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Open AccessArticle

Vegetable Diversity, Injurious Falls, and Fracture Risk in Older Women: A Prospective Cohort Study

1
School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia
2
Medical School, Royal Perth Hospital Unit, The University of Western Australia, Perth, WA 6000, Australia
3
Centre for Kidney Research, Children’s Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW 2145, Australia
4
Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia
5
Medical School, Sir Charles Gairdner Unit, The University of Western Australia, Nedlands, WA 6009, Australia
6
Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, SA 5042, Australia
*
Author to whom correspondence should be addressed.
Nutrients 2018, 10(8), 1081; https://doi.org/10.3390/nu10081081
Received: 23 July 2018 / Revised: 3 August 2018 / Accepted: 8 August 2018 / Published: 13 August 2018
(This article belongs to the Special Issue Dietary Intake and Musculoskeletal Health)
The importance of vegetable diversity for the risk of falling and fractures is unclear. Our objective was to examine the relationship between vegetable diversity with injurious falling and fractures leading to hospitalization in a prospective cohort of older Australian women (n = 1429, ≥70 years). Vegetable diversity was quantified by assessing the number of different vegetables consumed daily. Vegetable intake (75 g servings/day) was estimated using a validated food frequency questionnaire at baseline (1998). Over 14.5 years, injurious falls (events = 568, 39.7%), and fractures (events = 404, 28.3%) were captured using linked health records. In multivariable-adjusted Cox regression models, women with greater vegetable diversity (per increase in one different vegetable/day) had lower relative hazards for falls (8%; p = 0.02) and fractures (9%; p = 0.03). A significant interaction between daily vegetable diversity (number/day) and total vegetable intake (75 g servings/day) was observed for falls (pinteraction = 0.03) and fractures (pinteraction < 0.001). The largest benefit of higher vegetable diversity were observed in the one third of women with the lowest vegetable intake (<2.2 servings/day; falls HR 0.83 95% CI (0.71–0.98); fractures HR 0.74 95% CI (0.62–0.89)). Increasing vegetable diversity especially in older women with low vegetable intake may be an effective way to reduce injurious fall and fracture risk. View Full-Text
Keywords: nutrition; epidemiology; ageing; musculoskeletal health; geriatrics; injury nutrition; epidemiology; ageing; musculoskeletal health; geriatrics; injury
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Sim, M.; Blekkenhorst, L.C.; Lewis, J.R.; Bondonno, C.P.; Devine, A.; Zhu, K.; Woodman, R.J.; Prince, R.L.; Hodgson, J.M. Vegetable Diversity, Injurious Falls, and Fracture Risk in Older Women: A Prospective Cohort Study. Nutrients 2018, 10, 1081.

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