Top

Osteoporosis International

Published in:

01-08-2014 | Original Article

Diet-quality scores and risk of hip fractures in elderly urban Chinese in Guangdong, China: a case–control study

Authors: F.F. Zeng, W.Q. Xue, W.T. Cao, B.H. Wu, H.L. Xie, F. Fan, H.L. Zhu, Y.M. Chen

Published in: Osteoporosis International | Issue 8/2014

Abstract

Summary

This case–control study compared the associations of four widely used diet-quality scoring systems with the risk of hip fractures and assessed their utility in elderly Chinese. We found that individuals avoiding a low-quality diet have a lower risk of hip fractures in elderly Chinese.

Introduction

Few studies examined the associations of diet-quality scores on bone health, and no studies were available in Asians and compared their validity and utility in a study. We assessed the associations and utility of four widely used diet-quality scoring systems with the risk of hip fractures.

Methods

A case–control study of 726 patients with hip fractures (diagnosed within 2 weeks) aged 55–80 years and 726 age– (within 3 years) and gender-matched controls was conducted in Guangdong, China (2009–2013). Dietary intake was assessed using a 79-item food frequency questionnaire with face-to-face interviews, and the Healthy Eating Index-2005 (HEI-2005, 12 items), the alternate Healthy Eating Index (aHEI, 8 items), the Diet Quality Index-International (DQI-I, 17 items), and the alternate Mediterranean Diet Score (aMed, 9 items) (the simplest one) were calculated.

Results

All greater values of the diet-quality scores were significantly associated with a similar decreased risk of hip fractures (all p trends <0.001). The multivariate-adjusted odds ratios (ORs) and 95 % confidential intervals (95 % CIs) comparing the extreme groups of diet-quality scores were 0.29 (0.18, 0.46) (HEI-2005), 0.20 (0.12, 0.33) (aHEI), 0.25 (0.16, 0.39) (DQI-I), and 0.28 (0.18, 0.43) (aMed) in total subjects; and the corresponding ORs ranged from 0.04 to 0.27 for men and from 0.26 to 0.44 for women (all p trends <0.05), respectively.

Conclusions

Avoiding a low-quality diet is associated with a lower risk of hip fractures, and the aMed score is the best scoring system due to its equivalent performance and simplicity for the user.

Available only for authorised users

Cashman KD (2007) Diet, nutrition, and bone health. J Nutr 137:2507S–2512SPubMed

Bonjour JP, Gueguen L, Palacios C, Shearer MJ, Weaver CM (2009) Minerals and vitamins in bone health: the potential value of dietary enhancement. Br J Nutr 101:1581–1596. doi:10.1017/S0007114509311721 PubMedCrossRef

Dargent-Molina P, Sabia S, Touvier M, Kesse E, Breart G, Clavel-Chapelon F, Boutron-Ruault MC (2008) Proteins, dietary acid load, and calcium and risk of postmenopausal fractures in the E3N French women prospective study. J Bone Miner Res 23:1915–1922. doi:10.1359/jbmr.080712 PubMedCentralPubMedCrossRef

Jacobs DR Jr, Steffen LM (2003) Nutrients, foods, and dietary patterns as exposures in research: a framework for food synergy. Am J Clin Nutr 78:508S–513SPubMed

Ledikwe JH, Blanck HM, Khan LK, Serdula MK, Seymour JD, Tohill BC, Rolls BJ (2006) Low-energy-density diets are associated with high diet quality in adults in the United States. J Am Diet Assoc 106:1172–1180. doi:10.1016/j.jada.2006.05.013 PubMedCrossRef

Zeng FF, Wu BH, Fan F, Xie HL, Xue WQ, Zhu HL, Chen YM (2013) Dietary patterns and the risk of hip fractures in elderly Chinese: a matched case–control study. J Clin Endocrinol Metab 98:2347–2355. doi:10.1210/jc.2013–1190 PubMedCrossRef

Langsetmo L, Poliquin S, Hanley DA, Prior JC, Barr S, Anastassiades T, Towheed T, Goltzman D, Kreiger N (2010) Dietary patterns in Canadian men and women ages 25 and older: relationship to demographics, body mass index, and bone mineral density. BMC Musculoskelet Disord 11:20. doi:10.1186/1471–2474–11–20 PubMedCentralPubMedCrossRef

