Abstract
BackgroundData from previous studies are inconsistent, and it is therefore uncertain whether, to what extent, and at what level leisure physical activity influences the risk of osteoporotic fractures in men.Methods and FindingsA cohort of 2,205 men, 49–51 y of age, was enrolled in a longitudinal, population-based study. Leisure physical activity and other lifestyle habits were established at baseline and at ages 60, 70, 77, and 82 y. During 35 y of follow-up, 482 men had at least one fracture. Cox's proportional hazards regression was used to determine hazard ratios (HRs) of fracture associated with time-dependent physical activity habits and covariates. Men with a sedentary lifestyle (HR 2.56, 95% confidence interval 1.55–4.24) or men who walked or bicycled only for pleasure (HR 1.61, 95% confidence interval 1.10–2.36) had an increased adjusted risk of hip fracture compared with men who participated in regular sports activities for at least 3 h/wk. At the end of follow-up, 8.4% of the men with a high physical activity, 13.3% of the men with a medium physical activity, and 20.5% of the men with a low physical activity had suffered a hip fracture. According to the estimation of population-attributable risk, one third of all hip fractures could be prevented by participation in regular sports activities. High activity also conferred a reduced overall fracture risk.ConclusionsOur data indicate that regular sports activities can reduce the risk of fractures in older men.
Highlights
Osteoporotic fractures, hip fractures, constitute a large and growing problem worldwide, in both women and men, with a profound impact on quality of life [1] and mortality [2]
Men with a sedentary lifestyle (HR 2.56, 95% confidence interval 1.55–4.24) or men who walked or bicycled only for pleasure (HR 1.61, 95% confidence interval 1.10–2.36) had an increased adjusted risk of hip fracture compared with men who participated in regular sports activities for at least 3 h/wk
Physical Activity Identical questions were asked at each of the five investigations: (1) Do you spend most of your time reading, watching TV, going to the cinema, or engaging in other, mostly sedentary, activities? (2) Do you often go walking or cycling for pleasure? (3) Do you engage in any active recreational sports or heavy gardening for at least 3 h every week? (4) Do you regularly engage in hard physical training or competitive sport? The answers are not mutually exclusive, but we considered the highest positive physical activity response level as prevailing
Summary
Osteoporotic fractures, hip fractures, constitute a large and growing problem worldwide, in both women and men, with a profound impact on quality of life [1] and mortality [2]. The fracture risk is influenced both by the genetic constitution and by environmental factors, with lifestyle becoming more important with increasing age [3]. One conceivable and modifiable risk factor, can prevent fractures by improving muscle mass and balance, and by increasing skeletal strength, and reducing the risk of injurious falls [4,5]. A priority area for medical research is finding ways in which osteoporosis can be reduced, with the aim of improving the lives of older people and reducing their risk of ‘‘osteoporotic fractures.’’ It is known that genetic and environmental factors can both play a part in how rapidly osteoporosis develops, but it is generally agreed that personal lifestyle factors are important.
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