title: Fruit and Vegetable Intake and Hip Fracture Incidence in Older Men and Women: The CHANCES Project.
abstract: The role of fruit and vegetable intake in relation to fracture prevention during adulthood and beyond is not adequately understood. We investigated the potential association between fruit and vegetable intake and hip fracture incidence in a large sample of older adults from Europe and the United States. A total of 142,018 individuals (116,509 women) aged ≥60 years, from five cohorts, were followed up prospectively for 1,911,482 person-years, accumulating 5552 hip fractures. Fruit and vegetable intake was assessed by validated, cohort-specific, food-frequency questionnaires (FFQ). Ηip fractures were ascertained through national patient registers or telephone interviews/questionnaires. Adjusted hazard ratios (HRs) derived by Cox proportional hazards regression were estimated for each cohort and subsequently pooled using random effects meta-analysis. Intake of ≤1 serving/day of fruit and vegetables combined was associated with 39% higher hip fracture risk (pooled adjusted HR, 1.39; 95% confidence interval [CI], 1.20 to 1.58) in comparison with moderate intake (>3 and ≤5 servings/day) (pfor heterogeneity  = 0.505), whereas higher intakes (>5 servings/day) were not associated with lower risk in comparison with the same reference. Associations were more evident among women. We concluded that a daily intake of 1 or <1 servings of fruits and vegetables was associated with increased hip fracture risk in relation to moderate daily intakes. Older adults with such low fruit and vegetable consumption may benefit from raising their intakes to moderate amounts in order to reduce their hip fracture risk. © 2016 American Society for Bone and Mineral Research.
authors.affiliation: Department of Hygiene, Epidemiology, and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.|Hellenic Health Foundation, Athens, Greece.
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Benetou
authors.affiliation: Department of Hygiene, Epidemiology, and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.|Hellenic Health Foundation, Athens, Greece.
authors.forename: Philippos
authors.initials: P
authors.lastname: Orfanos
authors.affiliation: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Diane
authors.initials: D
authors.lastname: Feskanich
authors.affiliation: Department of Surgical Sciences, Section of Orthopedics, Uppsala University, Uppsala, Sweden.
authors.forename: Karl
authors.initials: K
authors.lastname: Michaëlsson
authors.affiliation: Department of Pharmacology and Clinical Neurosciences, Umeå University, Umeå, Sweden.|Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: Ulrika
authors.initials: U
authors.lastname: Pettersson-Kymmer
authors.affiliation: Department of Community Medicine, Umeå University, Umeå, Sweden.
authors.forename: Sture
authors.initials: S
authors.lastname: Eriksson
authors.affiliation: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Francine
authors.initials: F
authors.lastname: Grodstein
authors.affiliation: Institute of Environmental Medicine, Division of Nutritional Epidemiology, Karolinska Institute, Stockholm, Sweden.
authors.forename: Alicja
authors.initials: A
authors.lastname: Wolk
authors.affiliation: Institute of Environmental Medicine, Division of Nutritional Epidemiology, Karolinska Institute, Stockholm, Sweden.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bellavia
authors.affiliation: Department of Health and Care Sciences, Faculty of Health Sciences, UiT-the Arctic University of Norway, Tromsø, Norway.|Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
authors.forename: Luai A
authors.initials: LA
authors.lastname: Ahmed
authors.affiliation: Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffeta
authors.affiliation: Department of Hygiene, Epidemiology, and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.|Hellenic Health Foundation, Athens, Greece.
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016001:Confidence Intervals; D004032:Diet; D005060:Europe / Q000453:epidemiology; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D006620:Hip Fractures / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D014481:United States / Q000453:epidemiology; D014675:Vegetables
keywords: EPIDEMIOLOGY; FRUITS; HIP FRACTURE; NUTRITION; VEGETABLES