores in all populations and women. The annual increase in LS of the entire population was greater with higher scores of FV, AP, and Western patterns (all β = 0.001 g/cm2/year/SD, p < 0.05). Higher scores of FV and snack were associated with a higher risk of LS BMD increasing over 10 years (p < 0.05 for all, except snack pattern in men) and incident fracture was not associated with any dietary pattern in the overall cohort and both men and women separately. CONCLUSIONS An FV dietary pattern may be beneficial for reducing falls risk. The associations of dietary patterns and BMD are modest in magnitude and did not translate into an improved fracture risk. Associations between diet and LS BMD may reflect osteoarthritis rather than osteoporosis.
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12
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Rogers-Soeder TS, Peters KE, Lane NE, Shikany JM, Judd S, Langsetmo L, Hoffman AR, Evans WJ, Cawthon PM. Dietary Intake, D3Cr Muscle Mass, and Appendicular Lean Mass in a Cohort of Older Men. J Gerontol A Biol Sci Med Sci 2020; 75:1353-1361. [PMID: 32556116 PMCID: PMC7302171 DOI: 10.1093/gerona/glz145] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND We examined cross-sectional associations between dietary patterns, macronutrient intake, and measures of muscle mass and lean mass in older men. METHODS Participants in the Osteoporotic Fractures in Men (MrOS) cohort (n = 903; mean ± SD age 84.2 ± 4 years) completed brief Block food frequency questionnaires (May 2014-May 2016); factor analysis was used to derive dietary patterns. The D3-creatine (D3Cr) dilution method was used to measure muscle mass; dual-energy x-ray absorptiometry (DXA) was used to measure appendicular lean mass (ALM). Generalized linear models were used to report adjusted means of outcomes by dietary pattern. Multiple linear regression models were used to determine associations between macronutrients and D3Cr muscle mass and DXA ALM. Multivariable models were adjusted for age, race, clinic site, education, depression, total energy intake, height, and percent body fat. RESULTS Greater adherence to a Western dietary pattern (high factor loadings for red meat, fried foods, and high-fat dairy) was associated with higher D3Cr muscle mass (p-trend = .026). Adherence to the Healthy dietary pattern (high factor loadings for fruit, vegetables, whole grains, and lean meats) was not associated with D3Cr muscle mass or DXA ALM. Total protein (β = 0.09, 95% CI = 0.03, 0.14) and nondairy animal protein (β = 0.16, 95% CI = 0.10, 0.21) were positively associated with D3Cr muscle mass. Nondairy animal protein (β = 0.06, 95% CI = 0.002, 0.11) was positively associated with DXA ALM. Associations with other macronutrients were inconsistent. CONCLUSIONS Nondairy animal protein intake (within a Western dietary pattern and alone) was positively associated with D3Cr muscle mass in older men.
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Affiliation(s)
- Tara S Rogers-Soeder
- Center for Musculoskeletal Health and Department of Internal Medicine, University of California at Davis, Sacramento
- True Health Center for Functional Medicine, El Dorado Hills, California
| | | | - Nancy E Lane
- Center for Musculoskeletal Health and Department of Internal Medicine, University of California at Davis, Sacramento
| | - James M Shikany
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham
| | - Suzanne Judd
- School of Public Health, University of Alabama at Birmingham
| | - Lisa Langsetmo
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis
| | | | - William J Evans
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley
- Division of Geriatrics, Duke University Medical Center, Durham, North Carolina
| | - Peggy M Cawthon
- California Pacific Medical Center Research Institute, San Francisco
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13
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Fabiani R, Naldini G, Chiavarini M. Reply to A Salari-Moghaddam et al. Adv Nutr 2020; 11:743. [PMID: 32419019 PMCID: PMC7231598 DOI: 10.1093/advances/nmz066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Roberto Fabiani
- From the Department of Chemistry, Biology, and Biotechnology, University of Perugia, Perugia, Italy,Address correspondence to RF (e-mail: )
| | - Giulia Naldini
- School of Specialization in Hygiene and Preventive Medicine, University of Perugia, Perugia, Italy
| | - Manuela Chiavarini
- Department of Experimental Medicine, Section of Public Heath, University of Perugia, Perugia, Italy
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14
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Salari-Moghaddam A, Larijani B, Esmaillzadeh A. Combining Population-Specific Dietary Patterns in Meta-analyses: True or False? Adv Nutr 2020; 11:463. [PMID: 32173749 PMCID: PMC7073310 DOI: 10.1093/advances/nmz071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Asma Salari-Moghaddam
- From the Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran,Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran,Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran,Address correspondence to AE (e-mail: )
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15
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Brondani JE, Comim FV, Flores LM, Martini LA, Premaor MO. Fruit and vegetable intake and bones: A systematic review and meta-analysis. PLoS One 2019; 14:e0217223. [PMID: 31150426 PMCID: PMC6544223 DOI: 10.1371/journal.pone.0217223] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 05/07/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Although intake of fruits and vegetables seemed to have a protective effect on bone metabolism, its effect on fractures remains uncertain. METHODS A systematic review of randomized controlled trials (RCTs) and cohort studies (PROSPERO: CRD42016041462) was performed. RCTs and cohort studies that evaluated the combined intake of fruits and vegetables in men and women aged over 50 years were included. We considered fractures as a primary outcome measure. Changes in bone markers were considered as secondary outcomes. The search strategy included the following descriptors: fruit, vegetables, vegetable products, bone and bones, bone fractures, postmenopausal osteoporosis, and osteoporosis. PubMed, Embase, and Cochrane Library were the databases used. The appraisal of the studies was performed by two independent reviewers, and discussed and agreed upon by both examiners. The data extracted from the RCTs and cohort studies were summarized separately. The risks of fractures were combined across studies using random models. Bone resorption marker (CTx) was summarized with standardized mean differences. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) method was used to evaluate the strength of recommendations. RESULTS Of the 1,192 studies screened, 13 articles were included in the systematic review and 10 were included in the pooled analysis (6 cohort studies and 4 RCTs). The six cohort studies included in the meta-analysis included a population of 225,062. The pooled hazard ratio (HR) (95% confidence interval (CI)) of the hip in five studies was 0.92 (0.87, 0.98). Its heterogeneity was moderate (I2 = 55.7%, p = 0.060), GRADE (⊕⊕⊕O). Two cohort studies evaluated the risk of any fracture; the HR was 0.90 (95% CI: 0.86-0.96), with aheterogeneity of 24.9% (p = 0.249, GRADE (⊕⊕⊕O)). There was no association between the bone resorption marker CTx and 3 months of fruit and vegetable intake evaluated by four RCTs, GRADE (⊕⊕O O). CONCLUSION There was an association between the increase of at least one serving of fruits and vegetables per day and decreases in the risk of fractures. The level of evidence for this association is moderate.
