Faculty Collaboration Database

Low-fat, increased fruit, vegetable, and grain dietary pattern, fractures, and bone mineral density: the Women's Health Initiative Dietary Modification Trial. Am J Clin Nutr 2009 Jun;89(6):1864-76

Date

05/01/2009

Pubmed ID

19403636

Pubmed Central ID

PMC2682999

DOI

10.3945/ajcn.2008.26956

Scopus ID

2-s2.0-66849111911 (requires institutional sign-in at Scopus site)   63 Citations

Abstract

BACKGROUND: The effects of dietary changes on osteoporosis, low bone density, and frequent falls are unestablished.

OBJECTIVE: We assessed the effect of the Women's Health Initiative Dietary Modification low-fat and increased fruit, vegetable, and grain intervention on incident hip, total, and site-specific fractures and self-reported falls, and, in a subset, on bone mineral density (BMD).

DESIGN: Postmenopausal women (n = 48,835) aged 50-79 y (18.6% of minority race-ethnicity) were randomly assigned to receive the Dietary Modification intervention (40%, n = 19,541) (daily goal: < or =20% of energy as fat, > or =5 servings of vegetables and fruit, and > or =6 servings of grains) or to a comparison group that received no dietary changes (60%; n = 29,294).

RESULTS: After a mean 8.1 y of follow-up, 215 women in the intervention group and 285 women in the comparison group (annualized rate: 0.14% and 0.12%, respectively) experienced a hip fracture (hazard ratio: 1.12; 95% CI: 0.94, 1.34; P = 0.21). The intervention group (n = 5423; annualized rate: 3.44%) had a lower rate of reporting > or =2 falls than did the comparison group (n = 8695; annualized rate: 3.67%) (HR: 0.92; 95% CI: 0.89, 0.96; P < 0.01). There was a significant interaction according to hormone therapy use; those in the comparison group receiving hormone therapy had the lowest incidence of hip fracture. In a subset of 3951 women, hip BMD at years 3, 6, and 9 was 0.4-0.5% lower in the intervention group than in the comparison group (P = 0.003).

CONCLUSIONS: A low-fat and increased fruit, vegetable, and grain diet intervention modestly reduced the risk of multiple falls and slightly lowered hip BMD but did not change the risk of osteoporotic fractures. This trial was registered at clinicaltrials.gov as NCT00000611.

Author List

McTiernan A, Wactawski-Wende J, Wu L, Rodabough RJ, Watts NB, Tylavsky F, Freeman R, Hendrix S, Jackson R, Women's Health Initiative Investigators

Author

Joan Neuner MD, MPH Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Accidental Falls
Aged
Bone Density
Diet, Fat-Restricted
Edible Grain
Female
Follow-Up Studies
Fractures, Bone
Fruit
Hip Fractures
Hormone Replacement Therapy
Humans
Incidence
Middle Aged
Osteoporosis, Postmenopausal
Patient Compliance
Proportional Hazards Models
Spinal Fractures
Vegetables