March 29, 2016
2 min read

Mediterranean diet slightly reduces hip fracture risk in postmenopausal women

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Healthy, postmenopausal women who adhere to a Mediterranean diet have a reduced risk for hip fracture, although the absolute risk reduction is small, according to an analysis of the Women’s Health Initiative.

Bernhard Haring, MD, MPH, of the department of internal medicine at the University of Wurzburg, Germany, and colleagues analyzed data from 90,014 women enrolled in the Women’s Health Initiative, an observational study of postmenopausal women aged 50 to 79 years (mean age, 64 years; median follow-up time 15.9 years). Participants completed a food frequency questionnaire at baseline; food items were transformed into standardized quantities and assessed by scores on the alternate Mediterranean diet (aMED), the Healthy Eating Index 2010 (HEI-2010), a 100-point measure of food components, the 11-item Alternate Healthy Eating Index 2010 (AHEI-2010) or the eight-component Dietary Approaches to Stop Hypertension (DASH) diet score. Researchers used Cox proportional hazards regression analyses to estimate HRs by quintiles of dietary scores; primary outcome measures included incident total and hip fractures. All fractures except hip fractures were self-reported. A subset of participants underwent DXA scanning to measure bone mineral density (n = 11,020).

Within the cohort, 2,121 women experienced hip fractures; there were 28,718 total fracture cases during follow-up. Researchers found that women scoring in the highest quintile (Q5) of the aMED index had a lower risk for hip fractures (HR = 0.8; 95% CI, 0.66-0.97), with an absolute risk reduction of 0.29% and a number needed to treat of 342 (95% CI, 249-502) after adjusting for age, race, BMI, smoking status, physical activity and other factors.

Researchers did not find an association between aMED score and total fractures. Higher HEI-2010 or DASH scores tended to be inversely related to hip fracture risk, but the results were not significant. AHEI-2010 score was associated with neither hip nor total fractures. Results did not change when researchers accounted for fall history.

“Unfortunately, the United States as well as other health care systems largely ignore nutrition and lifestyle measures in favor of pharmacology, although organizations such as the American Heart Association or the 2015 US Dietary Guidelines provide detailed suggestions and advice,” Haring told Endocrine Today. “Increasing adherence to current recommendations and guidelines would have great public health effects, as it reduces health care costs on the one hand while improving the individual and overall well-being.” – by Regina Schaffer

For more information:

Bernhard Haring, MD, MPH, can be reached at the department of medicine, University of Würzburg, Sanderring 2, 97070 Würzburg, Germany; email:

Disclosure: The researchers report no relevant financial disclosures.