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Affiliation(s)
- Juliana E. Brondani
- Pós-graduação em Farmacologia, Health Sciences Center, Federal University of Santa Maria, Santa Maria, Brazil
| | - Fabio V. Comim
- Pós-graduação em Farmacologia, Health Sciences Center, Federal University of Santa Maria, Santa Maria, Brazil
| | - Liziane M. Flores
- Departamento de Saúde Coletiva, Health Sciences Center, Federal University of Santa Maria, Santa Maria, Brazil
| | | | - Melissa O. Premaor
- Pós-graduação em Farmacologia, Health Sciences Center, Federal University of Santa Maria, Santa Maria, Brazil
- * E-mail:
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16
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Wu S, Li Z, Zhang J, Rui Y. The genetic association between osteoprotegerin gene polymorphisms and fracture risk in Chinese Han population. J Cell Physiol 2019; 234:20603-20607. [PMID: 31025334 DOI: 10.1002/jcp.28664] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 02/20/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Shuwen Wu
- Department of Orthopedics Baodi People's Hospital Tianjin China
| | - Zhiyong Li
- Department of Orthopedics Baodi People's Hospital Tianjin China
| | - Jian Zhang
- Department of Spinal Joint Surgery Baodi People's Hospital Tianjin China
| | - Yanxiang Rui
- Department of Hand and Foot Surgery Baodi People's Hospital Tianjin China
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17
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Fabiani R, Naldini G, Chiavarini M. Dietary Patterns in Relation to Low Bone Mineral Density and Fracture Risk: A Systematic Review and Meta-Analysis. Adv Nutr 2019; 10:219-236. [PMID: 30657847 PMCID: PMC6416046 DOI: 10.1093/advances/nmy073] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/09/2018] [Accepted: 08/23/2018] [Indexed: 12/17/2022] Open
Abstract
Low bone mineral density (BMD) and osteoporosis-related fractures constitute a considerable public health burden. Several studies have demonstrated the association between diet and bone health. We performed a systematic review to provide an estimate of the association between different dietary patterns defined through the use of a posteriori methods and fracture or low BMD risk. A literature search on PubMed, Web of Science, and Scopus databases, up to March 2018, was performed to identify all eligible case-control, prospective, or cross-sectional studies involving subjects of both sexes and any age. Random-effects models were used. Heterogeneity and publication bias were evaluated. Stratified analyses were conducted on study characteristics. The meta-analysis includes 20 studies and identifies 3 prevalent dietary patterns: "Healthy," "Milk/dairy," and "Meat/Western." From the 10 studies on fracture, adherence to the "Healthy" pattern reduced the risk, particularly in older people (OR: 0.79; 95% CI: 0.66, 0.95; P = 0.011) and in Eastern countries (OR: 0.64; 95% CI: 0.43, 0.97; P = 0.037), whereas the risk increased with the "Meat/Western" pattern, especially for older people (OR: 1.11; 95% CI: 1.04, 1.18, P = 0.001), in those with hip fractures (OR: 1.15; 95% CI: 1.05, 1.25; P = 0.002), and in Western countries (OR: 1.10; 95% CI: 1.07, 1.14; P < 0.0001). Analyses on low BMD showed a reduced risk in the "Healthy" pattern, particularly for younger people (OR: 0.62; 95% CI: 0.44, 0.89; P = 0.009). The "Meat/Western" pattern increased low BMD risk, especially in older people (OR: 1.31; 95% CI: 1.05, 1.64; P = 0.015). The "Milk/dairy" pattern resulted in the strongest reduction in low BMD risk; when stratifying, this effect remained significant (e.g., older women-OR: 0.57; 95% CI: 0.46, 0.70; P < 0.0001). Nutrition is an important modifiable factor affecting bone health. The "Healthy" and "Milk/dairy" patterns are associated with a reduced risk of low BMD and fracture. In contrast, the "Western" pattern is inversely associated.
