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A case-control study of hip fracture: evaluation of selected dietary variables and teenage physical activity

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Abstract

Recent diet, teenage physical activity and teenage calcium consumption were examined as risk factors for hip fracture in a case-control study. Cases were 161 white women admitted to one of 30 participating hospitals with a first hip fracture. Controls included 168 white women from general and orthopedic surgical services frequency-matched to cases by age group and hospital. Information on exposure to possible risk factors was obtained by in-person interview. No association was found between recent intake of calcium, phosphorus, protein, vitamin C or caffeine and hip fracture. Also, teenage calcium intake and milk drinking were not related to hip fracture risk. Recreational activities in adolescence and early adulthood appeared to afford protection against hip fracture. The highest quartile of recreational activity (⩾4 times/week) was associated with an odds ratio of 0.24 (95% confidence interval 0.08–0.75) relative to the lowest quartile (<1 time/week).

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References

  1. Graves EJ. Ultilization of Short-stay hospitals, US 1986: annual summary. National Center for Health Statistics, Vital and health statistics, series 13, No. 96. DHHS Pub. No. (PHS) 88-1757. Washington, DC:GPO, 1988.

    Google Scholar 

  2. Cummings SR, Kelsey JL, Nevitt MC, O'Dowd KJ. Epidemiology of osteoporosis and osteoporotic fractures. Epidemiol Rev 1985;7:178–208.

    Google Scholar 

  3. Petitti DB, Sidney S. Hip fracture in women:incidence, in-hospital mortality, and five year survival probabilities in members of a prepaid health plan. Clin Orthop Rel Res 1989;246:150–5.

    Google Scholar 

  4. Holbrook TL, Barrett-Connor E, Wingard DL. Dietary calcium and risk of hip fracture: 14-year prospective population study. Lancet 1988;2:1046–9.

    Google Scholar 

  5. Matkovic V, Kostial D, Simonovic I et al. Bone status and fracture rates in two regions of Yugoslavia. Am J Clin Nutr 1979;32:540–9.

    Google Scholar 

  6. Lau E, Donnan S, Barker DJP, Cooper C. Physical activity and calcium intake in fracture of the proximal femur in Hong Kong. Br Med J 1988;297:1141–3.

    Google Scholar 

  7. Cooper C, Barker DJP, Wickham CW. Physical activity, muscle strength, and calcium intake in fracture of the proximal femur in Britain. Br Med J 1988; 297:1443–6.

    Google Scholar 

  8. Wootton R, Brereton PJ, Clark MB et al. Fractured neck of femur in the elderly: an attempt to identify patients at risk. Clin Sci 1979;57:93–101.

    Google Scholar 

  9. Sandler RB, Slemanda CW, LaPorte RE, Cauley JA et al. Postmenopausal bone density and milk consumption in childhood and adolescence. Am J Clin Nutr 1985;42:270–4.

    Google Scholar 

  10. Kanders B, Lindsay R, Dempster D, Markhard L, Valiquette G. Determinants of bone mass in young healthy women. In: Christiansen C, Arnaud CD, Nordin BEC, Parfit AM, Peck WA, Riggs BL, editors. Osteoporosis:proceedings of the Copenhagen Symposium on Osteoporosis, 3–8 June 1984. Copenhagen, Denmark: Department of Clinical Chemistry, Glostrup Hospital, 1984:337–40.

    Google Scholar 

  11. Anderson JJB, Tylavsky FA. Diet and osteopenia in elderly Caucasian women. In: Christiansen C, Arnaud CD, Nordin BEC, Parfitt AM, Peck WA, Riggs BL, editors. Osteoporosis:proceedings of the Copenhagen Symposium on Osteoporosis, 3–8 June 1984. Copenhagen, Denmark: Department of Clinical Chemistry, Glostrup Hospital, 1984:299–304.

    Google Scholar 

  12. Sowers MFR, Wallace RB, Lemke JH. Correlates of mid-radius bone density among postmenopausal women: a community study. Am J Clin Nutr 1985;41:1045–53.

    Google Scholar 

  13. Yano K, Heilbrun LK, Wasnich RD, Hankin JH, Vogel JM. The relationship between diet and bone mineral content of multiple skeletal sites in elderly Japanese—American men and women living in Hawaii. Am J Clin Nutr 1985;42:877–88.

    Google Scholar 

  14. Freudenheim JL, Johnson NE, Smith EL. Relationships between usual nutrient intake and bone mineral content of women 35–65 years of age: longitudinal and cross-sectional analysis. Am J Clin Nutr 1986;44:863–76.

    Google Scholar 

  15. Picard D, Ste-Marie IG, Carrier I, Chartrand R, Lepage R, D'Amour P. Influence of calcium intake during early adulthood on bone mineral content in premenopausal women. In: Cohn DV, Martin TJ, Meunier PJ, editors. Calcium regulation and bone metabolism: basic and clinical aspects. Amsterdam: Excerpta Medica, 1987;9:128–32.

