Limited Benefit of Fish Consumption on Risk of Hip Fracture among Men in the Community-Based Hordaland Health Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Subjects
2.2. Dietary Assessment
2.3. Hip Fractures
2.4. Covariate Assessment
2.5. Ethics
2.6. Statistical Analyses
3. Results
3.1. Baseline Characteristics and Dietary Intake
3.2. Fish Consumption and the Risk of Hip Fractures
4. Discussion
4.1. Comparison with Other Studies
4.2. Fish and Hip Fracture
4.3. Strength and Limitations
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Women | p for Trend | Men | p for Trend | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Total Fish, g/1000 kcal (min–max) | Total 1–263 | 1st Quartile (n = 387) 1–28 | 2nd Quartile (n = 387) 28–41 | 3rd Quartile (n = 388) 41–57 | 4th Quartile (n = 387) 57–263 | Total 3–186 | 1st Quartile (n = 329) 3–33 | 2nd Quartile (n = 329) 33–48 | 3rd Quartile (n = 329) 48–65 | 4th Quartile (n = 329) 65–186 | ||
Hip fracture incidence, (%) | 9.9 | 11.6 | 10.1 | 9.8 | 8.3 | 0.128 | 5.5 | 7.9 | 3.6 | 5.2 | 5.2 | 0.234 |
Femoral neck BMD, g/cm2 | 0.763 (0.113) | 0.746 (0.108) | 0.769 (0.121) | 0.766 (0.116) | 0.772 (0.106) | 0.016 | 0.901 (0.140) | 0.895 (0.127) | 0.892 (0.133) | 0.913 (0.146) | 0.907 (0.152) | 0.157 |
BMI, kg/m2 | 26.2 (4.4) | 25.8 (4.3) | 26.1 (4.4) | 26.6 (4.3) | 26.3 (4.5) | 0.028 | 26.0 (3.2) | 25.8 (3.3) | 25.7 (3.0) | 25.9 (3.1) | 26.5 (3.3) | 0.008 |
Weight, kg | 67.7 (11.8) | 66.5 (11.6) | 67.8 (11.5) | 68.5 (11.6) | 68.1 (12.4) | 0.036 | 79.5 (11.1) | 78.8 (11.2) | 78.7 (10.7) | 79.1 (10.7) | 81.5 (11.6) | 0.002 |
Hard physical activity, % | ||||||||||||
≤1 h/week | 79.7 | 81.6 | 78.1 | 77.0 | 82.3 | 0.900 | 63.9 | 67.4 | 62.8 | 62.9 | 62.3 | 0.209 |
>1 h/week | 20.3 | 18.4 | 21.9 | 23.0 | 17.7 | 0.900 | 36.1 | 32.6 | 37.2 | 37.1 | 37.7 | 0.209 |
Smoking habits, % | ||||||||||||
Current smoker | 15.2 | 19.9 | 11.4 | 12.6 | 16.8 | 0.322 | 19.5 | 21.0 | 20.1 | 18.2 | 18.5 | 0.351 |
Former smoker | 25.0 | 23.8 | 22.3 | 24.7 | 29.2 | 0.057 | 60.1 | 62.3 | 56.8 | 62.3 | 59.0 | 0.706 |
Never smoked | 61.2 | 57.6 | 67.9 | 62.6 | 56.8 | 0.496 | 24.0 | 20.4 | 25.8 | 24.0 | 25.8 | 0.166 |
Cotinine ≥85 nmol/L, % | 15.3 | 20.1 | 11.5 | 12.7 | 17.0 | 0.316 | 19.4 | 20.8 | 20.2 | 17.7 | 18.9 | 0.400 |
Alcohol categories, % 1 | ||||||||||||
None | 55.5 | 64.1 | 55.3 | 53.1 | 49.4 | <0.001 | 32.6 | 35.6 | 31.9 | 30.1 | 32.8 | 0.386 |
Low | 39.8 | 32.6 | 39.0 | 43.0 | 44.7 | <0.001 | 59.8 | 58.7 | 60.8 | 61.4 | 58.4 | 0.980 |
Moderate | 4.1 | 2.8 | 5.2 | 3.6 | 4.9 | 0.305 | 3.7 | 2.4 | 3.6 | 3.6 | 5.2 | 0.079 |
High | 0.6 | 0.5 | 0.5 | 0.3 | 1.0 | 0.455 | 3.9 | 3.3 | 3.6 | 4.9 | 3.6 | 0.655 |
Estrogen therapy (for women), % | 14.8 | 13.4 | 14.0 | 16.8 | 15.2 | 0.309 | NA | NA | NA | NA | NA | NA |