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Affiliation(s)
- Roberto Fabiani
- Department of Chemistry, Biology, and Biotechnology,Address correspondence to RF (e-mail: )
| | - Giulia Naldini
- School of Specialization in Hygiene and Preventive Medicine
| | - Manuela Chiavarini
- Department of Experimental Medicine, Section of Public Heath, University of Perugia, Perugia, Italy
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18
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Kim HS, Sohn C, Kwon M, Na W, Shivappa N, Hébert JR, Kim MK. Positive Association between Dietary Inflammatory Index and the Risk of Osteoporosis: Results from the KoGES_Health Examinee (HEXA) Cohort Study. Nutrients 2018; 10:nu10121999. [PMID: 30563032 PMCID: PMC6316268 DOI: 10.3390/nu10121999] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/11/2018] [Accepted: 12/13/2018] [Indexed: 12/17/2022] Open
Abstract
Previous studies have found that diet’s inflammatory potential is related to various diseases. However, little is known about its relationship with osteoporosis. The aim of this study was to investigate the association between the dietary inflammatory index (DII®) and osteoporosis risk in a large-scale prospective cohort study in Korea. This prospective cohort study included 159,846 participants (men 57,740; women 102,106) from South Korea with a mean follow-up of 7.9 years. The DII was calculated through a validated semi-quantitative FFQ (SQFFQ), and information on osteoporosis was self-reported by the participants. Analyses were performed by using a multivariable Cox proportional hazard model. Higher DII scores were associated with higher osteoporosis risk (HR 1.33; 95% CI 1.12–1.58). In women, a higher DII score indicated a higher risk of osteoporosis (HR 1.33; 95% CI 1.11–1.59). However, a hazards ratio of similar magnitude in men was not significant (HR 1.32; 95% CI 0.64–2.71). Post-menopausal women had higher risks of osteoporosis for higher DII scores (HR 1.33; 95% CI 1.09–1.63), whereas among pre-menopausal women, the relationship was not statistically significant (HR 1.39; 95% CI 0.87–2.21). Also, there was an increase in osteoporosis risk when the DII increased among women participants with irregular physical activity (HR 1.53; 95% CI 1.17–2.01); however, there was no statistically significant increase in osteoporosis risk among women participants with regular physical activity (HR 1.19; 95% CI 0.93–1.52). A more pro-inflammatory diet was significantly associated with higher osteoporosis risk in women. Given the similar magnitude of the hazards ratio, studies with sufficient numbers of men are warranted.
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Affiliation(s)
- Hye Sun Kim
- Cancer Epidemiology Branch, Division of Cancer Epidemiology and Prevention, National Cancer Center, 10408 Goyang, Gyeonggi do, Korea.
| | - Cheongmin Sohn
- Department of Food and Nutrition, Wonkwang University, 54538 Iksan, Korea.
| | - Minji Kwon
- Cancer Epidemiology Branch, Division of Cancer Epidemiology and Prevention, National Cancer Center, 10408 Goyang, Gyeonggi do, Korea.
| | - Woori Na
- Department of Food and Nutrition, Wonkwang University, 54538 Iksan, Korea.
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA.
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
- Connecting Health Innovations LLC, Columbia, SC 29201, USA.
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC 29208, USA.
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
- Connecting Health Innovations LLC, Columbia, SC 29201, USA.
| | - Mi Kyung Kim
- Cancer Epidemiology Branch, Division of Cancer Epidemiology and Prevention, National Cancer Center, 10408 Goyang, Gyeonggi do, Korea.
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Dietary Patterns, Bone Mineral Density, and Risk of Fractures: A Systematic Review and Meta-Analysis. Nutrients 2018; 10:nu10121922. [PMID: 30563066 PMCID: PMC6316557 DOI: 10.3390/nu10121922] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 11/30/2018] [Accepted: 12/02/2018] [Indexed: 01/22/2023] Open
Abstract
The aim of this systematic review was to assess the evidence on the relation between dietary patterns, bone mineral density (BMD), and risk of fracture in different age groups. Medline and Embase were searched for articles that identified dietary patterns and related these to BMD or risk of fracture through May 2018. Multivariable adjusted odds ratios (ORs) and 95% confidence intervals (95%CI) comparing the lowest and highest categories of dietary pattern were combined by using a random effects meta-analysis. In total, 31 studies were selected for review, including 18 cohorts, 1 case-control, and 12 cross-sectional studies, in the meta-analysis of Prudent/healthy and Western/unhealthy dietary pattern, BMD, and risk of fracture. There was evidence of a lower risk of fracture when intakes in the highest categories were compared with the lowest categories of Prudent/healthy dietary pattern (OR = 0.81; 95%CI: 0.69, 0.95; p = 0.01). In contrast, when intakes in the highest categories were compared with the lowest categories of Western/unhealthy dietary pattern, a greater risk of fracture (OR = 1.10; 95%CI: 1.02, 1.19; p = 0.01) was observed among men. The present systematic review and meta-analysis provides evidence of an inverse association between a Prudent/healthy dietary pattern and risk of low BMD and a positive relation between Western/unhealthy dietary pattern and risk of low BMD.
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20
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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. Mediterranean diet and hip fracture incidence among older adults: the CHANCES project. Osteoporos Int 2018; 29:1591-1599. [PMID: 29656347 DOI: 10.1007/s00198-018-4517-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 03/28/2018] [Indexed: 12/29/2022]
Abstract
UNLABELLED 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.
