Mediterranean Diet Associated with Lower Risk of Hip Fractures


For post-menopausal women, following the Mediterranean diet could lower their risk of hip fracture, according to new study from Germany.

For post-menopausal women, following the Mediterranean diet could lower their risk of hip fracture, according to new study from Germany. In a study from the University of Würtzburg published in the March 28 JAMA Internal Medicine, researchers evaluated whether adhering to dietary patterns was associated with hip- and total-fracture risk. According to investigators, the study’s aim was two-fold: to examine the association between adherence to a diet quality index based on dietary recommendations and patterns, bone health and outcomes in post-menopausal women and to examine the association between diet quality bone mineral density and lean body mass measurements.  [[{"type":"media","view_mode":"media_crop","fid":"48186","attributes":{"alt":"(©NeilLockhart/","class":"media-image","id":"media_crop_7932978491486","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"%7BMCIID%7D","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"font-size: 13.008px; line-height: 1.538em;","title":"(©NeilLockhart/","typeof":"foaf:Image"}}]] Data was collected from 90,014 women, average age 64, from 40 clinical centers through the Women’s Health Initiative food frequency questionnaire (FFQ). Investigators examined results from four dietary programs: the alternate Mediterranean Diet (aMED), the Healthy Eating Index 2010 (HEI-2010), the alternate Healthy Eating Index 2010 (aHEI-2010), and the Dietary Approaches to Stop Hypertension (DASH) Diet. Food intake and fractures were self-reported. Each diet emphasized some combination of fruits, vegetables, fish, nuts, legumes, whole grains and monounsaturated fats.  [[{"type":"media","view_mode":"media_crop","fid":"48187","attributes":{"alt":"(©NeilLockhart/","class":"media-image media-image-right","id":"media_crop_6042010887466","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"5741","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"font-size: 13.008px; line-height: 1.538em; float: right;","title":"(©NeilLockhart/","typeof":"foaf:Image"}}]] Throughout the study, which lasted from 1993 to 2014, women experienced 2,121 hip fractures and 28,718 total fractures. Women in the highest aMED quintile reported the lowest hip-fracture (HR 0.80) with an absolute risk reduction of 0.29 percent, but there was no aMED total-fracture association (HR 1.01). The higher HEI-2010 and DASH quintiles were inversely-related to hip-fracture risk, but the associations weren’t significant (HR 0.87 and 0.89, respectively). A HEI-2010 wasn’t associated with hip- or total-fracture risk. The researchers suggest that following the Mediterranean diet lowers the risk of hip fracture among post-menopausal women. In fact, Mediterranean countries have lower incidence of osteoarthritis and osteoarthritis-related fractures that Northern European countries, they wrote.

“Our data support an association between the extent of adherence to a healthy diet characterized by adherence to a Mediterranean diet and lower fracture risk,” researchers wrote. “However, given the apparent risk reductions across various dietary patterns, a specific dietary index may not be associated with lower risk; rather, high diet quality reflected by various dietary indexes and their common components may achieve a lower risk.”

The study should be considered cautiously, however. According to Walter C. Willett, M.D., DrPH, from the Harvard T.H. Chan School of Public Health, additional research is needed to confirm these results.

“In the analysis…only a single measure of diet and physical activity was available, and participants with better diets might have improved their level of physical activity during the follow-up. Repeated measures of activity could have helped to reduce measurement error,” Willett wrote in a commentary published with the study. “Had physical activity been measured even somewhat better, it is likely that the observed inverse association between diet quality and risk of hip fracture would have become nonsignificant.”



Walter C. Willett, MD, DrPH. 

"Mediterranean Diet and Fracture Risk,"

 Published online March 28, 2016. doi:10.1001/jamainternmed.2016.0494 Bernhard Haring, MD, MPH; Carolyn J. Crandall, MD, et al.

"Dietary Patterns and Fractures in Postmenopausal Women Results From the Women’s Health Initiative,"

JAMA Internal Medicine. Published online March 28, 2016. doi:10.1001/jamainternmed.2016.0482  

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