Women | p for Trend | Men | p for Trend | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Total fish, g/1000 kcal (min–max) | Total 1–263 | 1st Quartile (n = 387) 1–28 | 2nd Quartile (n = 387) 28–41 | 3rd Quartile (n = 388) 41–57 | 4th Quartile (n = 387) 57–263 | Total 3–186 | 1st Quartile (n = 329) 3–33 | 2nd Quartile (n = 329) 33–48 | 3rd Quartile (n = 329) 48–65 | 4th Quartile (n = 329) 65–186 | ||
Total energy, kcal | 1605 (491) | 1557 (495) | 1602 (475) | 1646 (492) | 1616 (499) | 0.050 | 2059 (594) | 2035 (599) | 2135 (603) | 2078 (553) | 1988 (611) | 0.180 |
Protein, E% | 15.6 (2.9) | 14.8 (2.1) | 15.9 (2.0) | 16.5 (2.1) | 18.4 (2.4) | <0.001 | 15.5 (1.9) | 14.5 (2.0) | 15.6 (1.8) | 16.3 (1.9) | 18.0 (2.2) | <0.001 |
n-3 long chained PUFA, E% | 0.1 (0.1) | 0.1 (0.1) | 0.1 (0.1) | 0.1 (0.1) | 0.2 (0.1) | <0.001 | 0.1 (0.1) | 0. 1 (0.1) | 0.1 (0.1) | 0.1 (0.1) | 0.2 (0.1) | <0.001 |
Vitamin D, g/1000 kcal 1 | 5.1 (4.3) | 4.1 (4.2) | 4.7 (4.0) | 5.1 (4.1) | 6.5 (4.4) | <0.001 | 5.6 (4.1) | 3.9 (3.1) | 5.3 (3.9) | 6.1 (4.0) | 7.2 (4.7) | <0.001 |
Calcium, g/1000 kcal 1 | 450 (138) | 467 (151) | 454 (132) | 447 (134) | 434 (131) | 0.001 | 377 (124) | 397 (144) | 383 (124) | 360 (107) | 358 (116) | <0.001 |
Supplements, % | ||||||||||||
Fish oil | 7.0 | 3.9 | 6.7 | 5.9 | 11.4 | <0.001 | 5.6 | 3.6 | 4.9 | 6.7 | 7.3 | 0.026 |
Cod liver oil | 32.8 | 31.8 | 30.5 | 34.4 | 34.6 | 0.245 | 38.8 | 28.3 | 42.2 | 46.8 | 38.0 | 0.005 |
Vitamin D | 2.6 | 2.8 | 2.3 | 2.6 | 2.6 | 0.885 | 1.8 | 0.9 | 3.0 | 0.9 | 2.4 | 0.462 |
Calcium | 14.5 | 10.3 | 16.3 | 16.2 | 15.2 | 0.067 | 2.3 | 2.1 | 1.8 | 2.4 | 2.7 | 0.509 |
Food intake, g/1000 kcal | ||||||||||||
Total fish | 45 (25) | 18 (6) | 34 (4) | 48 (5) | 78 (22) | <0.001 | 51 (25) | 23 (7) | 41 (4) | 55 (5) | 85 (20) | <0.001 |
Lean fish | 20 (17) | 7 (5) | 14 (7) | 21 (9) | 38 (22) | <0.001 | 23 (17) | 9 (7) | 17 (8) | 25 (11) | 41 (20) | <0.001 |
Fatty fish | 13 (13) | 5 (5) | 9 (7) | 13 (9) | 23 (18) | <0.001 | 15 (13) | 6 (6) | 12 (8) | 16 (10) | 26 (17) | <0.001 |
Processed fish | 12 (8) | 6 (4) | 11 (7) | 14 (8) | 17 (10) | <0.001 | 13 (9) | 8 (6) | 12 (6) | 15 (8) | 19 (11) | <0.001 |
Vegetables | 115 (73) | 94 (72) | 114 (70) | 117 (66) | 135 (79) | <0.001 | 90 (60) | 78 (59) | 87 (57) | 90 (52) | 106 (69) | <0.001 |
Fruit and berries | 151 (101) | 138 (104) | 158 (104) | 152 (90) | 157 (104) | 0.032 | 114 (74) | 109 (79) | 118 (77) | 116 (66) | 113 (74) | 0.542 |
Meat | 40 (20) | 34 (18) | 41 (20) | 42 (20) | 42 (20) | <0.001 | 45 (21) | 41 (21) | 47 (20) | 48 (20) | 46 (21) | 0.002 |
Dairy | 193 (119) | 217 (132) | 201 (122) | 187 (112) | 166 (103) | <0.001 | 161 (106) | 173 (118) | 170 (106) | 158 (97) | 145 (102) | <0.001 |