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Affiliation(s)
- V Benetou
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias street, 115 27, Athens, Greece.
| | - P Orfanos
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias street, 115 27, Athens, Greece
- Hellenic Health Foundation, Athens, Greece
| | - D Feskanich
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
| | - K Michaëlsson
- Department of Surgical Sciences, Section of Orthopedics, Uppsala University, Uppsala, Sweden
| | - U Pettersson-Kymmer
- Department of Pharmacology and Clinical Neurosciences and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - L Byberg
- Department of Surgical Sciences, Section of Orthopedics, Uppsala University, Uppsala, Sweden
| | - S Eriksson
- Department of Community Medicine, Umeå University, Umeå, Sweden
| | - F Grodstein
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
| | - A Wolk
- Department of Surgical Sciences, Section of Orthopedics, Uppsala University, Uppsala, Sweden
- Institute of Environmental Medicine, Division of Nutritional Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - N Jankovic
- Center of Clinical Epidemiology, Institute of Medical Informatics, Biometry, and Epidemiology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - L C P G M de Groot
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - P Boffetta
- Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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21
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Rogers TS, Harrison S, Judd S, Orwoll ES, Marshall LM, Shannon J, Langsetmo L, Lane NE, Shikany JM. Dietary patterns and longitudinal change in hip bone mineral density among older men. Osteoporos Int 2018; 29:1135-1145. [PMID: 29450584 PMCID: PMC6842326 DOI: 10.1007/s00198-018-4388-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 01/05/2018] [Indexed: 01/15/2023]
Abstract
UNLABELLED Studying dietary patterns is often more informative than individual nutrients or foods. We found that a Prudent dietary pattern (rich in vegetables and fish) was associated with reduced loss of total hip BMD in older men. A Prudent dietary pattern may be a potential lifestyle strategy for minimizing bone loss. INTRODUCTION This study aimed to identify baseline dietary patterns using factor analysis in a cohort of older men and to evaluate whether the dietary patterns were associated with bone mineral density change (%ΔBMD) at the total hip and femoral neck over time. METHODS Participants (n = 4379; mean age 72.9 ± 5.5 years) were from the Osteoporotic Fractures in Men (MrOS) prospective cohort study and had dietary data collected at baseline (March 2000-April 2002) and BMD measured at baseline and Visit 2 (March 2005-May 2006). Dietary intake was assessed with a brief Block food frequency questionnaire (FFQ); factor analysis was used to derive dietary patterns. BMD was measured by dual-energy x-ray absorptiometry (DXA); %ΔBMD was calculated from baseline to Visit 2. We used generalized linear regression to estimate least square (LS) means of %ΔBMD in quartiles of the dietary pattern scores adjusted for potential confounding factors. RESULTS Two major dietary patterns were derived: Prudent (abundant in vegetables, salad, and non-fried fish) and Western (rich in hamburger, fries, processed meats, cheese, and sweets/desserts). There was an inverse association between adherence to the Prudent pattern and total hip %ΔBMD (p-trend = 0.028 after adjusting for age and clinical site; p-trend = 0.033 after further adjustment for smoking, calcium supplement use, diabetes, hypertension, and total energy intake). No other consistent associations between dietary patterns and %ΔBMD were observed. CONCLUSIONS Greater adherence to a Prudent dietary pattern may attenuate total hip BMD loss (%ΔBMD) in older men.
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Affiliation(s)
- T S Rogers
- Center for Musculoskeletal Health and Department of Internal Medicine, University of California - Davis Medical Center, 4625 2nd Avenue, Suite 2000, Sacramento, CA, 95817, USA.
| | - S Harrison
- California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | - S Judd
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - E S Orwoll
- Oregon Health and Science University, Portland, OR, USA
| | - L M Marshall
- Oregon Health and Science University, Portland, OR, USA
| | - J Shannon
- Oregon Health and Science University, Portland, OR, USA
| | - L Langsetmo
- University of Minnesota Epidemiology and Community Health, Minneapolis, MN, USA
| | - N E Lane
- Center for Musculoskeletal Health and Department of Internal Medicine, University of California - Davis Medical Center, 4625 2nd Avenue, Suite 2000, Sacramento, CA, 95817, USA
| | - J M Shikany
- University of Alabama at Birmingham, Birmingham, AL, USA
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22
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Veronese N, Stubbs B, Koyanagi A, Hébert JR, Cooper C, Caruso MG, Guglielmi G, Reginster JY, Rizzoli R, Maggi S, Shivappa N. Pro-inflammatory dietary pattern is associated with fractures in women: an eight-year longitudinal cohort study. Osteoporos Int 2018; 29:143-151. [PMID: 29018920 PMCID: PMC5760322 DOI: 10.1007/s00198-017-4251-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 09/27/2017] [Indexed: 01/17/2023]
Abstract
In this study, during 8 years of follow-up, we reported that higher dietary inflammatory index values were associated with a higher risk of incident fractures in women, but not in men, after adjusting for potential confounders. INTRODUCTION Inflammation is a key risk factor for many adverse outcomes in older people. While diet is a potential source of inflammation, little is known about the impact of inflammatory diet on fractures. Thus, we investigated whether higher Dietary Inflammatory Index (DII)™ ® scores are associated with fractures in a cohort of North American people. METHODS This longitudinal study with a follow-up of 8 years included 3648 participants (1577 males and 2071 females; mean age = 60.6 years) with/at risk of knee osteoarthritis participating with in the Osteoarthritis Initiative. DII scores were calculated using the validated Block Brief 2000 Food Frequency Questionnaire, categorized into sex-specific quintiles. Information on fractures was obtained through self-reported history of fractures at hip, spine, and forearm. The relationship between baseline DII score and incident fracture was assessed through a Cox's regression analysis, adjusted for potential baseline confounders, and reported as hazard ratios (HRs). RESULTS During 8 years of follow-up, 560 individuals developed fractures (15.4%). Adjusting for 10 potential confounders, women in the highest DII score quintile (i.e., most pro-inflammatory diet) had a significantly higher risk for fractures (HR = 1.46; 95% CI = 1.02-2.11) compared to women in the lowest quintile. An increase in one standard deviation of DII scores significantly predicted fracture onset in women (adjusted HR = 1.14; 95% CI = 1.02-1.27). The association between DII score and fractures was not significant among men or in the sample as whole. CONCLUSION Pro-inflammatory diet is associated with a higher incidence of fractures in women but not men.
