A10. Dietary intake and anthropometric indices of hip fracture patients: a case control study

Abstract

Background There is concern regarding the increasing rates of fractures that are being attributed to osteoporosis. It is estimated that around 60 000 hip fractures occur annually in the U.K. The majority being in the elderly, resulting in considerable morbidity and mortality ( DoH, 1998). Investigations into the causes, prevention and treatment of fractures are therefore of both clinical and economic importance. Aim The aim of this study was to compare a group of elderly, fractured neck of femur patients (female, 60–102 years, n 64) with a group of healthy age-matched controls (female, 63–90, n 45). Differences in their current dietary intake, intake in the recent and distant past, anthropometric indices lifestyle factors and food choice were all investigated. Methods Interviewer administered questionnaires were used to obtain the information necessary and three consecutive 24 h recalls determined current dietary intake (analysed using ’Dietplan’). Anthropometric indices examined included; weight, height, demispan, mindex, demiquet, body mass index (BMI), triceps skinfold thickness (TSF), mid upper arm circumference (MUAC), mid upper arm muscle circumference (MUAMC) and maximum calf circumference. Independent t-tests and chi-square were used to assess statistical significance. Results Current dietary intake data revealed that the control group consumed almost all nutrients in greater amounts. Energy, carbohydrate, protein, thiamine, pyridoxine, calcium, phosphate, magnesium, potassium, iron, selenium, iodine and fibre were all significantly greater in the control group (P = < 0.01). Although, neither the cases nor controls achieved 100% of the RNI for energy (mean values). There was also found to be a significant difference between the majority of the anthropometric indices measured. The controls were significantly heavier than the cases (P = 0.001) and had a greater mean mindex value (P = 0.001). Also, significantly lower TSF and MUAC values were seen in the cases (P = 0.005 and 0.001, respectively). All these results suggest that the fractured neck of femur patients were nutritionally compromised and would benefit from supplementation to aid recovery. Analysis of past calcium intake produced surprising results, in that a greater percentage of the cases than controls stated consuming a ’high’ calcium intake in both childhood and early adulthood. The effect of recall bias needs to be considered here. But, although these results contradict the majority of findings in this field, similar results have previously been found ( New et al., 1998 ). Conclusions Various potential risk factors for hip fractures have been highlighted in this study (including; low body weight, low muscle mass and low activity level). Therefore, in conclusion, improved nutrition could help to prevent hip fracture occurrence and supplementation of the diet is an important part of the treatment for fractured neck of femur.