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Adherence to a Mediterranean diet and risk of fractures in French older persons

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Abstract

Summary

Prevention of fractures is a considerable public health challenge. In a population-based cohort of French elderly people, a diet closer to a Mediterranean type had a borderline significant deleterious effect on the risk of fractures, in part linked to a low consumption of dairy products and a high consumption of fruits.

Introduction

Higher adherence to the Mediterranean diet (MeDi) is linked to a lower risk of several chronic diseases, but its association with the risk of fractures is unclear. Our aim was to investigate the association between MeDi adherence and the risk of fractures in older persons.

Methods

The sample consisted of 1,482 individuals aged 67 years or older, from Bordeaux, France, included in the Three-City Study in 2001–2002. Occurrences of hip, vertebral and wrist fractures were self-reported every 2 years over 8 years, and 155 incident fractures were recorded. Adherence to the MeDi was evaluated at baseline by a MeDi score, on a 10-point scale based on a food frequency questionnaire and a 24-h recall. Multivariate Cox regression tests were performed to estimate the risk of fractures according to MeDi adherence.

Results

Higher MeDi adherence was associated with a non-significant increased risk of fractures at any site (hazard ratio [HR] per 1-point increase of MeDi score = 1.10, P = 0.08) in fully adjusted model. Among MeDi components, higher fruits consumption (>2 servings/day) was significantly associated with an increased risk of hip fractures (HR = 1.95, P = 0.04), while low intake of dairy products was associated with a doubled risk of wrist fractures (HR = 2.03, P = 0.007). An inverse U-shaped association between alcohol intake and risk of total fracture was observed (HR high vs. moderate = 0.61, P for trend = 0.03).

Conclusions

Greater MeDi adherence was not associated with a decreased risk of fractures in French older persons. The widely recognized beneficial effects of the MeDi do not seem to apply to bone health in these people.

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Acknowledgments

The Three-City Study is conducted under a partnership agreement between the Institut National de la Santé et de la Recherche Médicale (INSERM), the Institut de Santé Publique et Développement of the Victor Segalen Bordeaux 2 University, and Sanofi-Aventis. The Fondation pour la Recherche Médicale funded the preparation and initiation of the study. The 3C Study is also supported by the Caisse Nationale Maladie des Travailleurs Salariés, Direction Générale de la Santé, Mutuelle Générale de l’Education Nationale, Institut de la Longévité, Regional Governments of Aquitaine and Bourgogne, Fondation de France, and Ministry of Research–INSERM Programme “Cohortes et collections de données biologiques.” This specific analysis within the Three-City Study was funded by a research agreement between the INSERM and Danone Research.

Conflicts of interest

Catherine Féart received fees for conferences from Danone Research. Cécilia Samieri and Simon Lorrain report no conflict of interest. Luc Letenneur receives research support from Danone Research. Vanessa Ginder Coupez and Damien Paineau are members of Danone Research. Pascale Barberger-Gateau served on a scientific advisory board for Caisse Nationale pour la Solidarite et l’Autonomie (CNSA); has received funding for travel and speaker honoraria from Lesieur, Bausch & Lomb, Aprifel, Danone Institute, Canadian Association of Gerontology, and the Jean Mayer Human Nutrition Research Center on Aging, Tufts University; serves on the editorial boards of Disability and Rehabilitation; has received consultancy fees from Vifor Pharma; and receives research support from Lesieur, Danone, Agence Nationale de la Recherche, Conseil Régional d’Aquitaine, Institut Carnot LISA and Groupe Lipides et Nutrition.

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Authors and Affiliations

  1. Univ. Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, 33000, Bordeaux, France

    C. Feart, S. Lorrain, C. Samieri, L. Letenneur & P. Barberger-Gateau

  2. INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, 33000, Bordeaux, France

    C. Feart, S. Lorrain, C. Samieri, L. Letenneur & P. Barberger-Gateau

  3. Danone Research, Centre Daniel Carasso, Global Nutrition Department, 91767, Palaiseau Cedex, France

    V. Ginder Coupez & D. Paineau

  4. Equipe Epidémiologie de la Nutrition et des Comportements Alimentaires, INSERM U897, Université Bordeaux Ségalen, ISPED Case 11, 146 rue Léo-Saignat, 33076, Bordeaux Cedex, France

    C. Feart

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  1. C. Feart
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  2. S. Lorrain
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Correspondence to C. Feart.

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Feart, C., Lorrain, S., Ginder Coupez, V. et al. Adherence to a Mediterranean diet and risk of fractures in French older persons. Osteoporos Int 24, 3031–3041 (2013). https://doi.org/10.1007/s00198-013-2421-7

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  • DOI: https://doi.org/10.1007/s00198-013-2421-7

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