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Affiliation(s)
- N Veronese
- National Research Council,, Neuroscience Institute, Aging Branch, Via Giustiniani, 2, 35128, Padova, Italy.
- Ambulatory of Nutrition, IRCCS "S. de Bellis", National Institute of Gastroenterology-Research Hospital, Castellana Grotte, Bari, Italy.
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, Box SE5 8AF, London, UK
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, CM1 1SQ, UK
| | - A Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - J R Hébert
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Connecting Health Innovations LLC, Columbia, SC, USA
| | - C Cooper
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK
- National Institute for Health Research Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Southampton, SO16 6YD, UK
| | - M G Caruso
- Ambulatory of Nutrition, IRCCS "S. de Bellis", National Institute of Gastroenterology-Research Hospital, Castellana Grotte, Bari, Italy
| | - G Guglielmi
- Department of Radiology, University of Foggia, Foggia, Italy
- Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Foggia, Italy
| | - J Y Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liege, CHU Sart Tilman B23, 4000, Liège, Belgium
| | - R Rizzoli
- Division of Bone Diseases, Department of Internal Medicine Specialties, and Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - S Maggi
- National Research Council,, Neuroscience Institute, Aging Branch, Via Giustiniani, 2, 35128, Padova, Italy
| | - N Shivappa
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Connecting Health Innovations LLC, Columbia, SC, USA
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23
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Melaku YA, Gill TK, Appleton SL, Taylor AW, Adams R, Shi Z. Prospective Associations of Dietary and Nutrient Patterns with Fracture Risk: A 20-Year Follow-Up Study. Nutrients 2017; 9:nu9111198. [PMID: 29088104 PMCID: PMC5707670 DOI: 10.3390/nu9111198] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 10/10/2017] [Accepted: 10/26/2017] [Indexed: 11/21/2022] Open
Abstract
Studies on long-term exposure to foods/nutrients and its associations with fracture risk are scarce. Using data from the China Health and Nutrition Survey (CHNS), we determined the prospective association of dietary and nutrient patterns with fractures. Data from 15,572 adults aged ≥18 years were analyzed. Fracture occurrence was self-reported and dietary intake data were collected using a 24-h recall method for three consecutive days, for each individual across nine waves (1989–2011). We used cumulative and overall mean, recent and baseline dietary and nutrient exposures. Hazard ratios (HR) were used to determine the associations. Two dietary (traditional and modern) and two nutrient (plant- and animal-sourced) patterns were identified. After adjusting for potential confounders, study participants in the third tertiles (highest intake) of the modern dietary and animal-sourced nutrient patterns’ cumulative scores had a 34% (HR = 1.34; 95% CI: 1.06–1.71) and 37% (HR = 1.37; 95% CI: 1.08–1.72) increase in fracture risks compared to those in the first tertiles, respectively. While the overall mean factor scores of dietary and nutrient patterns had a similar (or stronger) pattern of association as the cumulative scores, no association between recent and baseline scores and fracture was found. Greater adherence to a modern dietary and/or an animal-sourced nutrient pattern is associated with a higher risk of total fractures. This suggests that a modern animal based diet is related to bone fragility. A repeated three-day 24-h recall dietary assessment provides a stronger association with fracture compared to a recent or baseline exposure.
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Affiliation(s)
- Yohannes Adama Melaku
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005, Australia.
- Department of Human Nutrition, Institute of Public Health, University of Gondar, Gondar 196, Ethiopia.
| | - Tiffany K Gill
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005, Australia.
| | - Sarah L Appleton
- The Health Observatory, Discipline of Medicine, The Queen Elizabeth Hospital Campus, University of Adelaide, Woodville, SA 5011, Australia.
- Freemason's Centre for Men's Health, Discipline of Medicine, The University of Adelaide, Adelaide, SA 5005, Australia.
| | - Anne W Taylor
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005, Australia.
| | - Robert Adams
- The Health Observatory, Discipline of Medicine, The Queen Elizabeth Hospital Campus, University of Adelaide, Woodville, SA 5011, Australia.
| | - Zumin Shi
- Adelaide Medical School, The University of Adelaide, Adelaide, SA 5005, Australia.
