Osteoporosis International

, Volume 25, Issue 8, pp 2131–2141

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

Original Article

DOI: 10.1007/s00198-014-2741-2

Cite this article as:
Zeng, F., Xue, W., Cao, W. et al. Osteoporos Int (2014) 25: 2131. doi:10.1007/s00198-014-2741-2

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.

Keywords

Case–control studyChineseDiet-quality scoreElderlyHip fracture

Supplementary material

198_2014_2741_MOESM1_ESM.doc (176 kb)
ESM 1(DOC 175 kb)

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2014

Authors and Affiliations

  1. 1.Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public HealthSun Yat-sen UniversityGuangzhouPeople’s Republic of China
  2. 2.Department of Medical Statistics & Epidemiology, School of Public HealthSun Yat-sen UniversityGuangzhouPeople’s Republic of China
  3. 3.Guangzhou Orthopaedics Trauma HospitalGuangzhouPeople’s Republic of China
  4. 4.Department of Nutrition, School of Public HealthSun Yat-sen UniversityGuangzhouPeople’s Republic of China