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Hip frac­tures are a seri­ous health con­cern, with approx­i­mately 1.6 mil­lion cases world­wide reported annu­ally. Nearly 75 per­cent of all hip frac­tures occur in women. Hip frac­tures are often asso­ci­ated with loss in qual­ity of life, chronic pain, reduced mobil­ity, dis­abil­ity, and an increas­ing degree of depen­dence, with 10 – 20 per­cent of cases need­ing long-term nurs­ing care.

While con­sid­er­able research has been con­ducted to relate sin­gle nutri­ents to bone health, results still remain incon­sis­tent. Many researchers now agree that nutri­ents act in syn­ergy within whole dietary pat­terns rather than as iso­lated nutri­ents. Therefore, it is of inter­est to estab­lish if dietary pat­terns can assist in risk reduc­tion for health con­cerns such as hip frac­tures.

In a recent study, pub­lished in JAMA Internal Medicine, 2016, 90,014 par­tic­i­pants, taken from the 93,676 par­tic­i­pants in the orig­i­nal Women’s Health Initiative obser­va­tional study, were eval­u­ated for inci­dence of total frac­tures and hip frac­tures. Women in the study ranged from 50 – 79 years, there was a median fol­low-up 15.9 years, and dietary scores were assessed from food fre­quency ques­tion­naires for adher­ence to a num­ber of healthy dietary pat­terns, the Mediterranean diet being one of them. The authors report that, ​“Diet qual­ity and adher­ence were assessed by scores on the alter­nate Mediterranean Diet (aMED), a 9‑category mea­sure of adher­ence to a Mediterranean dietary pat­tern.”

The analy­sis showed there were 2,121 cases of hip frac­ture and 28,718 total frac­tures. No asso­ci­a­tion was found between total frac­ture and the aMed score. However, women scor­ing in the high­est quin­tile aMed score had a sig­nif­i­cantly lower risk of hip frac­ture, the absolute risk reduc­tion was 0.29 per­cent. No sig­nif­i­cant results were found for any of the other dietary pat­terns assessed.

The authors con­cluded, ​“Higher adher­ence to a Mediterranean diet is asso­ci­ated with a lower risk for hip frac­tures. These results sup­port that a healthy dietary pat­tern may play a role in main­tain­ing bone health in post­menopausal women.”

Being the first results of their kind and con­sid­er­ing the large sam­ple size eval­u­ated, these results do seem like a promis­ing lifestyle strat­egy for risk reduc­tion of hip frac­tures. However, because this is only an obser­va­tional study, more research will need to be con­ducted to con­firm the asso­ci­a­tion.

Still, regard­less of more research being needed, because the Mediterranean diet has been shown to be incred­i­bly ben­e­fi­cial for many health con­di­tions, there is cer­tainly no harm in health prac­ti­tion­ers using it as a treat­ment strat­egy for those at risk of, or as adjunct to treat­ment for hip frac­tures.

• International Osteoporosis Association


• JAMA Internal Medicine: Dietary Patterns and Fractures in Postmenopausal Women