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24
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Association between Dietary Patterns of Meat and Fish Consumption with Bone Mineral Density or Fracture Risk: A Systematic Literature. Nutrients 2017; 9:nu9091029. [PMID: 29358568 PMCID: PMC5622789 DOI: 10.3390/nu9091029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 08/31/2017] [Accepted: 09/11/2017] [Indexed: 12/11/2022] Open
Abstract
This systematic review aimed to investigate the association of fish and sea fish dietary patterns (FishDiet) and meat or processed meat dietary patterns (MeatDiet) with bone mineral density (BMD) and/or risk of fractures (RF). This review includes 37 studies with a total of 432,924 subjects. The results suggest that MeatDiet and FishDiet did not affect BMD or RF in 48.2% of the subjects with MeatDiet and in 86.5% of the subjects with FishDiet. Positive effects on bone were found in 3% of subjects with MeatDiet and in 12% with FishDiet. Negative effects on bone were observed in 2.7% of FishDiet and in 47.9% of MeatDiet. Major negative effects of MeatDiet were found in subjects located in the Netherlands, Greece, Germany, Italy, Norway, UK and Spain who do not sustain a Mediterranean diet (92.7%); in Korea (27.1%); in Brazil and Mexico (96.4%); and in Australia (62.5%). This study suggests that protein intake from fish or meat is not harmful to bone. Negative effects on bone linked to FishDiet are almost null. Negative effects on bone were associated to MeatDiet in the setting of a Western Diet but not in Mediterranean or Asian Diets.
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25
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Long-term a posteriori dietary patterns and risk of hip fractures in a cohort of women. Eur J Epidemiol 2017; 32:605-616. [PMID: 28585122 PMCID: PMC5570766 DOI: 10.1007/s10654-017-0267-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 05/29/2017] [Indexed: 12/11/2022]
Abstract
Dietary pattern analysis is a useful tool to study the importance of food components in the context of a diet and how they relate to health and disease. The association between dietary patterns and fractures is at present uncertain. We aimed to study associations between dietary patterns and risk of hip fracture in the Swedish Mammography Cohort, including 56,736 women (median baseline age 52 years). Diet data was collected in food frequency questionnaires at two investigations and dietary patterns were defined by principal component analysis using 31 food groups. Information on hip fractures was collected from the Swedish National Patient Register. Multivariable adjusted hazard ratios (HR) with 95% confidence intervals (CI) were estimated in Cox proportional hazards regression analysis. The two patterns identified—the healthy and Western/convenience dietary patterns—were time-updated and analysed. During a median follow-up time of 25.5 years, 4997 women experienced a hip fracture. Hip fracture rate was 31% lower in the highest compared to the lowest quartile of the healthy dietary pattern [HR (95% CI) 0.69 (0.64; 0.75)]. In contrast, women in the highest compared to the lowest quartile of the Western/convenience dietary pattern had a 50% higher [HR (95% CI) 1.50 (1.38; 1.62)] hip fracture rate. Further, in each stratum of a Western/convenience dietary pattern a higher adherence to a healthy dietary pattern was associated with less hip fractures. The present results suggest that a varied healthy diet may be beneficial for the prevention of fragility fractures in women.
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26
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Fat, Sugar, and Bone Health: A Complex Relationship. Nutrients 2017; 9:nu9050506. [PMID: 28513571 PMCID: PMC5452236 DOI: 10.3390/nu9050506] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 04/26/2017] [Accepted: 05/12/2017] [Indexed: 02/05/2023] Open
Abstract
With people aging, osteoporosis is expected to increase notably. Nutritional status is a relatively easily-modified risk factor, associated with many chronic diseases, and is involved in obesity, diabetes, and coronary heart disease (CHD), along with osteoporosis. Nutrients, such as fats, sugars, and proteins, play a primary function in bone metabolism and maintaining bone health. In Western nations, diets are generally high in saturated fats, however, currently, the nutritional patterns dominating in China continue to be high in carbohydrates from starch, cereals, and sugars. Moreover, high fat or high sugar (fructose, glucose, or sucrose) impart a significant impact on bone structural integrity. Due to diet being modifiable, demonstrating the effects of nutrition on bone health can provide an approach for osteoporosis prevention. Most researchers have reported that a high-fat diet consumption is associated with bone mineral density (BMD) and, as bone strength diminishes, adverse microstructure changes occur in the cancellous bone compartment, which is involved with lipid metabolism modulation disorder and the alteration of the bone marrow environment, along with an increased inflammatory environment. Some studies, however, demonstrated that a high-fat diet contributes to achieving peak bone mass, along with microstructure, at a younger age. Contrary to these results, others have shown that a high-fructose diet consumption leads to stronger bones with a superior microarchitecture than those with the intake of a high-glucose diet and, at the same time, research indicated that a high-fat diet usually deteriorates cancellous bone parameters, and that the incorporation of fructose into a high-fat diet did not aggravate bone mass loss. High-fat/high-sucrose diets have shown both beneficial and detrimental influences on bone metabolism. Combined, these studies showed that nutrition exerts different effects on bone health. Thus, a better understanding of the regulation between dietary nutrition and bone health might provide a basis for the development of strategies to improve bone health by modifying nutritional components.
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27
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Marchand NE, Jensen MK. The Role of Dietary and Lifestyle Factors in Maintaining Cognitive Health. Am J Lifestyle Med 2017; 12:268-285. [PMID: 32063810 DOI: 10.1177/1559827617701066] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 02/04/2017] [Accepted: 03/03/2017] [Indexed: 01/18/2023] Open
Abstract
Concern over loss of cognitive function, including descent into Alzheimer's disease or dementia, grips a growing percentage of men and women worldwide as the global population ages. Many studies, though not all, suggest that maintaining cognitive health, as well as slowing and even preventing cognitive decline, dementia, and Alzheimer's disease, can be achieved by consuming healthy diets over a long enough period of time. This appears to be the case even for those who initiated dietary changes later in life, as evidenced by an intervention study assessing consumption of a healthy diet among those who were >50 years of age. All such diets share the common traits of being rich in fruits, vegetables, whole grains, and fish or seafood, while also being low in red meat and sweets. A Mediterranean-style diet shares these characteristics and has been associated with an estimated 40% lower risk of cognitive impairment, including mild cognitive impairment, dementia, and Alzheimer's disease in prospective studies, in addition to being associated with both a 65% lower risk of mild cognitive impairment and improved cognitive performance in a notable randomized controlled trial.
