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Fruit and vegetable intake and risk of hip fracture: a cohort study of Swedish men and women.
J Bone Miner Res 2015; 30(6):976-84JB

Abstract

Dietary guidelines recommend a daily intake of 5 servings of fruits and vegetables. Whether such intakes are associated with a lower risk of hip fracture is at present unclear. The aim of the present study was to investigate the dose-response association between habitual fruit and vegetable intake and hip fracture in a cohort study based on 40,644 men from the Cohort of Swedish Men (COSM) and 34,947 women from the Swedish Mammography Cohort (SMC) (total n = 75,591), free from cardiovascular disease and cancer, who answered lifestyle questionnaires in 1997 (age 45 to 83 years). Intake of fruits and vegetables (servings/day) was assessed by food frequency questionnaire and incident hip fractures were retrieved from the Swedish Patient Register (1998 to 2010). The mean follow-up time was 14.2 years. One-third of the participants reported an intake of fruits and vegetables of >5 servings/day, one-third reported >3 to ≤5 servings/day, 28% reported >1 to ≤3 servings/day, and 6% reported ≤1 serving/day. During 1,037,645 person-years we observed 3644 hip fractures (2266 or 62% in women). The dose-response association was found to be strongly nonlinear (p < 0.001). Men and women with zero consumption had 88% higher rate of hip fracture compared with those consuming 5 servings/day; adjusted hazard ratio (HR) was 1.88 (95% CI, 1.53 to 2.32). The rate was gradually lower with higher intakes; adjusted HR for 1 versus 5 servings/day was 1.35 (95% CI, 1.21 to 1.58). However, more than 5 servings/day did not confer additionally lower HRs (adjusted HR for 8 versus 5 servings/day was 0.96; 95% CI, 0.90 to 1.03). Similar results were observed when men and women were analyzed separately. We conclude that there is a dose-response association between fruit and vegetable intake and hip fracture such that an intake below the recommended five servings/day confers higher rates of hip fracture. Intakes above this recommendation do not seem to further lower the risk.

Authors+Show Affiliations

Department of Surgical Sciences, Orthopedics, Uppsala University, Uppsala, Sweden.Institute of Environmental Medicine, Unit of Nutritional Epidemiology, Karolinska Institutet, Solna, Sweden.Institute of Environmental Medicine, Unit of Nutritional Epidemiology, Karolinska Institutet, Solna, Sweden.Institute of Environmental Medicine, Unit of Nutritional Epidemiology, Karolinska Institutet, Solna, Sweden.Department of Surgical Sciences, Orthopedics, Uppsala University, Uppsala, Sweden.

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25294687

Citation

Byberg, Liisa, et al. "Fruit and Vegetable Intake and Risk of Hip Fracture: a Cohort Study of Swedish Men and Women." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 30, no. 6, 2015, pp. 976-84.
Byberg L, Bellavia A, Orsini N, et al. Fruit and vegetable intake and risk of hip fracture: a cohort study of Swedish men and women. J Bone Miner Res. 2015;30(6):976-84.
Byberg, L., Bellavia, A., Orsini, N., Wolk, A., & Michaëlsson, K. (2015). Fruit and vegetable intake and risk of hip fracture: a cohort study of Swedish men and women. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 30(6), pp. 976-84. doi:10.1002/jbmr.2384.
Byberg L, et al. Fruit and Vegetable Intake and Risk of Hip Fracture: a Cohort Study of Swedish Men and Women. J Bone Miner Res. 2015;30(6):976-84. PubMed PMID: 25294687.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fruit and vegetable intake and risk of hip fracture: a cohort study of Swedish men and women. AU - Byberg,Liisa, AU - Bellavia,Andrea, AU - Orsini,Nicola, AU - Wolk,Alicja, AU - Michaëlsson,Karl, PY - 2014/06/16/received PY - 2014/09/25/revised PY - 2014/10/03/accepted PY - 2014/10/9/entrez PY - 2014/10/9/pubmed PY - 2016/3/19/medline KW - EPIDEMIOLOGY KW - FRUITS AND VEGETABLES KW - HIP FRACTURE KW - NUTRITION KW - OSTEOPOROSIS SP - 976 EP - 84 JF - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JO - J. Bone Miner. Res. VL - 30 IS - 6 N2 - Dietary guidelines recommend a daily intake of 5 servings of fruits and vegetables. Whether such intakes are associated with a lower risk of hip fracture is at present unclear. The aim of the present study was to investigate the dose-response association between habitual fruit and vegetable intake and hip fracture in a cohort study based on 40,644 men from the Cohort of Swedish Men (COSM) and 34,947 women from the Swedish Mammography Cohort (SMC) (total n = 75,591), free from cardiovascular disease and cancer, who answered lifestyle questionnaires in 1997 (age 45 to 83 years). Intake of fruits and vegetables (servings/day) was assessed by food frequency questionnaire and incident hip fractures were retrieved from the Swedish Patient Register (1998 to 2010). The mean follow-up time was 14.2 years. One-third of the participants reported an intake of fruits and vegetables of >5 servings/day, one-third reported >3 to ≤5 servings/day, 28% reported >1 to ≤3 servings/day, and 6% reported ≤1 serving/day. During 1,037,645 person-years we observed 3644 hip fractures (2266 or 62% in women). The dose-response association was found to be strongly nonlinear (p < 0.001). Men and women with zero consumption had 88% higher rate of hip fracture compared with those consuming 5 servings/day; adjusted hazard ratio (HR) was 1.88 (95% CI, 1.53 to 2.32). The rate was gradually lower with higher intakes; adjusted HR for 1 versus 5 servings/day was 1.35 (95% CI, 1.21 to 1.58). However, more than 5 servings/day did not confer additionally lower HRs (adjusted HR for 8 versus 5 servings/day was 0.96; 95% CI, 0.90 to 1.03). Similar results were observed when men and women were analyzed separately. We conclude that there is a dose-response association between fruit and vegetable intake and hip fracture such that an intake below the recommended five servings/day confers higher rates of hip fracture. Intakes above this recommendation do not seem to further lower the risk. SN - 1523-4681 UR - https://www.unboundmedicine.com/medline/citation/25294687/Fruit_and_vegetable_intake_and_risk_of_hip_fracture:_a_cohort_study_of_Swedish_men_and_women_ L2 - https://doi.org/10.1002/jbmr.2384 DB - PRIME DP - Unbound Medicine ER -