Abstract
ObjectivesFish is rich in nutrients that are favorable to bone health, but limited data are available regarding the relationship between fish intake and hip fractures. Our study examined the association between habitual fish intake and risk of hip fractures.MethodsA case-control study was performed between June 2009 and June 2012 in Guangdong Province, China. Five hundred and eighty-one hip fracture incident cases, aged 55 to 80 years (mean: 71 years), were enrolled from four hospitals. 1∶1 matched controls by gender and age (±3 years) were also recruited from communities and hospitals. Face-to-face interviews were used to obtain habitual dietary intake and information on various covariates.ResultsUnivariate conditional logistic regression analyses showed significantly dose-dependent inverse correlations between the risk of hip fractures and the intake of fresh-water fish, sea fish, mollusca, shellfish, and total fish in all of the subjects (p-trend: <0.001–0.016). After adjusting for covariates, the associations were slightly attenuated but remained significant for all (p-trend: <0.001–0.017) except for fresh-water fish (p = 0.553). The ORs (95%CI) of hip fractures for the highest (vs. lowest) quartile were 0.80 (0.48–1.31) for fresh-water fish, 0.31 (0.18–0.52) for sea fish, 0.55 (0.34–0.88) for mollusca and shellfish, and 0.47 (0.28–0.79) for total fish, respectively. Stratified and interaction analyses showed that the association was more significant in males than in females (p-interaction = 0.052).ConclusionHigher intake of seafood is independently associated with lower risk of hip fractures in elderly Chinese. Increasing consumption of sea fish may benefit the prevention of hip fractures in this population.
Highlights
Hip fractures are considered to be the most severe complication of osteoporosis, and have attracted increased attention because of poor prognosis such as leading to chronic pain, increasing the risk of mortality (20–24% patients die in the first year following injury) [1] and disability (40% of survivors lose the ability to walk) [1] and enhancing medical burdens (USD17.14 billion in China in 2011) [2]
The controls were more likely than the case patients to have a higher BMI, education level, and household income in addition to the following: no family history of fracture, engaging in mental work, drinking tea, being married, increased physical activity, and the consumption of multivitamin and calcium supplements
Our finding suggests that an increase in fish consumption, especially sea fish, may benefit the prevention of hip fractures in this population
Summary
Hip fractures are considered to be the most severe complication of osteoporosis, and have attracted increased attention because of poor prognosis such as leading to chronic pain, increasing the risk of mortality (20–24% patients die in the first year following injury) [1] and disability (40% of survivors lose the ability to walk) [1] and enhancing medical burdens (USD17.14 billion in China in 2011) [2]. Fish is a major source of high-bioavailability protein, n-3 polyunsaturated fatty acids (PUFA), fat-soluble vitamins (such as A and D), and minerals (e.g., calcium, zinc, selenium, and iodine). Many of these nutrients may have beneficial effects on bone health [4]. Others have explored the effects of fish consumption on fractures, but the inconsistent results are thought to be the result of various study designs and populations or weak effects [9,10,11,12]. This study examines the association of habitual intake of total fish and different types of fish with the risk of hip fractures in middle-aged and elderly Chinese in Guangdong Province, a coastal region of China
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