Tucker KL, Chen H, Hannan MT, Cupples LA, Wilson PW, Felson D, Kiel DP (2002) Bone mineral density and dietary patterns in older adults: the Framingham osteoporosis study. Am J Clin Nutr 76:245–252PubMed

Samieri C, Ginder Coupez V, Lorrain S, Letenneur L, Alles B, Feart C, Paineau D, Barberger-Gateau P (2013) Nutrient patterns and risk of fracture in older subjects: results from the three-city study. Osteoporos Int 24:1295–1305. doi:10.1007/s00198–012–2132–5 PubMedCrossRef

10.

Kontogianni MD, Melistas L, Yannakoulia M, Malagaris I, Panagiotakos DB, Yiannakouris N (2009) Association between dietary patterns and indices of bone mass in a sample of Mediterranean women. Nutrition 25:165–171. doi:10.1016/j.nut.2008.07.019 PubMedCrossRef

11.

Langsetmo L, Hanley DA, Prior JC, Barr SI, Anastassiades T, Towheed T, Goltzman D, Morin S, Poliquin S, Kreiger N (2011) Dietary patterns and incident low-trauma fractures in postmenopausal women and men aged ≥50 y: a population-based cohort study. Am J Clin Nutr 93:192–199. doi:10.3945/ajcn.110.002956 PubMedCrossRef

12.

Kant AK (1996) Indexes of overall diet quality: a review. J Am Diet Assoc 96:785–791PubMedCrossRef

13.

Guenther PM, Reedy J, Krebs-Smith SM (2008) Development of the Healthy Eating Index-2005. J Am Diet Assoc 108:1896–1901. doi:10.1016/j.jada.2008.08.016 PubMedCrossRef

14.

McCullough ML, Feskanich D, Giovannucci ELSMJ, RimmEB HFB, Spiegelman D, Hunter DJ, Colditz GA, Willett WC (2002) Diet quality and major chronic disease risk in men and women: moving toward improved dietary guidance. Am J Clin Nutr 76:1261–1271PubMed

15.

Kim S, Haines PS, Siega-Riz AM, Popkin BM (2003) The Diet Quality Index-International (DQI-I) provides an effective tool for cross-national comparison of diet quality as illustrated by China and the United States. J Nutr 133:3476–3484PubMed

16.

Fung TT, Rexrode KM, Mantzoros CS, Manson JE, Willett WC, Hu FB (2009) Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women. Circulation 119:1093–1100. doi:10.1161/CIRCULATIONAHA.108.816736 PubMedCentralPubMedCrossRef

17.

(2005) Department of Health and Human Services and Department of Agriculture. Dietary guidelines for Americans 2005. 6th ed Washington, DC: Government Printing Office. http://www.healthierus.gov/dietaryguidelines/

18.

Willett W (2001) Medical school guide to healthy eating: eat, drink, and be healthy. The Harvard New York Free Press, NY

19.

de Koning L, Chiuve SE, Fung TT, Willett WC, RimmEB HFB (2011) Diet-quality scores and the risk of type 2 diabetes in men. Diabetes Care 34:1150–1156. doi:10.2337/dc10–2352 PubMedCentralPubMedCrossRef

20.

Reedy J, MitrouPN K-SSM, Wirfält E, Flood A, Kipnis V, Leitzmann M, Mouw T, Hollenbeck A, Schatzkin A, Subar AF (2008) Index-based dietary patterns and risk of colorectal cancer: the NIH-AARP diet and health study. Am J Epidemiol 168:38–48. doi:10.1093/aje/kwn097 PubMedCrossRef

21.

Rivas A, Romero A, Mariscal-Arcas M, Monteagudo C, Feriche B, Lorenzo ML, Olea F (2013) Mediterranean diet and bone mineral density in two age groups of women. Int J Food SciNutr 64:155–161. doi:10.3109/09637486.2012.718743 CrossRef

22.

Benetou V, Orfanos P, Pettersson-Kymmer U, Bergström U, Svensson O, Johansson I, Berrino F, Tumino R, Borch KB, Lund E, Peeters PH, Grote V, Li K, AltzibarJM KT, Boeing H, von Ruesten A, Norat T, Wark PA, Riboli E, Trichopoulou A (2012) Mediterranean diet and incidence of hip fractures in a European cohort. Osteoporos Int 24:1587–1598. doi:10.1007/s00198–012–2187–3 PubMedCrossRef

23.

