Byberg Liisa, Bellavia Andrea, Larsson Susanna C, Orsini Nicola, Wolk Alicja, Michaëlsson Karl
Department of Surgical Sciences, Orthopedics, Uppsala University, Uppsala, Sweden.
Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
J Bone Miner Res. 2016 Dec;31(12):2098-2105. doi: 10.1002/jbmr.2896. Epub 2016 Sep 8.
A Mediterranean diet, known to have beneficial effects on cardiovascular health, may also influence the risk of hip fracture although previous studies present discrepant results. We therefore aimed to determine whether the rate of hip fracture was associated with degree of adherence to a Mediterranean diet. We combined two Swedish cohort studies consisting of 37,903 men and 33,403 women (total n = 71,333, mean age 60 years) free of previous cardiovascular disease and cancer who answered a medical and a food-frequency questionnaire in 1997. A modified Mediterranean diet score (mMED; range, 0 to 8 points) was created based on high consumption of fruits and vegetables, legumes and nuts, whole grains, fermented dairy products, fish, and olive/rapeseed oil, moderate intake of alcohol, and low intake of red and processed meat. Incident hip fractures between January 1, 1998, and December 31, 2012, were retrieved from the National Patient Register. Hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for potential confounders were calculated using Cox proportional hazards regression. Differences in age at hip fracture were calculated using multivariable Laplace regression. During follow-up, 3175 hip fractures occurred at a median age of 73.3 years. One unit increase in the mMED was associated with 6% lower hip fracture rate (adjusted HR = 0.94; 95% CI, 0.92 to 0.96) and with a 3-month higher median age at hip fracture (50th percentile difference = 2.8 months; 95% CI, 1.4 to 4.2). Comparing the highest quintile of adherence to the mMED (6 to 8 points) with the lowest (0 to 2 points) conferred an adjusted HR of hip fracture of 0.78 (95% CI, 0.69 to 0.89) and a 12-month higher median age of hip fracture (50th percentile difference = 11.6 months; 95% CI, 4.2 to 19.0). Results were similar in men and women. We conclude that higher adherence to a Mediterranean-like diet is associated with lower risk of future hip fracture. © 2016 American Society for Bone and Mineral Research.
已知地中海饮食对心血管健康有益，它可能还会影响髋部骨折风险，尽管先前的研究结果并不一致。因此，我们旨在确定髋部骨折发生率是否与对地中海饮食的依从程度相关。我们将两项瑞典队列研究合并，这两项研究共纳入了37903名男性和33403名女性（总计n = 71333，平均年龄60岁），这些人既往无心血管疾病和癌症，于1997年回答了一份医疗问卷和一份食物频率问卷。基于大量食用水果和蔬菜、豆类和坚果、全谷物、发酵乳制品、鱼类以及橄榄油/菜籽油，适量饮酒，以及少量食用红肉和加工肉类，创建了一个改良的地中海饮食评分（mMED；范围为0至8分）。1998年1月1日至2012年12月31日期间的新发髋部骨折病例从国家患者登记处获取。使用Cox比例风险回归计算调整了潜在混杂因素后的风险比（HRs）和95%置信区间（CIs）。使用多变量拉普拉斯回归计算髋部骨折时年龄的差异。在随访期间，共发生3175例髋部骨折，中位年龄为73.3岁。mMED每增加一个单位，髋部骨折发生率降低6%（调整后HR = 0.94；95% CI，0.92至0.96），髋部骨折的中位年龄增加3个月（第50百分位数差异 = 2.8个月；95% CI，1.4至4.2）。将依从mMED的最高五分位数（6至8分）与最低五分位数（0至2分）进行比较，髋部骨折的调整后HR为0.78（95% CI，0.69至0.89），髋部骨折的中位年龄高12个月（第50百分位数差异 = 11.6个月；95% CI，4.2至19.0）。男性和女性的结果相似。我们得出结论，更高程度地依从类似地中海的饮食与未来髋部骨折风险较低相关。© 2016美国骨与矿物质研究学会。
