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

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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.

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Acknowledgments

This study was jointly supported by the National Natural Science Foundation of China (Grant No. 30872100 and No. 81072299 to YMC) and the 5010 Program for Clinical Researches of Sun Yat-sen University (Grant No. 2007032 to YMC). The sponsor played no role in the study design, in the collection, analysis, and interpretation of data, in the writing of the manuscript, and in the decision to submit the manuscript for publication. We are grateful to Dr. Wei-fu Ouyang and SulanTu for the data collection and the doctors and nurses in the above-mentioned hospitals in facilitating both the recruitment of participants and the interviews.

Conflicts of interest

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Authors and Affiliations

  1. Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China

    F.F. Zeng, W.Q. Xue, W.T. Cao, H.L. Xie, F. Fan, H.L. Zhu & Y.M. Chen

  2. Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People’s Republic of China

    F.F. Zeng, W.Q. Xue, W.T. Cao, B.H. Wu, H.L. Xie, F. Fan & Y.M. Chen

  3. Guangzhou Orthopaedics Trauma Hospital, Guangzhou, People’s Republic of China

    B.H. Wu

  4. Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People’s Republic of China

    H.L. Zhu

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  1. F.F. Zeng
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  2. W.Q. Xue
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Correspondence to H.L. Zhu or Y.M. Chen.

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Zeng, F., Xue, W., Cao, W. et al. Diet-quality scores and risk of hip fractures in elderly urban Chinese in Guangdong, China: a case–control study. Osteoporos Int 25, 2131–2141 (2014). https://doi.org/10.1007/s00198-014-2741-2

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  • DOI: https://doi.org/10.1007/s00198-014-2741-2

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