Hamidi M, Tarasuk V, Corey P, Cheung AM (2011) Association between the healthy eating index and bone turnover markers in US postmenopausal women aged ≥45 y. Am J Clin Nutr 94:199–208. doi:10.3945/ajcn.110.009605 PubMedCrossRef

24.

Nkondjock A, Ghadirian P (2007) Diet quality and BRCA-associated breast cancer risk. Breast Cancer Res Treat 103:361–369. doi:10.1007/s10549–006–9371–0 PubMedCrossRef

25.

Fan F, XueWQ WBH, He MG, Xie HL, Ouyang WF, Tu SL, Chen YM (2013) Higher fish intake is associated with a lower risk of hip fractures in Chinese men and women: a matched case-control study. PLoS One 8:e56849. doi:10.1371/journal.pone.0056849 PubMedCentralPubMedCrossRef

26.

Zhang CX, Ho SC (2009) Validity and reproducibility of a food frequency questionnaire among Chinese women in Guangdong province. Asia Pac J Clin Nutr 18:240–250PubMed

27.

Yang YX, Wang GY, Pan XC (2002) China food composition table. Peking University Medical Press, Beijing

28.

Astrup A, Dyerberg J, Selleck M, Stender S (2008) Nutrition transition and its relationship to the development of obesity and related chronic diseases. Obes Rev 9(Suppl 1):48–52. doi:10.1111/j.1467–789X.2007.00438.x PubMedCrossRef

29.

Trichopoulou A, Costacou T, Bamia C, Trichopoulos D (2003) Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 348:2599–2608. doi:10.1056/NEJMoa025039 PubMedCrossRef

30.

Trichopoulou A, Kouris-Blazos A, Wahlqvist ML, Gnardellis C, Lagiou P, Polychronopoulos E, Vassilakou T, Lipworth L, Trichopoulos D (1995) Diet and overall survival in elderly people. BMJ 311:1457–1460. doi:10.1136/bmj.311.7018.1457 PubMedCentralPubMedCrossRef

31.

O’Donnell MJ, Xavier D, Liu L et al (2010) Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet 376:112–123. doi:10.1016/S0140–6736(10)60834–3 PubMedCrossRef

32.

Bai XC, Lu D, Bai J, Zheng H, KeZY LXM, Luo SQ (2004) Oxidative stress inhibits osteoblastic differentiation of bone cells by ERK and NF-kappaB. Biochem Biophys Res Commun 314:197–207. doi:10.1016/j.bbrc.2003.12.073 PubMedCrossRef

33.

Basu S, Michaelsson K, Olofsson H, Johansson S, Melhus H (2001) Association between oxidative stress and bone mineral density. Biochem Biophys Res Commun 288:275–279. doi:10.1006/bbrc.2001.5747 PubMedCrossRef

34.

Mangiafico RA, Malaponte G, Pennisi P, Li Volti G, Trovato G, Mangiafico M, Bevelacqua Y, Mazza F, Fiore CE (2007) Increased formation of 8-iso-prostaglandinF (2alpha) is associated with altered bone metabolism and lower bone mass in hypercholesterolaemic subjects. J Intern Med 261:587–596. doi:10.1111/j.1365–2796.2007.01784.x PubMedCrossRef

35.

Zalloua PA, Hsu YH, Terwedow H, Zang T, Wu D, Tang G, Li Z, Hong X, Azar ST, Wang B, Bouxsein ML, Brain J, Cummings SR, Rosen CJ, Xu X (2007) Impact of seafood and fruit consumption on bone mineral density. Maturitas 56:1–11. doi:10.1016/j.maturitas.2006.05.001 PubMedCrossRef

36.

Farina EK, Kiel DP, Roubenoff R, Schaefer EJ, Cupples LA, Tucker KL (2011) Protective effects of fish intake and interactive effects of long-chain polyunsaturated fatty acid intakes on hip bone mineral density in older adults: the Framingham Osteoporosis study. Am J Clin Nutr 93:1142–1151. doi:10.3945/ajcn.110.005926 PubMedCentralPubMedCrossRef

37.