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Affiliation(s)
- Nathalie E Marchand
- Departments of Nutrition and Epidemiology (NEM), Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Department of Nutrition (MKJ), Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,The Channing Division of Network Medicine, Beth Israel Deaconess Medical Center Boston, Boston, Massachusetts (MKJ)
| | - Majken K Jensen
- Departments of Nutrition and Epidemiology (NEM), Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Department of Nutrition (MKJ), Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,The Channing Division of Network Medicine, Beth Israel Deaconess Medical Center Boston, Boston, Massachusetts (MKJ)
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28
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de Jonge EA, Kiefte-de Jong JC, Hofman A, Uitterlinden AG, Kieboom BC, Voortman T, Franco OH, Rivadeneira F. Dietary patterns explaining differences in bone mineral density and hip structure in the elderly: the Rotterdam Study. Am J Clin Nutr 2017; 105:203-211. [PMID: 27903522 DOI: 10.3945/ajcn.116.139196] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 10/19/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Evidence on the association between dietary patterns, measures of hip bone geometry, and subsequent fracture risk are scarce. OBJECTIVE The objective of this study was to evaluate whether dietary patterns that explain most variation in bone mineral density (BMD) and hip bone geometry are associated with fracture risk. DESIGN We included 4028 subjects aged ≥55 y from the Rotterdam study. Intake of 28 food groups was assessed with the use of food-frequency questionnaires. BMD, bone width, section modulus (SM; reflecting bending strength) and cortical buckling ratio (BR; reflecting bone instability) were measured with the use of dual-energy X-ray absorptiometry. BMD and geometry-specific dietary patterns were identified with the use of reduced rank regression. Fracture data were reported by general practitioners (median follow-up 14.8 y). RESULTS We identified 4 dietary patterns. Of the 4, we named 2 patterns "fruit, vegetables, and dairy" and "sweets, animal fat, and low meat," respectively. These 2 patterns were used for further analysis. Independently of confounders, adherence to the fruit, vegetables, and dairy pattern was associated with high BMD, high SM, low BR, and low risk of fractures [HR (95% CI) for osteoporotic fractures: 0.90 (0.83, 0.96); for hip fractures: 0.85 (0.81, 0.89) per z score of dietary pattern adherence]. Adherence to the sweets, animal fat, and low meat pattern was associated with high bone width, high SM, high BR, and high risk of fractures [HR (95% CI) for osteoporotic fractures: 1.08 (1.00, 1.06); for hip fractures: 1.06 (1.02, 1.12) per z score]. CONCLUSION The fruit, vegetables, and dairy pattern might be associated with lower fracture risk because of high BMD, high bending strength, and more stable bones. The sweets, animal fat, and low meat pattern might be associated with higher fracture risk because of widened, unstable bones, independently of BMD. Dietary recommendations associated with bone geometry in addition to BMD might influence risk of fractures.
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Affiliation(s)
- Ester Al de Jonge
- Department of Epidemiology and.,Department of Internal Medicine, Erasmus Medical University Centre, Rotterdam, Netherlands
| | - Jessica C Kiefte-de Jong
- Department of Epidemiology and .,Department of Global Public Health, Leiden University College, The Hague, Netherlands
| | - Albert Hofman
- Department of Epidemiology and.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; and
| | - André G Uitterlinden
- Department of Epidemiology and.,Department of Internal Medicine, Erasmus Medical University Centre, Rotterdam, Netherlands
| | - Brenda Ct Kieboom
- Department of Epidemiology and.,Department of Internal Medicine, Erasmus Medical University Centre, Rotterdam, Netherlands.,Inspectorate for Health Care, Utrecht, Netherlands
| | | | | | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus Medical University Centre, Rotterdam, Netherlands
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29
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Movassagh EZ, Vatanparast H. Current Evidence on the Association of Dietary Patterns and Bone Health: A Scoping Review. Adv Nutr 2017; 8:1-16. [PMID: 28096123 PMCID: PMC5227978 DOI: 10.3945/an.116.013326] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Nutrition is an important modifiable factor that affects bone health. Diet is a complex mixture of nutrients and foods that correlate or interact with each other. Dietary pattern approaches take into account contributions from various aspects of diet. Findings from dietary pattern studies could complement those from single-nutrient and food studies on bone health. In this study we aimed to conduct a scoping review of the literature that assessed the impact of dietary patterns (derived with the use of both a priori and data-driven approaches) on bone outcomes, including bone mineral status, bone biomarkers, osteoporosis, and fracture risk. We retrieved 49 human studies up to June 2016 from the PubMed, Embase, and CINAHL databases. Most of these studies used a data-driven method, especially factor analysis, to derive dietary patterns. Several studies examined adherence to a variety of the a priori dietary indexes, including the Mediterranean diet score, the Healthy Eating Index (HEI), and the Alternative Healthy Eating Index (AHEI). The bone mineral density (BMD) diet score was developed to measure adherence to a dietary pattern beneficial to bone mineral density. Findings revealed a beneficial impact of higher adherence to a "healthy" dietary pattern derived using a data-driven method, the Mediterranean diet, HEI, AHEI, Dietary Diversity Score, Diet Quality Index-International, BMD Diet Score, Healthy Diet Indicator, and Korean Diet Score, on bone. In contrast, the "Western" dietary pattern and those featuring some aspects of an unhealthy diet were associated inversely with bone health. In both a priori and data-driven dietary pattern studies, a dietary pattern that emphasized the intake of fruit, vegetables, whole grains, poultry and fish, nuts and legumes, and low-fat dairy products and de-emphasized the intake of soft drinks, fried foods, meat and processed products, sweets and desserts, and refined grains showed a beneficial impact on bone health. Overall, adherence to a healthy dietary pattern consisting of the above-mentioned food groups can improve bone mineral status and decrease osteoporosis and fracture risk.
