Nutrition and subsequent hip fracture risk among a national cohort of white women.

This study investigated three aspects of general nutritional status (dietary intake, biochemical markers, and anthropometric measurements) in relation to subsequent hip fracture risk by using prospective data from the First National Health and Nutrition Examination Survey (NHANES I) epidemiologic follow-up studies. A cohort of 2,513 white women 45 years and over who participated in the NHANES I survey in 1971-1975 were subsequently followed in the three follow-up studies in 1982-1984, 1986, and 1987, respectively. Multiple nutritional variables were measured at baseline, and 130 incident hip fractures were identified by hospital records or by death certificates during the follow-up period. Cox regression analyses showed that baseline dietary energy intake; serum albumin; and weight, body mass index, skinfold, and arm muscle area were significantly and inversely related to subsequent hip fracture risk (relative risks for a 1-standard deviation increment in these variables ranged from 0.68 to 0.83). The authors suggest that poor nutritional status, evident in inadequate dietary intake, reduced serum albumin, and decreased body mass and soft tissues, increases the risk for subsequent hip fracture. The study also showed that age and previous fracture history were significant risk factors; however, self-reported physical activity, parity, and alcohol use were not significantly related to subsequent hip fracture.