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Low-fat, increased fruit, vegetable, and grain dietary pattern, fractures, and bone mineral density: the Women's Health Initiative Dietary Modification Trial.
Am J Clin Nutr. 2009 Jun; 89(6):1864-76.AJ

Abstract

BACKGROUND

The effects of dietary changes on osteoporosis, low bone density, and frequent falls are unestablished.

OBJECTIVE

We assessed the effect of the Women's Health Initiative Dietary Modification low-fat and increased fruit, vegetable, and grain intervention on incident hip, total, and site-specific fractures and self-reported falls, and, in a subset, on bone mineral density (BMD).

DESIGN

Postmenopausal women (n = 48,835) aged 50-79 y (18.6% of minority race-ethnicity) were randomly assigned to receive the Dietary Modification intervention (40%, n = 19,541) (daily goal: < or =20% of energy as fat, > or =5 servings of vegetables and fruit, and > or =6 servings of grains) or to a comparison group that received no dietary changes (60%; n = 29,294).

RESULTS

After a mean 8.1 y of follow-up, 215 women in the intervention group and 285 women in the comparison group (annualized rate: 0.14% and 0.12%, respectively) experienced a hip fracture (hazard ratio: 1.12; 95% CI: 0.94, 1.34; P = 0.21). The intervention group (n = 5423; annualized rate: 3.44%) had a lower rate of reporting > or =2 falls than did the comparison group (n = 8695; annualized rate: 3.67%) (HR: 0.92; 95% CI: 0.89, 0.96; P < 0.01). There was a significant interaction according to hormone therapy use; those in the comparison group receiving hormone therapy had the lowest incidence of hip fracture. In a subset of 3951 women, hip BMD at years 3, 6, and 9 was 0.4-0.5% lower in the intervention group than in the comparison group (P = 0.003).

CONCLUSIONS

A low-fat and increased fruit, vegetable, and grain diet intervention modestly reduced the risk of multiple falls and slightly lowered hip BMD but did not change the risk of osteoporotic fractures. This trial was registered at clinicaltrials.gov as NCT00000611.

Authors+Show Affiliations

Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, WA 98019, USA. amctiern@fhcrc.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

19403636

Citation

McTiernan, Anne, et al. "Low-fat, Increased Fruit, Vegetable, and Grain Dietary Pattern, Fractures, and Bone Mineral Density: the Women's Health Initiative Dietary Modification Trial." The American Journal of Clinical Nutrition, vol. 89, no. 6, 2009, pp. 1864-76.
McTiernan A, Wactawski-Wende J, Wu L, et al. Low-fat, increased fruit, vegetable, and grain dietary pattern, fractures, and bone mineral density: the Women's Health Initiative Dietary Modification Trial. Am J Clin Nutr. 2009;89(6):1864-76.
McTiernan, A., Wactawski-Wende, J., Wu, L., Rodabough, R. J., Watts, N. B., Tylavsky, F., Freeman, R., Hendrix, S., & Jackson, R. (2009). Low-fat, increased fruit, vegetable, and grain dietary pattern, fractures, and bone mineral density: the Women's Health Initiative Dietary Modification Trial. The American Journal of Clinical Nutrition, 89(6), 1864-76. https://doi.org/10.3945/ajcn.2008.26956
McTiernan A, et al. Low-fat, Increased Fruit, Vegetable, and Grain Dietary Pattern, Fractures, and Bone Mineral Density: the Women's Health Initiative Dietary Modification Trial. Am J Clin Nutr. 2009;89(6):1864-76. PubMed PMID: 19403636.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low-fat, increased fruit, vegetable, and grain dietary pattern, fractures, and bone mineral density: the Women's Health Initiative Dietary Modification Trial. AU - McTiernan,Anne, AU - Wactawski-Wende,Jean, AU - Wu,LieLing, AU - Rodabough,Rebecca J, AU - Watts,Nelson B, AU - Tylavsky,Frances, AU - Freeman,Ruth, AU - Hendrix,Susan, AU - Jackson,Rebecca, AU - ,, Y1 - 2009/04/29/ PY - 2009/5/1/entrez PY - 2009/5/1/pubmed PY - 2009/6/13/medline SP - 1864 EP - 76 JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 89 IS - 6 N2 - BACKGROUND: The effects of dietary changes on osteoporosis, low bone density, and frequent falls are unestablished. OBJECTIVE: We assessed the effect of the Women's Health Initiative Dietary Modification low-fat and increased fruit, vegetable, and grain intervention on incident hip, total, and site-specific fractures and self-reported falls, and, in a subset, on bone mineral density (BMD). DESIGN: Postmenopausal women (n = 48,835) aged 50-79 y (18.6% of minority race-ethnicity) were randomly assigned to receive the Dietary Modification intervention (40%, n = 19,541) (daily goal: < or =20% of energy as fat, > or =5 servings of vegetables and fruit, and > or =6 servings of grains) or to a comparison group that received no dietary changes (60%; n = 29,294). RESULTS: After a mean 8.1 y of follow-up, 215 women in the intervention group and 285 women in the comparison group (annualized rate: 0.14% and 0.12%, respectively) experienced a hip fracture (hazard ratio: 1.12; 95% CI: 0.94, 1.34; P = 0.21). The intervention group (n = 5423; annualized rate: 3.44%) had a lower rate of reporting > or =2 falls than did the comparison group (n = 8695; annualized rate: 3.67%) (HR: 0.92; 95% CI: 0.89, 0.96; P < 0.01). There was a significant interaction according to hormone therapy use; those in the comparison group receiving hormone therapy had the lowest incidence of hip fracture. In a subset of 3951 women, hip BMD at years 3, 6, and 9 was 0.4-0.5% lower in the intervention group than in the comparison group (P = 0.003). CONCLUSIONS: A low-fat and increased fruit, vegetable, and grain diet intervention modestly reduced the risk of multiple falls and slightly lowered hip BMD but did not change the risk of osteoporotic fractures. This trial was registered at clinicaltrials.gov as NCT00000611. SN - 1938-3207 UR - https://www.unboundmedicine.com/medline/citation/19403636/Low_fat_increased_fruit_vegetable_and_grain_dietary_pattern_fractures_and_bone_mineral_density:_the_Women's_Health_Initiative_Dietary_Modification_Trial_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.3945/ajcn.2008.26956 DB - PRIME DP - Unbound Medicine ER -