title: Greater intake of fruit and vegetables is associated with a lower risk of osteoporotic hip fractures in elderly Chinese: a 1:1 matched case-control study.
abstract: In this case-control study, we examined the relationship between the consumption of fruit and vegetables and risk of hip fractures in 646 pairs of incident cases and controls in elderly Chinese. We found that greater consumption of both fruit and vegetables in men and vegetables in women was associated with a lower risk of osteoporotic hip fractures in elderly Chinese.
  
  
  BACKGROUND
  The association between fruit and vegetable consumption and the risk of osteoporotic fractures remains controversial due to limited published evidence. The purpose of this study was to determine whether consuming fruits and vegetables has a protective effect against hip fractures.
  
  
  METHODS
  Between January 2008 and December 2012, 646 (162 males, 484 females) incident cases (70.9 ± 6.8 years) of hip fractures were enrolled from five hospitals, with 646 sex- and age-matched (±3 years) controls (70.7 ± 6.8 years) from hospitals or the community. Face-to-face interviews were conducted to assess habitual dietary intakes using a 79-item food frequency questionnaire and various covariates by structured questionnaires.
  
  
  RESULTS
  Multivariate conditional logistic regression analyses showed dose-dependent inverse correlations between the intake of total fruit (p-trend = 0.014), total vegetables (p-trend <0.001), fruits and vegetables combined (p-trend < 0.001) and the risk of hip fractures after adjustment for sociodemographic characteristics, dietary factors and other potential confounders. The adjusted odds ratios (95% confidence interval) for hip fractures in the top quartiles (vs. the lowest quartiles) for the intake of fruits, vegetables and the combination of fruits and vegetables were 0.53 (0.32-0.87), 0.37 (0.23-0.60) and 0.25 (0.15-0.41), respectively. Stratified analyses showed that the benefits remained significant in males (p = 0.001) but not in females (p = 0.210) (p-interaction 0.045). Among the subcategories of fruits and vegetables, similar associations were observed for all subgroups except light-coloured fruits.
  
  
  CONCLUSIONS
  Our findings suggest that greater consumption of both fruits and vegetables in men and vegetables in women may decrease the risk of osteoporotic hip fractures in elderly Chinese.
authors.affiliation: Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.
authors.forename: H-L
authors.initials: HL
authors.lastname: Xie
authors.forename: B-H
authors.initials: BH
authors.lastname: Wu
authors.forename: W-Q
authors.initials: WQ
authors.lastname: Xue
authors.forename: M-G
authors.initials: MG
authors.lastname: He
authors.forename: F
authors.initials: F
authors.lastname: Fan
authors.forename: W-F
authors.initials: WF
authors.lastname: Ouyang
authors.forename: S-L
authors.initials: SL
authors.lastname: Tu
authors.forename: H-L
authors.initials: HL
authors.lastname: Zhu
authors.forename: Y-M
authors.initials: YM
authors.lastname: Chen
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D004032:Diet / Q000706:statistics & numerical data; D004034:Diet Surveys; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D006620:Hip Fractures / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D058866:Osteoporotic Fractures / Q000453:epidemiology / Q000517:prevention & control*; D018570:Risk Assessment / Q000379:methods; D012959:Socioeconomic Factors; D014675:Vegetables