Dietary Patterns and the Risk of Hip Fractures in Elderly Chinese: A Matched Case-Control Study

Abstract

Many studies have investigated the effects of individual foods or nutrients on bone health, but limited research has focused on dietary patterns. We examined the association of dietary patterns with the risk of hip fractures in elderly Chinese. This 1:1 age- (±3 years) and gender-matched case-control study were performed between June 2009 and June 2012. The study was conducted in Guangdong Province, China. A total of 581 pairs of hip fracture incident cases and controls (71 ± 7 years) were studied. Face-to-face interviews were conducted to assess dietary intake using a 79-item food frequency questionnaire, whereas general information was collected using structured questionnaires. Dietary patterns were identified by a principal components factor analysis. Univariate and multivariate conditional logistic regression were used to analyze the association. We identified 4 dietary patterns: healthy, prudent, traditional, and high-fat. Dose-dependent lower risks of hip fracture were observed in relation to higher scores in the healthy dietary pattern related to high fruit and vegetable intake and in the prudent pattern typified by a higher intake of nuts, mushrooms, algae, and seafood but lower in grains, whereas the same were associated with lower scores in the high-fat dietary pattern (all P trend < .05). The adjusted odds ratios (95% confidence intervals) for hip fractures, comparing the extreme tertiles of the 3 patterns, were 0.42 (0.24-0.73) for healthy, 0.51 (0.28-0.90) for prudent, and 2.25 (1.38-3.69) for high-fat. No significant association was found between the traditional dietary pattern (with a high intake of Chinese herbal tea, double stewed soup, processed meat and fish, and organ meat) and hip fracture risk. Our findings suggest that the consumption of a healthy or prudent dietary pattern can protect against hip fractures, whereas a high-fat pattern promotes the incidence of such fractures.