A recent study published in Frontiers in Aging has highlighted the significant role that diet and exercise play in reducing the risk of fractures and cardiovascular mortality in older adults. The research, conducted by the University of Southampton, UK, examined the associations between lifestyle factors, such as nutrition and physical activity, and the incidence of fractures and heart-related deaths.
Osteoporosis, a condition marked by reduced bone density and fragility, increases the likelihood of fractures, particularly in the spine, wrist, and hip. These fractures represent a major public health concern, especially as the global population ages. The risk of fractures in men, despite a lifetime risk of up to 25%, remains less discussed, and bone health awareness is often lower in this demographic. The study aimed to explore how lifestyle factors, particularly in middle age, might influence bone health later in life and encourage greater engagement with bone health messaging.
Study Overview
The study tracked participants for 20 years, using NHS hospital records to gather long-term data on how midlife habits affect late-life bone health outcomes. Researchers focused on the Hertfordshire Cohort Study, which involved individuals born between 1931 and 1939, and living in Hertfordshire between 1998 and 2004. These participants underwent health assessments and home interviews, providing valuable data on smoking, diabetes, hypertension, physical activity, and dietary habits.
A food frequency questionnaire (FFQ) was used to assess participants’ diets, classifying foods into 51 groups based on their nutrient composition. A “prudent diet” was defined as one rich in vegetables, fruits, oily fish, and whole-grain cereals, and low in processed foods like chips, white bread, full-fat dairy, and sugar. The study evaluated how adherence to this dietary pattern, alongside factors such as physical activity, smoking, and hypertension, influenced the risk of fractures and cardiovascular death.
Key Findings
The study, which included 1,579 men and 1,418 women with an average age of 65-66, found that participants with higher prudent diet scores had better physical activity levels and lower risks of fractures and heart disease. Specifically, those with the highest diet scores were 6% more likely to engage in physical activity than those with poorer diets, establishing a clear link between nutrition and mobility in older age.
Over the follow-up period, from 1998 to 2018, the study found that 22% of women and 9% of men experienced any fracture, 5% of women and 2% of men suffered hip fractures, and 5% of women and 11% of men died from cardiovascular disease. While there was borderline evidence suggesting that a higher diet quality reduced the risk of hip fractures (p = 0.052), dietary calcium intake did not show a strong association with fracture risk. However, higher dietary calcium intake was found to protect against cardiovascular mortality.
Interestingly, calcium supplements were not linked to increased cardiovascular risk—an important reassurance, given past concerns—but their use did correlate with a higher fracture risk. This finding likely reflects reverse causality, where supplements are prescribed after a fracture occurs. The study found that comorbidities and other lifestyle factors, such as low physical activity and smoking, increased the risk of both fractures and cardiovascular deaths.
Implications and Conclusions
The study suggests that adopting a prudent diet, characterized by healthier food choices, is modestly protective against both cardiovascular mortality and hip fractures over a 20-year period. Moreover, higher diet quality was associated with healthier behaviors like never smoking and higher physical activity, both of which are beneficial for bone health and cardiovascular outcomes.
These findings offer valuable insights for public health strategies, particularly in targeting men, by framing the promotion of bone health within the context of reducing heart disease risk—a concern that is often more familiar and motivating for this demographic.
However, the study’s limitations include its focus on a predominantly Caucasian cohort, which may affect the applicability of the results to other populations. Additionally, the reliance on self-reported dietary data rather than blood biomarkers could limit the accuracy of the nutritional assessments.
Overall, this research underscores the importance of maintaining a healthy diet and staying physically active as we age, offering a path toward reducing the risks of fractures and heart disease in later life.
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