Egg | 10 (8) | 9 (8) | 10 (8) | 9 (7) | 10 (8) | 0.520 | 9 (7) | 8 (8) | 10 (7) | 9 (6) | 9 (6) | 0.742 |
Model 1 | Model 2 | Model 3 | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Total Fish Intake g/1000 kcal | n Hip Fracture/n Total | HR | 95% CI | p for Trend | HR | 95% CI | p for Trend | HR | 95% CI | p for Trend | ||
Men | Q1 | 23 (3–33) | 26/329 | 1.56 | (0.84, 2.87) | 0.093 | 1.51 | (0.82, 2.79) | 0.091 | 1.75 | (0.88, 3.47) | 0.124 |
Q2 | 41 (33–48) | 12/329 | 0.68 | (0.33, 1.43) | 0.66 | (0.31, 1.38) | 0.79 | (0.35, 1.78) | ||||
Q3 | 55 (48–65) | 17/329 | 0.94 | (0.48, 1.83) | 0.91 | (0.46, 1.79) | 1.06 | (0.50, 2.24) | ||||
Q4 | 85 (65–186) | 17/329 | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) | |||||||
Women | Q1 | 18 (1–28) | 45/387 | 1.39 | (0.87, 2.19 | 0.554 | 1.34 | (0.85, 2.21) | 0.649 | 1.47 | (0.88, 2.44) | 0.499 |
Q2 | 34 (28–41) | 39/387 | 1.23 | (0.77, 1.96) | 1.22 | (0.76, 1.94) | 1.37 | (0.82, 2.30) | ||||
Q3 | 48 (41–57) | 38/388 | 1.18 | (0.74, 1.89) | 1.20 | (0.75, 1.92) | 1.32 | (0.76, 2.21) | ||||
Q4 | 78 (57–263) | 32/387 | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) |
Model 1 | Model 2 | Model 3 | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Total Fish Intake g/1000 kcal | HR | 95% CI | p | HR | 95% CI | p | HR | 95% CI | p | ||
Total cohort | Q1 | 21 (0.9–33) | 1.40 | (1.06, 1.85) | 0.020 | 1.39 | (1.05, 1.84) | 0.022 | 1.36 | (1.00, 1.85) | 0.048 |
Q2-Q4 | 57 (28–263) | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) | |||||||
Men | Q1 | 23 (3–33) | 1.78 | (1.10, 2.88) | 0.018 | 1.77 | (1.10, 2.87) | 0.019 | 1.84 | (1.10, 3.08) | 0.021 |
Q2-Q4 | 60 (33–186) | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) | |||||||
Women | Q1 | 18 (1–28) | 1.23 | (0.87, 1.74) | 0.250 | 1.18 | (0.83, 1.67) | 0.350 | 1.20 | (0.82, 1.75) | 0.359 |
Q2-Q4 | 53 (28–263) | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) |
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Rosendahl-Riise, H.; Sulo, G.; Karlsson, T.; Drevon, C.A.; Dierkes, J.; Tell, G.S. Limited Benefit of Fish Consumption on Risk of Hip Fracture among Men in the Community-Based Hordaland Health Study. Nutrients 2018, 10, 873. https://doi.org/10.3390/nu10070873
Rosendahl-Riise H, Sulo G, Karlsson T, Drevon CA, Dierkes J, Tell GS. Limited Benefit of Fish Consumption on Risk of Hip Fracture among Men in the Community-Based Hordaland Health Study. Nutrients. 2018; 10(7):873. https://doi.org/10.3390/nu10070873
Chicago/Turabian StyleRosendahl-Riise, Hanne, Gerhard Sulo, Therese Karlsson, Christian A. Drevon, Jutta Dierkes, and Grethe S. Tell. 2018. "Limited Benefit of Fish Consumption on Risk of Hip Fracture among Men in the Community-Based Hordaland Health Study" Nutrients 10, no. 7: 873. https://doi.org/10.3390/nu10070873