Dietary patterns and hip fracture in the Adventist Health Study 2: Combined vitamin D and calcium supplementation reduces the increased risk of hip fracture in vegans.

PMID: 33964850 DOI: 10.1093/ajcn/nqab095

Commentary

The purpose of this study was to investigate the effect of five dietary patterns on the risk of hip fracture and whether this association is modified by concurrent calcium and vitamin D supplementation.

Proportional hazards regression analysis was used to estimate fracture risk in a prospective cohort study in which participants were enrolled between 2002 and 2007.

Participants were a total of 34,542 non-Hispanic white peri- and postmenopausal women and men aged 45 years and older residing throughout the United States and Canada who completed a biennial hospital history form and were followed for four years.

Results confirmed that 679 hip fractures occurred during the follow-up period in 249,186 individuals. Fracture risk varied with dietary patterns, and the effects of simultaneous supplementation with both vitamin D and calcium were clearly variable.

In a multivariate model that included adjustment for calcium and vitamin D supplementation, female vegans were shown to have a 55% higher risk of hip fracture than non-vegetarians (NVEG), but there was no association between dietary patterns in men.

When women were further stratified for the use of these supplements, vegans who took both supplements were shown to have no higher risk of hip fracture than subjects with other dietary patterns, including NVEG.