    Google Scholar 

  16. Halioua L, Anderson JB. Lifetime calcium intake and physical activity habits: independent and combined effects on the radial bone of healthy premenopausal Caucasian women. Am J Clin Nutr 1989;49:534–41

    Google Scholar 

  17. Jacobson PC, Beaver W, Grubb SA, Taft TN, Talmage RV. Bone density in women: college athletes and older athletic women. J Orthop Res 1984;2:328–32.

    Google Scholar 

  18. Talmage RV, Stinnet SS, Landwehr JT, Vincent LM, McCartney WH. Age-related loss of bone mineral density in non-athletic and athletic women. Bone Miner 1986;1:115–25.

    Google Scholar 

  19. Anderson JJB, Tylavsky FA, Lacey JM, Talmage RV, Taft T. Major factors influencing radial bone mass in college-age women [abstr]. Fed Proc 1987; 46:1841.

    Google Scholar 

  20. Grisso JA, Kelsey JL, Strom BL et al. Risk factors for falls as determinants of hip fractures. N Engl J Med 1991;324:1326–31.

    Google Scholar 

  21. Cummings SR, Block G, McHenry K, Baron RB. Evaluation of two food frequency methods of measuring dietary calcium intake. Am J Epidemiol 1987;126:796–802.

    Google Scholar 

  22. Block G, Hartman AM, Dresser CM et al. A data-based approach to diet questionnaire design and testing. Am J Epidemiol 1986;124:453–69.

    Google Scholar 

  23. Kiel DP, Felson DT, Hannan MT, Anderson JJ, Wilson PWF. Caffeine and the risk of hip fracture: the Framingham study. Am J Epidemiol 1990;132:675–84.

    Google Scholar 

  24. US Department of Agriculture. Nutritive value of American foods. Agriculture handbook No. 456. Washington, DC: US GPO, 1975.

    Google Scholar 

  25. Florey CDV. The use and interpretation of ponderal index and other weight-height ratios in epidemiological studies. J Chron Dis 1970;23:93–103.

    Google Scholar 

  26. Micozzi MS, Albanes D, Jone Y, Chumlea WC. Correlations of body mass incidences with weight, stature and body composition in men and women in NHANES I and II. Am J Clin Nutr 1986;44:725–31.

    Google Scholar 

  27. Breslow NE, Day NE. Statistical methods in cancer research, Vol 1, The analysis of case-control studies. IARC publication no. 32. Lyon: International Agency for Research on Cancer, 1980.

    Google Scholar 

  28. EGRET Statistical Software, 1985. Statistics and Epidemiological Research Corporation and Cytel Software Corporation.

  29. McCulloch RG, Bailey DA, Houston S, Dodd BL. Effects of physical activity, dietary calcium intake and selected lifestyle factors on bone density in young women. Can Med Assoc J 1990;142:221–7.

    Google Scholar 

  30. Kelsey JL, O'Brien LA, Grisso JA, Hoffman S. Issues in carrying out epidemiologic research in the elderly. Am J Epidemiol 1989;130:857–66.

    Google Scholar 

  31. Heaney RP. Calcium, bone health, and osteoporosis. In: Peck WA, editor. Bone and Mineral Research, vol 4. Amsterdam: Elsevier, 1986.

    Google Scholar 

  32. Cumming RG. Calcium intake and bone mass:a quantitative review of the evidence. Calcif Tissue Int 1990;47:194–201.

    Google Scholar 

  33. Goodhart RS, Shils ME. Modern nutrition in health and disease, 6th edn. Philadelphia: Lea and Febiger, 1980.

    Google Scholar 

  34. Lynch SR, Berelowitz I, Seftel HC et al. Osteoporosis in Johannesburg Bantu males: its relationship to siderosis and ascorbic acid deficiency. Am J Clin Nutr 1967;20:799–807.

    Google Scholar 

  35. Block G, Dresser CM, Hartman AM, Carroll MD. Nutrient sources in the American diet: quantitative data from the NHANES II survey. I. Vitamins and minerals. Am J Epidemiol 1985;122:13–26.

    Google Scholar 

  36. Massey LK, Berg TA. The effect of dietary caffeine on urinary excretion of calcium, magnesium, sodium and potassium in healthy young females. Nutr Res 1984;4:43–50.

    Google Scholar 

  37. Heaney RP, Recker RR. Effects of nitrogen, phosphorus, and caffeine on calcium balance in women. J Lab Clin Med 1982;99:46–55.

    Google Scholar 

  38. Daniell HW. Osteoporosis of the splender smoker. Vertebral compression fractures and loss of metacarpal cortex in relation to postmenopausal cigarette smoking and lack of obesity. Arch Intern Med 1976;136:298–304.

    Google Scholar 

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Nieves, J.W., Grisso, J.A. & Kelsey, J.L. A case-control study of hip fracture: evaluation of selected dietary variables and teenage physical activity. Osteoporosis Int 2, 122–127 (1992). https://doi.org/10.1007/BF01623818

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