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Affiliation(s)
| | - Hassan Vatanparast
- College of Pharmacy and Nutrition and
- School of Public Health, University of Saskatchewan, Saskatoon, Canada
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30
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Benetou V, Orfanos P, Feskanich D, Michaëlsson K, Pettersson-Kymmer U, Eriksson S, Grodstein F, Wolk A, Bellavia A, Ahmed LA, Boffeta P, Trichopoulou A. Fruit and Vegetable Intake and Hip Fracture Incidence in Older Men and Women: The CHANCES Project. J Bone Miner Res 2016; 31:1743-52. [PMID: 27061845 DOI: 10.1002/jbmr.2850] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 03/22/2016] [Accepted: 04/07/2016] [Indexed: 12/20/2022]
Abstract
The role of fruit and vegetable intake in relation to fracture prevention during adulthood and beyond is not adequately understood. We investigated the potential association between fruit and vegetable intake and hip fracture incidence in a large sample of older adults from Europe and the United States. A total of 142,018 individuals (116,509 women) aged ≥60 years, from five cohorts, were followed up prospectively for 1,911,482 person-years, accumulating 5552 hip fractures. Fruit and vegetable intake was assessed by validated, cohort-specific, food-frequency questionnaires (FFQ). Ηip fractures were ascertained through national patient registers or telephone interviews/questionnaires. Adjusted hazard ratios (HRs) derived by Cox proportional hazards regression were estimated for each cohort and subsequently pooled using random effects meta-analysis. Intake of ≤1 serving/day of fruit and vegetables combined was associated with 39% higher hip fracture risk (pooled adjusted HR, 1.39; 95% confidence interval [CI], 1.20 to 1.58) in comparison with moderate intake (>3 and ≤5 servings/day) (pfor heterogeneity = 0.505), whereas higher intakes (>5 servings/day) were not associated with lower risk in comparison with the same reference. Associations were more evident among women. We concluded that a daily intake of 1 or <1 servings of fruits and vegetables was associated with increased hip fracture risk in relation to moderate daily intakes. Older adults with such low fruit and vegetable consumption may benefit from raising their intakes to moderate amounts in order to reduce their hip fracture risk. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- Vassiliki Benetou
- Department of Hygiene, Epidemiology, and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Hellenic Health Foundation, Athens, Greece
| | - Philippos Orfanos
- Department of Hygiene, Epidemiology, and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Hellenic Health Foundation, Athens, Greece
| | - Diane Feskanich
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Karl Michaëlsson
- Department of Surgical Sciences, Section of Orthopedics, Uppsala University, Uppsala, Sweden
| | - Ulrika Pettersson-Kymmer
- Department of Pharmacology and Clinical Neurosciences, Umeå University, Umeå, Sweden.,Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Sture Eriksson
- Department of Community Medicine, Umeå University, Umeå, Sweden
| | - Francine Grodstein
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Alicja Wolk
- Institute of Environmental Medicine, Division of Nutritional Epidemiology, Karolinska Institute, Stockholm, Sweden
| | - Andrea Bellavia
- Institute of Environmental Medicine, Division of Nutritional Epidemiology, Karolinska Institute, Stockholm, Sweden
| | - Luai A Ahmed
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT-the Arctic University of Norway, Tromsø, Norway.,Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Paolo Boffeta
- Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Antonia Trichopoulou
- Department of Hygiene, Epidemiology, and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Hellenic Health Foundation, Athens, Greece
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31
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Increased intake of vegetables, but not fruits, may be associated with reduced risk of hip fracture: A meta-analysis. Sci Rep 2016; 6:19783. [PMID: 26806285 PMCID: PMC4726403 DOI: 10.1038/srep19783] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 12/17/2015] [Indexed: 01/21/2023] Open
Abstract
Association between dietary intake of vegetables and fruits and risk of hip fracture has been reported for many years. However, the findings remain inconclusive. We conducted a meta-analysis to evaluate the relationship between intake of vegetables and fruits, and risk of hip fracture. Literature search for relevant studies was performed on PubMed and Embase databases. Five observational studies were included in the meta-analysis. Summary hazard ratio (HR) with corresponding 95% confidence interval (CI) was calculated from pooled data using the random-effects model irrespective of heterogeneity. Sensitivity and subgroup analysis were performed to explore possible reasons for heterogeneity. The summary HR for hip fracture in relation to high intake vs. low intake of only vegetables, only fruits, and combined intake of fruits and vegetables, was 0.75 (95% CI, 0.61–0.92), 0.87 (95% CI, 0.74–1.04), and 0.79 (95% CI, 0.61–1.03), respectively. Subgroup analyses based on study design, geographical location, number of cases, and gender showed similar results. Increased intake of vegetables, but not fruits, was found to be associated with a lower risk of hip fracture. Large prospective clinical trials with robust methodology are required to confirm our findings.
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