BACKGROUND Although a number of studies showed a lower risk of hip fractures with high-quality diets, few of them were conducted in the United States. OBJECTIVE This prospective analysis examined the association between several diet quality indexes and risk of hip fractures in US men and women. DESIGN This is a prospective cohort study. PARTICIPANTS/SETTING The participants were 74,446 postmenopausal women from the Nurses' Health Study and 36,602 men aged 50 years and older from the Health Professionals Follow-Up Study in the United States. MAIN OUTCOME MEASURE Hip fractures were self-reported on biennial questionnaires between 1980-2012 in women, and between 1986-2012 in men. STATISTICAL ANALYSIS Diet was assessed every 4 years with a validated food frequency questionnaire. Relative risks were computed for hip fracture by quintiles of the Alternate Mediterranean Diet score (aMed), the Alternate Healthy Eating Index-2010 (AHEI-2010), and the Dietary Approaches to Stop Hypertension score using Cox proportional hazards models, adjusting for potential confounders. RESULTS Two thousand one hundred forty-three incident hip fractures in women and 603 in men were reported during follow-up. A significant inverse trend was observed with the cumulative AHEI-2010 score in women (relative risk comparing extreme quintiles 0.87, 95% CI 0.75 to 1.00; P for trend=0.02). There was also a suggestion of an inverse association with the Dietary Approaches to Stop Hypertension score (P for trend=0.03). In addition, significant inverse trends were observed between all three diet quality scores and hip fractures in women younger than age 75 years but not older women. There was no clear association between diet quality indexes and hip fracture in men. CONCLUSIONS Higher AHEI-2010 scores were associated with a lower risk of hip fractures in US women. The inverse associations with diet quality may be more apparent among those younger than age 75 years.

中文翻译：

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绝经后女性和 50 岁及以上男性的饮食质量评分与髋部骨折风险之间的关联

背景尽管许多研究表明，高质量饮食可降低髋部骨折的风险，但在美国进行的研究很少。目的 本前瞻性分析检验了美国男性和女性的几种饮食质量指标与髋部骨折风险之间的关联。设计 这是一项前瞻性队列研究。参与者/环境 参与者是来自护士健康研究的 74,446 名绝经后女性和来自美国卫生专业人员随访研究的 36,602 名 50 岁及以上的男性。主要结果测量 髋部骨折是在 1980-2012 年女性和 1986-2012 年男性两年期问卷中自我报告的。统计分析 每 4 年使用经过验证的食物频率问卷对饮食进行评估。通过替代地中海饮食评分 (aMed)、替代健康饮食指数 - 2010 (AHEI-2010) 和使用 Cox 比例风险模型的饮食停止高血压评分的五分位数计算髋部骨折的相对风险，调整潜在的混杂因素. 结果 随访期间报告了 2143 例女性髋部骨折和 603 例男性髋部骨折。观察到女性的累积 AHEI-2010 得分呈显着的反向趋势（比较极端五分位数的相对风险为 0.87，95% CI 为 0.75 至 1.00；趋势 P=0.02）。也有人建议与饮食方法停止高血压评分呈负相关（趋势 P = 0.03）。此外，在年龄小于 75 岁的女性中，所有三个饮食质量评分和髋部骨折之间都观察到了显着的反向趋势，但没有观察到老年女性。男性的饮食质量指数与髋部骨折之间没有明确的关联。结论 较高的 AHEI-2010 评分与美国女性髋部骨折风险较低相关。与饮食质量的负相关在 75 岁以下的人群中可能更为明显。