Vegetable Diversity, Injurious Falls, and Fracture Risk in Older Women: A Prospective Cohort Study.

Marc Sim, Lauren C Blekkenhorst, Joshua R Lewis, Catherine P Bondonno, Amanda Devine, Kun Zhu, Richard J Woodman, Richard L Prince, Jonathan M Hodgson

Journal: Nutrients 2018;10(8):1081

PMID: 30104494

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Plain Language Summary

Vegetables contain a variety of nutrients and phytochemicals, with a range of health benefits. Previous research has linked higher vegetable consumption in older populations with a lower risk of falls. The importance of vegetable diversity (number of different vegetables consumed) for the risk of falling and fractures is unclear. The objective of this study was to examine the relationship between vegetable diversity with falls and fractures leading to hospitalisation in a prospective cohort of Australian women aged 70 years or over. Vegetable diversity was quantified by assessing the number of different vegetables consumed daily. Vegetable intake was estimated using a food frequency questionnaire at baseline in 1998. Over 14.5 years, injurious falls and fractures were captured using health records. Over 14.5 years of follow-up 39.7% of participants experienced an injurious fall. The percentage of women who experienced an injurious fall in the low (≤3/day), moderate (4/day) and high (≥5/day) vegetable diversity groups were 42.6%, 40.2%, and 36.6%, respectively. For each additional vegetable consumed, there was an 8% reduction in the risk of falls and a 9% reduction in the risk of fractures. The largest benefit of higher vegetable diversity were observed in the one third of women with the lowest vegetable intake (<2.2 servings/day). The authors concluded that increasing vegetable diversity, especially in older women with low vegetable intake, may be an effective way to reduce injurious fall and fracture risk.

Abstract

The importance of vegetable diversity for the risk of falling and fractures is unclear. Our objective was to examine the relationship between vegetable diversity with injurious falling and fractures leading to hospitalization in a prospective cohort of older Australian women ( = 1429, ≥70 years). Vegetable diversity was quantified by assessing the number of different vegetables consumed daily. Vegetable intake (75 g servings/day) was estimated using a validated food frequency questionnaire at baseline (1998). Over 14.5 years, injurious falls (events = 568, 39.7%), and fractures (events = 404, 28.3%) were captured using linked health records. In multivariable-adjusted Cox regression models, women with greater vegetable diversity (per increase in one different vegetable/day) had lower relative hazards for falls (8%; = 0.02) and fractures (9%; = 0.03). A significant interaction between daily vegetable diversity (number/day) and total vegetable intake (75 g servings/day) was observed for falls ( = 0.03) and fractures ( < 0.001). The largest benefit of higher vegetable diversity were observed in the one third of women with the lowest vegetable intake (<2.2 servings/day; falls HR 0.83 95% CI (0.71⁻0.98); fractures HR 0.74 95% CI (0.62⁻0.89)). Increasing vegetable diversity especially in older women with low vegetable intake may be an effective way to reduce injurious fall and fracture risk.

Address: School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia. [email protected].; Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, WA 6000, Australia. [email protected].; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia. [email protected].; Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, WA 6000, Australia. [email protected].; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia. [email protected].; Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, WA 6000, Australia. [email protected].; Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW 2145, Australia. [email protected].; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia. [email protected].; Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, WA 6000, Australia. [email protected].; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia. [email protected].; Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia. [email protected].; Medical School, Sir Charles Gairdner Unit, The University of Western Australia, Nedlands, WA 6009, Australia. [email protected].; Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, SA 5042, Australia. [email protected].; Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia. [email protected].; Medical School, Sir Charles Gairdner Unit, The University of Western Australia, Nedlands, WA 6009, Australia. [email protected].; School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia. [email protected].; Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, WA 6000, Australia. [email protected].

DOI: 10.3390/nu10081081

Patient Centred Factor

Antecedents: Vegetable diversity

Clinical Imbalances

Structural Integrity and Musculoskeletal

Modifiable Lifestyle Factors

Diet

Nutrition Evidence Keywords

Phytonutrients Menopause Falls Postmenopause Vegetable diversity Vegetable consumption

Bioactive Substances

None

Link outs

Free resources

Full Text Sources:

Medical:

https://medlineplus.gov/falls.html

Other Literature Sources:

https://scite.ai/reports/30104494

MeSH Terms: Accidental Falls, Age Factors, Aged, Diet, Healthy, Female, Fractures, Bone, Healthy Aging, Humans, Nutritional Status, Nutritive Value, Prospective Studies, Protective Factors, Risk Factors, Sex Factors, Vegetables, Western Australia