Dietary patterns associated with fall-related fracture in elderly Japanese: a population based prospective study

Abstract

BackgroundDiet is considered an important factor for bone health, but is composed of a wide variety of foods containing complex combinations of nutrients. Therefore we investigated the relationship between dietary patterns and fall-related fractures in the elderly.MethodsWe designed a population-based prospective survey of 1178 elderly people in Japan in 2002. Dietary intake was assessed with a 75-item food frequency questionnaire (FFQ), from which dietary patterns were created by factor analysis from 27 food groups. The frequency of fall-related fracture was investigated based on insurance claim records from 2002 until 2006. The relationship between the incidence of fall-related fracture and modifiable factors, including dietary patterns, were examined. The Cox proportional hazards regression model was used to examine the relationships between dietary patterns and incidence of fall-related fracture with adjustment for age, gender, Body Mass Index (BMI) and energy intake.ResultsAmong 877 participants who agreed to a 4 year follow-up, 28 suffered from a fall-related fracture. Three dietary patterns were identified: mainly vegetable, mainly meat and mainly traditional Japanese. The moderately confirmed (see statistical methods) groups with a Meat pattern showed a reduced risk of fall-related fracture (Hazard ratio = 0.36, 95% CI = 0.13 - 0.94) after adjustment for age, gender, BMI and energy intake. The Vegetable pattern showed a significant risk increase (Hazard ratio = 2.67, 95% CI = 1.03 - 6.90) after adjustment for age, gender and BMI. The Traditional Japanese pattern had no relationship to the risk of fall-related fracture.ConclusionsThe results of this study have the potential to reduce fall-related fracture risk in elderly Japanese. The results should be interpreted in light of the overall low meat intake of the Japanese population.

Current Evidence on the Association of Dietary Patterns and Bone Health: A Scoping Review

“…Studies were conducted in >20 countries: Australia (16,44), Brazil (24), Canada (25,26,32), China (22,28,30,34,49,55), France (33,56), Greece (14), Iran (20,21,48), Ireland (19), Italy (38), Japan (13,18,31), Korea (23,27,29,40,43,53,54), Netherlands (51), Norway (45), Portugal (41,60), Scotland (17), Spain (47), Sweden (59), United Kingdom (15,39), United States (35-37, 42, 46, 52, 58), and 10 European countries (57).…”

“…The dairy (29), dairy and fruit (27), and calcium (28) dietary patterns were associated with a lower risk of osteoporosis. Conversely, the vegetable dietary pattern, reflecting a high intake of vegetables, seaweeds, soy products, and salt, was associated with an increased risk of fracture in Japanese elderly men and women (31).…”

“…Hip fracture incidence was the main outcome measured in the studies (30,(33)(34)(35)(55)(56)(57)(58)(59). Some studies measured overall incidence of fall-related or low-trauma fractures (31,32,58), and some also included wrist and vertebrae fractures in analysis (33,56 …”

“…The traditional dietary pattern characteristics varied between different study populations, including Irish (19), Korean (29), English (15), Japanese (13,31), and Chinese (28, 30) traditional dietary patterns. The English traditional dietary pattern, characterized by a high intake of fried fish, fried potatoes, legumes, red and processed meats, savory pies, and cruciferous vegetables (e.g., cabbage and cauliflower), was inversely associated with BMD (15).…”

“…Two to nine dietary patterns were derived from different study populations with the use of this method. Naming of the retained dietary patterns was arbitrary, and the common names of some reproducible dietary patterns were the "healthy" (n = 7) (also referred to as "nutrient dense" or "prudent") (13, 17, 19, 24-26, 30, 32, 35), "traditional" (n = 7) (13,15,19,(28)(29)(30)(31), and "Western" (n = 6) (also called "energy-dense") (13, 24-26, 28, 29, 32, 35) dietary patterns. These dietary patterns were repeatedly extracted, along with a variety of other dietary patterns in the studies ( Table 1).…”