title: Physical activity in middle-aged women and hip fracture risk: the UFO study.
abstract: In a population-based case-control study, we demonstrate that middle-aged women who were active with walking or in different physical spare time activities were at lower risk of later sustaining a hip fracture compared to more sedentary women.
  
  
  BACKGROUND
  In middle-aged women participating in the Umeå Fracture and Osteoporosis (UFO) study, we investigated whether physical activity is associated with a subsequent decreased risk of sustaining a hip fracture.
  
  
  METHODS
  The UFO study is a nested case-control study investigating associations between bone markers, lifestyle, and osteoporotic fractures. We identified 81 female hip fracture cases that had reported lifestyle data before they sustained their fracture. Each case was compared with two female controls who were identified from the same cohort and matched for age and week of reporting data, yielding a total cohort of 237 subjects. Mean age at baseline was 57.2 ± 5.0 years, and mean age at fracture was 65.4 ± 6.4 years.
  
  
  RESULTS
  Conditional logistic regression analysis with adjustments for height, weight, smoking, and menopausal status showed that subjects who were regularly active with walking or had a moderate or high frequency of physical spare time activities (i.e. berry/mushroom picking and snow shovelling) were at reduced risk of sustaining a hip fracture (OR 0.14; 95% CI; 0.05-0.53 for walking and OR 0.19; 95% CI; 0.08-0.46, OR 0.17, 95% CI; 0.05-0.64 for moderate and high frequency of spare time activities, respectively) compared to more sedentary women.
  
  
  CONCLUSIONS
  An active lifestyle in middle age seems to reduce the risk of future hip fracture. Possible mechanisms may include improved muscle strength, coordination, and balance resulting in a decreased risk of falling and perhaps also direct skeletal benefits.
authors.affiliation: Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.
authors.forename: U
authors.initials: U
authors.lastname: Englund
authors.forename: P
authors.initials: P
authors.lastname: Nordström
authors.forename: J
authors.initials: J
authors.lastname: Nilsson
authors.forename: G
authors.initials: G
authors.lastname: Bucht
authors.forename: U
authors.initials: U
authors.lastname: Björnstig
authors.forename: G
authors.initials: G
authors.lastname: Hallmans
authors.forename: O
authors.initials: O
authors.lastname: Svensson
authors.forename: U
authors.initials: U
authors.lastname: Pettersson
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009043:Motor Activity; D011446:Prospective Studies; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D016138:Walking
references.citation: Osteoporos Int. 2006;17(8):1154-64
references.pmid: 16758134
references.citation: Osteoporos Int. 2005 Feb;16(2):155-62
references.pmid: 15175845
references.citation: JAMA. 1995 May 3;273(17):1341-7
references.pmid: 7715058
references.citation: Int J Epidemiol. 1995 Aug;24(4):783-6
references.pmid: 8550276
references.citation: JAMA. 2002 Nov 13;288(18):2300-6
references.pmid: 12425707
references.citation: J Bone Miner Res. 2003 Sep;18(9):1674-81
references.pmid: 12968677
references.citation: Osteoporos Int. 1996;6(5):361-7
references.pmid: 8931030
references.citation: Am J Med. 1997 Aug 18;103(2A):20S-25S; discussion 25S-26S
references.pmid: 9302894
references.citation: Osteoporos Int. 2007 Dec;18(12):1583-93
references.pmid: 17566814
references.citation: Lancet. 1999 Mar 6;353(9155):802-5
references.pmid: 10459962
references.citation: J Bone Miner Res. 2006 Dec;21(12):1836-8
references.pmid: 17002578
references.citation: N Engl J Med. 1995 Mar 23;332(12):767-73
references.pmid: 7862179
references.citation: Bone. 2008 Sep;43(3):521-31
references.pmid: 18602880
references.citation: Ann Epidemiol. 2008 Nov;18(11):827-35
references.pmid: 18809340
references.citation: Bone. 1996 Oct;19(4):407-13
references.pmid: 8894148
references.citation: Osteoporos Int. 2008 Sep;19(9):1267-73
references.pmid: 18214568
references.citation: Am J Epidemiol. 2001 Jul 1;154(1):60-8
references.pmid: 11427405
references.citation: BMJ. 2008 Jan 19;336(7636):124-6
references.pmid: 18202065
references.citation: Bone. 2003 Jan;32(1):78-85
references.pmid: 12584039
references.citation: Osteoporos Int. 2005 Sep;16(9):1117-23
references.pmid: 16133653
references.citation: Osteoporos Int. 2003 Nov;14(11):941-9
references.pmid: 12955315
references.citation: Lancet. 1996 Jul 20;348(9021):145-9
references.pmid: 8684153
references.citation: Bone. 1996 Mar;18(3 Suppl):121S-125S
references.pmid: 8777076
references.citation: Injury. 2002 Dec;33 Suppl 3:C1-7
references.pmid: 12423584
references.citation: PLoS Med. 2007 Jun;4(6):e199
references.pmid: 17579509
references.citation: Nutr Rev. 2003 May;61(5 Pt 1):157-67
references.pmid: 12822704
references.citation: Calcif Tissue Int. 2009 Jul;85(1):22-30
references.pmid: 19533013
references.citation: Osteoporos Int. 2005 Dec;16(12):2185-94
references.pmid: 16177836
references.citation: Ann Intern Med. 1998 Jul 15;129(2):81-8
references.pmid: 9669990
references.citation: Acta Orthop Scand. 1999 Feb;70(1):19-22
references.pmid: 10191741
references.citation: Food Nutr Res. 2008;52:
references.pmid: 19158939
references.citation: Osteoporos Int. 1997;7(6):503-13
references.pmid: 9604045
references.citation: Hip Int. 2008 Apr-Jun;18(2):101-7
references.pmid: 18645983
references.citation: Scand J Public Health Suppl. 2003;61:18-24
references.pmid: 14660243
references.citation: Osteoporos Int. 1992 Nov;2(6):298-302
references.pmid: 1421798
references.citation: J Gerontol. 1990 May;45(3):M82-8
references.pmid: 2335723
references.citation: Epidemiology. 1991 Jan;2(1):16-25
references.pmid: 2021661