Calcified Tissue International

, Volume 52, Issue 6, pp 425–433

Life-style and different fracture prevalence: A cross-sectional comparative population-based study

  • Brynjólfur Jónsson
  • Per Gärdsell
  • Olof Johnell
  • Ingemar Sernbo
  • Bo Gullberg
Clinical Investigations


In order to explain the higher prevalence of fractures in urban compared with rural areas, 782 residents in the city of Malmö, Sweden and 486 inhabitants from the nearby rural municipality of Sjöbo were invited to participate in an sex- and age-matched cross-sectional study on life-style differences; 73 and 80% respectively responded. Responders answered a questionnaire on medical and social background and were interviewed on past and present physical activity. The men and women of the rural area were found to be significantly more active physically at work and during spare time. Housing was larger in the rural area. For women, these differences are decreasing in the younger age groups. Bone mass was found to be correlated to heavier work load for men. Other life-style variable such as dairy calcium intake, coffee drinking, estrogen medication, and morbidity, could not explain this difference. Higher prevalence of fractures in the city could therefore be explained by physicall less active life-style.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Falch J, Ilebekk A, Slungaard U (1985) Epidemiology of hip fractures in Norway. Acta Orthop Scand 55:12–16Google Scholar
  2. 2.
    Finsen V, Benum P (1987) Changing incidence of hip fractures in rural and urban areas of central Norway. Clin Orthop 218: 104–110Google Scholar
  3. 3.
    Mannius S, Mellström D, Odén A, Rundgren A, Zetterberg C (1987) Incidence of hip fracture in western Sweden 1974–1982. Acta Orthop Scand 58:38–42Google Scholar
  4. 4.
    Sernbo I, Johnell O, Andersson T (1988) Differences in the incidence of hip fracture: comparison of an urban and a rural population in southern Sweden. Acta Orthop Scand 59:382–385Google Scholar
  5. 5.
    Larsson S, Eliasson P, Hansson L-I (1989) Hip fractures in northern Sweden 1973–1984: a comparison of rural and urban populations. Acta Orthop Scand 60:567–571Google Scholar
  6. 6.
    Jónsson B, Gärdsell P, Johnell O, Redlund-Johnell I, Sernbo I (1992) Differences in fracture pattern between an urban and a rural population: a comparative population-based study in southern Sweden. Osteoporosis Int 2:269–273Google Scholar
  7. 7.
    Gärdsell P, Johnell O, Nilsson BE, Sernbo I (1991) Bone mass in an urban and a rural population: a comparative, populationbased study in southern Sweden. J Bone Miner Res 6:67–75Google Scholar
  8. 8.
    Keys A (1980) Physical activity. In: Seven countries: a multivariate analysis of death and coronary heart disease. Harvard University Press, Cambridge Mass, London, pp 196–217Google Scholar
  9. 9.
    Gärdsell P, Johnell O, Nilsson BE (1989) Predicting fractures in women by using forearm bone densitometry. Calcif Tissue Int 44:235–342Google Scholar
  10. 10.
    Isacsson S-O, Hansson BS, Janzon L, Lindell SE, Steen B (1987) Methods to assess alcohol consumption in 68-year-old men: results from the population study “Men born in 1914,” Malmö, Sweden. Br J Addict 82:1235–1244Google Scholar
  11. 11.
    Nauclér LOW, Nilsson BE, Westlin NE (1974) An apparatus for gamma absorptiometry of bone-technical data. Opuscula Medicotechnica Lundensia 12:1Google Scholar
  12. 12.
    Åström J, Ahnqvist S, Beertema J, Jónsson B (1987) Physical activity in women sustaining fracture of the neck of the femur. J Bone Joint Surg 69-B:381–388Google Scholar
  13. 13.
    Smith E, Gilligan C (1991) Physical activity effects on bone metabolism. Calcif Tissue Int 49(suppl):S50–S54Google Scholar
  14. 14.
    Matkovic V, Kostial K, Simonovic I, Buzina R, Brodarec A, Nordin BEC (1979) Bone status and fracture rate in two regions in Yugoslavia. Am J Clin Nutr 32:540–549Google Scholar
  15. 15.
    Kanis JA, Passmore RA (1989) Calcium supplementation of diet: not justified by present evidence. BMJ 298:137–140, 205–208Google Scholar
  16. 16.
    Nordin BEC, Heany RP (1990) Calcium supplementation of the diet: justified by present evidence. BMJ 30:1056–1060Google Scholar
  17. 17.
    Lamke B, Brundin J, Moberg P (1977) Changes of bone mineral content during pregnancy and lactation. Acta Obstet Gynecol Scand 56:217–219Google Scholar
  18. 18.
    Sonwers M, Crutchfield M, Jannausch M, Updike S, Corton G (1991) A prospective evaluation of bone mineral change in pregnancy. Obstet Gynecol 77:841–845Google Scholar
  19. 19.
    Nilsson BE (1969) Parity and osteoporosis. Surg Gynecol Obstet 129:27–28Google Scholar
  20. 20.
    Johnell O, Nilsson BE (1984) Life-style and bone mineral mass in perimenopausal women. Calcif Tissue Int. 36:354–356Google Scholar
  21. 21.
    Axmacher B, Lindberg H (in press) Coxarthrosis in farmers. Clin OrthopGoogle Scholar
  22. 22.
    Forsberg K, Nilsson BE (1992) Coxarthrosis on the island of Gotland: increased prevalence in a rural population. Acta Orthop Scand 63:1–3Google Scholar
  23. 23.
    Lindberg H, Montgomery F (1987) Heavy labour and the occurrence of gonarthrosis. Clin Orthop 214:235–236Google Scholar
  24. 24.
    Rehnberg L, Olerud C (1990) Incidence of hip fractures in the elderly: Uppsala county 1980–1987. Acta Orthop Scand 61:148–151Google Scholar
  25. 25.
    Johnell O, Nilsson B, Obrant K, Sernbo I (1984) Age and sex patterns of hip fracture: changes in 30 years. Acta Orthop Scand 55:290–294Google Scholar

Copyright information

© Springer-Verlag New York Inc. 1993

Authors and Affiliations

  • Brynjólfur Jónsson
    • 1
    • 2
  • Per Gärdsell
    • 1
    • 2
  • Olof Johnell
    • 1
    • 2
  • Ingemar Sernbo
    • 1
    • 2
  • Bo Gullberg
    • 1
    • 2
  1. 1.Department of Orthopaedics, Malmö General HospitalUniversity of LundMalmöSweden
  2. 2.Department of Community Health Sciences, Malmö General HospitalUniversity of LundMalmöSweden

Personalised recommendations