Feskanich D, Willett WC, Colditz GA (2003) Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women. Am J Clin Nutr 77:504–511PubMed

38.

Suzuki T, Yoshida H, Hashimoto T, Yoshimura N, Fujiwara S, Fukunaga M, Nakamura T, Yoh K, Inoue T, Hosoi T, Orimo H (1997) Case-control study of risk factors for hip fractures in the Japanese elderly by a Mediterranean Osteoporosis Study (MEDOS) questionnaire. Bone 21:461–467. doi:10.1016/S8756–3282(97)00179–8 PubMedCrossRef

39.

Hu JF, Zhao XH, Parpia B, Campbell TC (1993) Dietary intakes and urinary excretion of calcium and acids: a cross-sectional study of women in China. Am J Clin Nutr 58:398–406PubMed

40.

McTiernan A, Wactawski-Wende J, Wu L, Rodabough RJ, Watts NB, Tylavsky F, Freeman R, Hendrix S, Jackson R (2009) Low-fat, increased fruit, vegetable, and grain dietary pattern, fractures, and bone mineral density: the Women’s Health Initiative Dietary Modification Trial. Am J Clin Nutr 89:1864–1876. doi:10.3945/ajcn.2008.26956 PubMedCentralPubMedCrossRef

41.

Hamidi M, Boucher BA, Cheung AM, Beyene J, Shah PS (2011) Fruit and vegetable intake and bone health in women aged 45 years and over: a systematic review. Osteoporos Int 22:1681–1693. doi:10.1007/s00198–010–1510–0 PubMedCrossRef

42.

Jacobs DR Jr, Hohe C, Mursu J, Robien K, Folsom AR (2010) Whole grain intake, incident hip fracture and presumed frailty in the Iowa Women’s Health Study. Br J Nutr 104:1537–1543. doi:10.1017/S0007114510002382 PubMedCentralPubMedCrossRef

43.

Koh WP, Wu AH, Wang R, AngLW HD, Yuan JM, Yu MC (2009) Gender-specific associations between soy and risk of hip fracture in the Singapore Chinese Health Study. Am J Epidemiol 170:901–909. doi:10.1093/aje/kwp220 PubMedCentralPubMedCrossRef

44.

Prentice A (2004) Diet, nutrition and the prevention of osteoporosis. Public Health Nutr 7:227–243. doi:10.1079/PHN2003590 PubMedCrossRef

45.

Kant AK, Schatzkin A, Ziegler RG (1995) Dietary diversity and subsequent cause-specific mortality in the NHANES I epidemiologic follow-up study. J Am Coll Nutr 14:233–238PubMedCrossRef

46.

Wang Q, Wang Y, Ji Z, Chen X, Pan Y, Gao G, Gu H, Yang Y, Choi BC, Yan Y (2012) Risk factors for multiple myeloma: a hospital-based case–control study in Northwest China. Cancer Epidemiol 36:439–444. doi:10.1016/j.canep.2012.05.002 PubMedCrossRef

Title: Diet-quality scores and risk of hip fractures in elderly urban Chinese in Guangdong, China: a case–control study
Authors: F.F. Zeng
W.Q. Xue
W.T. Cao
B.H. Wu
H.L. Xie
F. Fan
H.L. Zhu
Y.M. Chen
Publication date: 01-08-2014
Publisher: Springer London
Published in: Osteoporosis International / Issue 8/2014
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-014-2741-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Diet-quality scores and risk of hip fractures in elderly urban Chinese in Guangdong, China: a case–control study

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 8/2014

The effect of exercise and education on fear of falling in elderly women with osteoporosis and a history of vertebral fracture: results of a randomized controlled trial

Calcium supplement intake and risk of cardiovascular disease in women

Vitamin D levels and response to biphosphonates in postmenopausal women receiving glucocorticoid therapy

Adult Brtl/+ mouse model of osteogenesis imperfecta demonstrates anabolic response to sclerostin antibody treatment with increased bone mass and strength

Adherence to oral bisphosphonates and the risk of subtrochanteric and femoral shaft fractures among female medicare beneficiaries

Influence of physical activity and skeleton geometry on bone mass at the proximal femur in 10- to 12-year-old children—a longitudinal study