Mediterranean Diet and Hip Fracture in Swedish Men and Women.

A Mediterranean diet, known to have beneficial effects on cardiovascular health, may also influence the risk of hip fracture although previous studies present discrepant results. We therefore aimed to determine whether the rate of hip fracture was associated with degree of adherence to a Mediterranean diet. We combined two Swedish cohort studies consisting of 37,903 men and 33,403 women (total n = 71,333, mean age 60 years) free of previous cardiovascular disease and cancer who answered a medical and a food-frequency questionnaire in 1997. A modified Mediterranean diet score (mMED; range 0-8 points) was created based on high consumption of fruits and vegetables, legumes and nuts, whole grains, fermented dairy products, fish, and olive/rapeseed oil, moderate intake of alcohol, and low intake of red and processed meat. Incident hip fractures between 1 January 1998 and 31 December 2012 were retrieved from the National Patient Register. Hazard ratios (HR) and 95% confidence intervals (CI) adjusted for potential confounders were calculated using Cox proportional hazards regression. Differences in age at hip fracture were calculated using multivariable Laplace regression. During follow-up, 3,175 hip fractures occurred at a median age of 73.3 years. One unit increase in the mMED was associated with 6% lower hip fracture rate (adjusted HR = 0.94; 95% CI 0.92-0.96) and with a three months higher median age at hip fracture (50(th) percentile difference = 2.8 months; 95% CI 1.4-4.2). Comparing the highest quintile of adherence to the mMED (6-8 points) with the lowest (0-2 points) conferred an adjusted HR of hip fracture of 0.78 (95% CI 0.69-0.89) and a 12 months higher median age of hip fracture (50(th) percentile difference = 11.6 months; 95% CI 4.2-19.0). Results were similar in men and women. We conclude that higher adherence to a Mediterranean-like diet is associated with lower risk of future hip fracture. This article is protected by copyright. All rights reserved.