Nutrient patterns and risk of fracture in older subjects: results from the Three-City Study
- 683 Downloads
We investigated the association between nutrient patterns and risk of fractures in 1,482 older subjects. Patterns associated with higher intakes of Ca, P, vitamin B12, proteins and unsaturated fats, and moderate alcohol intake, provided by diets rich in dairies and charcuteries, were related to a lower risk of wrist and hip fractures.
The purpose of this study was to investigate the relationship between patterns of nutrient intake and the risk of fractures in older subjects.
Among 1,482 participants from the Bordeaux sample of the Three-City (3C) Study who completed a 24-h dietary recall and a food frequency questionnaire, we examined the association between patterns of nutrient intake derived from principal component analysis and 8-year incidence of self-reported fractures of the hip, the wrist, and the vertebrae.
A “nutrient-dense” pattern rich in Ca and P, iron, vitamins B including B12, vitamins C and E, alcohol, proteins, and unsaturated fats, and characterized by a higher consumption of fruits and vegetables, meats and fish, cheese and milk, charcuteries, cereals, rice, pasta, and potatoes, was associated with a 19 % (95 % CI 2–34 %, P = 0.03) lower risk of wrist fractures. The same pattern was associated with a 14 % (95 % CI 2–25 %) lower risk of fractures at any site. A “south-western French” pattern rich in Ca, P, vitamins D and B12, retinol, alcohol, proteins, and fats-including unsaturated fats; poor in vitamins C, E, and K, carotenes, folates, and fibers; and related to a higher consumption of cheese, milk, and charcuterie and a lower consumption of fruits and vegetables was related to a 33 % lower risk of hip fractures (95 % CI 3–39 %, P = 0.03).
Higher intakes of Ca, P, vitamin B12, proteins, and unsaturated fats and moderate alcohol, provided by dietary patterns rich in cheese, milk, and charcuteries, were related to a lower risk of wrist and hip fractures in our cohort.
KeywordsCohort studies Dietary patterns Fractures Nutrition Risk factors in epidemiology
Source of funding
The Three-City Study is conducted under a partnership agreement between the Institut National de la Santé et de la Recherche Médicale (INSERM), the Institut de Santé Publique et Développement of the Bordeaux Segalen 2 University, and Sanofi-Aventis. The Fondation pour la Recherche Médicale funded the preparation and initiation of the study. The 3C Study is also supported by the Caisse Nationale Maladie des Travailleurs Salariés, Direction Générale de la Santé, Mutuelle Générale de l’Education Nationale, Institut de la Longévité, Regional Governments of Aquitaine and Bourgogne, Fondation de France, and Ministry of Research–INSERM Programme “Cohortes et collections de données biologiques.” This work was carried out with the financial support of the “ANR–Agence Nationale de la Recherche—The French National Research Agency” under the “Programme National de Recherche en Alimentation et nutrition humaine,” project “COGINUT ANR-06-PNRA-005.” This specific analysis within the 3C study was funded by a research agreement between the INSERM and Danone Research.
Conflicts of interest
C. Samieri, V. Ginder Coupez, S. Lorrain, and B. Allès report no conflict of interest. C. Féart received fees for conferences from Danone. L. Letenneur received research support from Danone. V. Ginder and D. Paineau are members of Danone Research. Dr. Barberger-Gateau served on a scientific advisory board for Caisse Nationale pour la Solidarite et l’Autonomie, has received funding for travel and speaker honoraria from Lesier, Bausch & Lomb, Aprifel, Danone Institute, Canadian Association of Gerontology, and the Jean Mayer Human Nutrition Research Center on Aging, Tufts University, serves on the editorial boards of Disability and Rehabilitation, has received consultancy fees from Vifor Pharma, and receives research support from Lesieur, Danone, Agence Nationale de la Recherche, Conseil Régional d’Aquitaine, Institut Carnot LISA, and Groupe Lipides et Nutrition.
- 7.Committee to review dietary reference intakes for vitamin D and calcium, (2010) Dietary reference intakes for calcium and vitamin D. Institute of Medicine, WashingtonGoogle Scholar
- 12.Favier J, Ireland-Ripert J, Toque C, Feinberg M (1995) Répertoire Général des Aliments. Table de Composition, 2nd edn. INRA Editions, ParisGoogle Scholar
- 13.Souci S, Fachman W, Kraut H (2000) Food composition and nutrition tables. Medpharm Scientific, StuttgartGoogle Scholar
- 14.Feart C, Jutand MA, Larrieu S, Letenneur L, Delcourt C, Combe N, Barberger-Gateau P (2007) Energy, macronutrient and fatty acid intake of French elderly community dwellers and association with socio-demographic characteristics: data from the Bordeaux sample of the Three-City Study. Br J Nutr 98:1046–1057PubMedCrossRefGoogle Scholar
- 16.Simermann J, Barberger-Gateau P, Beer C (2007) Validation of a food frequency questionnaire in older population. 25th Annual Congress of SFNEP: clinical nutrition and metabolism S69–70. Montpellier (France)Google Scholar
- 17.World Health Organization–World Health Organizing Collaborating Centre for Drug Statistics Methodology (2000) Guidelines for ATC classification and DDD assignment. WHO, OsloGoogle Scholar
- 20.Van Buuren S, Oudshoorn CGM (2000) Multivariate imputation by chained equations: MICE V1.0 User’s Manual. TNO Report PG/VGZ/00.038Google Scholar
- 27.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 93:1142–1151PubMedCrossRefGoogle Scholar
- 32.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 89:1864–1876PubMedCrossRefGoogle Scholar
- 40.Fairweather-Tait SJ, Skinner J, Guile GR, Cassidy A, Spector TD, Macgregor AJ (2011) Diet and bone mineral density study in postmenopausal women from the TwinsUK registry shows a negative association with a traditional English dietary pattern and a positive association with wine. Am J Clin Nutr 94:1371–1375PubMedCrossRefGoogle Scholar
- 41.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 93:192–199PubMedCrossRefGoogle Scholar