title: Anthropometry, physical activity and hip fractures in the elderly.
abstract: BACKGROUND
  Hip fractures constitute a major and growing public health problem amongst the elderly worldwide. We examined the association of anthropometry and physical activity with hip fracture incidence in a cohort of elderly Europeans, participants in the European Prospective Investigation into Cancer and nutrition (EPIC) study.
  
  
  METHODS
  The study population consisted of 27 982 volunteers (10 553 men and 17 429 women) aged 60 years and above from five European countries. Information on anthropometry, physical activity, medical history and other characteristics was collected at baseline. During a median follow-up of 8 years, 261 incident hip fractures (203 women and 58 men) were recorded. Data were analysed through Cox proportional hazard regression with adjustment for potential confounders.
  
  
  RESULTS
  A higher body mass index (BMI) was associated with lower hip fracture risk (hazard ratio (HR)per increasing sex-specific-quintile: 0.85, 95% confidence interval (95% CI): 0.77–0.94). Body height was associated with increased hip fracture risk (HR per 5 cm: 1.13, 95% CI: 1.01–1.25). Waist-to-hip ratio was not related to hip fracture risk. Increasing levels of leisure-time physical activity were related to lower risk (HR per increasing tertile: 0.84, 95% CI: 0.70–0.99, p for trend: 0.039).
  
  
  CONCLUSIONS
  In a prospective cohort study of elderly Europeans, we found evidence that high body stature increased and high BMI decreased the incidence of hip fractures. After adjustment for BMI,waist to-hip ratio was not associated with hip fracture risk. Leisure-time physical activity appears to play a beneficial role in the prevention of hip fractures.
authors.affiliation: Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, 75 Mikras Asias St., 115 27 Athens, Greece. vben@nut.uoa.gr
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Benetou
authors.forename: Philippos
authors.initials: P
authors.lastname: Orfanos
authors.forename: Ioannis S
authors.initials: IS
authors.lastname: Benetos
authors.forename: Valeria
authors.initials: V
authors.lastname: Pala
authors.forename: Alberto
authors.initials: A
authors.lastname: Evangelista
authors.forename: Graziella
authors.initials: G
authors.lastname: Frasca
authors.forename: Maria Concetta
authors.initials: MC
authors.lastname: Giurdanella
authors.forename: Petra H M
authors.initials: PH
authors.lastname: Peeters
authors.forename: Ivonne T
authors.initials: IT
authors.lastname: van der Schouw
authors.forename: Sabine
authors.initials: S
authors.lastname: Rohrmann
authors.forename: Jakob
authors.initials: J
authors.lastname: Linseisen
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
authors.forename: Cornelia
authors.initials: C
authors.lastname: Weikert
authors.forename: Ulrika
authors.initials: U
authors.lastname: Pettersson
authors.forename: Bethany
authors.initials: B
authors.lastname: Van Guelpen
authors.forename: H Bas
authors.initials: HB
authors.lastname: Bueno de Mesquita
authors.forename: Jone
authors.initials: J
authors.lastname: Altzibar
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
mesh_terms: D000368:Aged; D001827:Body Height; D015992:Body Mass Index; D015519:Bone Density / Q000502:physiology*; D004032:Diet / Q000009:adverse effects; D005060:Europe / Q000453:epidemiology; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D049629:Waist-Hip Ratio