Diet and Hip Fracture Risk in the United Kingdom Women's Cohort
Condition: Hip Fracture (First Incidence of)
MeSH terms: Fractures, Bone; Hip Fractures
Study type: Observational

Summary: 
      Hip fracture is a common serious injury in older women that reduces quality of life and can
      lead to premature death. In the United Kingdom, hip fractures are estimated to account for
      1.5 million hospital bed days used per year due to long hospitalisation and rehabilitation
      periods post-surgery, costing the National Health Service over £1 billion per year. Diet can
      affect bone health and risk of hip fracture, with varying risks in women on specific diets,
      and specific foods and nutrients playing more important roles than others. Vegetarians may be
      at a greater risk of hip fracture than meat-eaters, and those who don't consume enough
      protein could be at a greater risk than those with adequate intakes. This research aims to
      investigate which dietary factors (and in what quantities) might predispose United Kingdom
      women to a greater risk of hip fracture, and which factors may be protective. The purpose of
      this study is to better understand the role of diet in reducing hip fracture risk in United
      Kingdom women. The research will use existing dietary and lifestyle data from the United
      Kingdom Women's Cohort Study and hospital records of hip fractures.
    

Detailed description: 
      Background: Hip fracture is an increasingly prevalent global health condition that increases
      morbidity and mortality. Previous observational studies have shown potential for risk
      reduction through diet modification, but associations between many dietary factors and hip
      fracture incidence are uncertain, and evidence in United Kingdom populations is limited.
      Therefore, this study aims to assess associations between diet and hip fracture incidence in
      the United Kingdom Women's Cohort.

      Research plan and methods: The investigators will utilise dietary and lifestyle data from the
      United Kingdom Women's Cohort which recruited 35,372 middle-aged women between 1995-1998.
      This data has been linked with Hospital Episode Statistics to provide hip fracture data of
      participants.

      Cox regression models will be applied to explore potential associations between dietary
      factors and hip fracture incidence. Dietary factors will be modelled both as categorical and
      continuous so that models can be fit comparing the risk of hip fracture between categories of
      intakes and per increment increase in exposure intake (linear dose-response). Cubic splines
      will be used to model non-linear associations for dietary intake of fruits, vegetables, tea,
      and coffee since previous research has suggested possible non-linear associations for these
      variables.
    

Intervention name(s): Dietary pattern; Fruit and vegetable intake; Meat intake; Fish intake; Egg intake; Dairy intake; Tea intake; Coffee intake; Tea and coffee intake; Protein intake; Calcium intake; Vitamin D intake
Intervention type(s): Other; Other; Other; Other; Other; Other; Other; Other; Other; Other; Other; Other
Intervention description(s): (regular meat-eater, occasional meat-eater, fish-eater, vegetarian, and vegan); Intake of fruits, vegetables, fruits and vegetables combined from food frequency questionnaire; Red meat, poultry, processed meat from food frequency questionnaire; Intake of fish from food frequency questionnaire; Intake of eggs from food frequency questionnaire; Intake of dairy products from food frequency questionnaire; Intake of tea (drink) from food frequency questionnaire; Intake of coffee (caffeinated or decaffeinated) from food frequency questionnaire; Combined intake of tea and coffee from food frequency questionnaire; Estimated intake of protein, derived from food frequency questionnaire; Estimated intake of calcium, derived from food frequency questionnaire; Estimated intake of vitamin D, derived from food frequency questionnaire and any recorded supplemental intake
Intervention MeSH terms: Vitamin D; Calcium
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        The UK Women's cohort profile is published here: [https://doi.org/10.1093/ije/dyv173].
      
Keywords: Nutrition; Fracture; Cohort study; Epidemiology; Osteoporosis