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International Journal of Epidemiology 2000;29:85-92
© International Epidemiological Association 2000

Diet, smoking and anthropometric indices and postmenopausal bone fractures: a prospective study

Ikuko Katoa,b, Paolo Tonioloa, Anne Zeleniuch-Jacquottea, Roy E Shorea, Karen L Koeniga, Arslan Akhmedkhanova and Elio Ribolic

a Nelson Institute of Environmental Medicine and Kaplan Comprehensive Cancer Center, New York University School of Medicine, New York 10016, NY, USA.
b Current address: Feist-Weller Cancer Center, Section of Cancer Prevention and Control, LSU Health Science Center, Shreveport, LA 71130, USA.
c Unit of Nutrition and Cancer, International Agency for Research on Cancer, 150 Cours Albert Thomas F-69372, Lyon cedex 08 France.

Reprint requests to: Dr I Kato, Feist-Weller Cancer Center, Section of Cancer Prevention and Control, LSU Health Science Center, 1501 Kings Highway, PO Box 33932, Shreveport, LA 71130, USA.

Objective Bone fractures are an important cause of morbidity and mortality among the elderly in the US. The present study assesses the possible role of a number of risk factors for postmenopausal bone fractures.

Methods We analysed the relationships of anthropometric, demographic and lifestyle factors with the risk of bone fracture among 6250 postmenopausal women in a prospective cohort study, the New York University Women's Health Study.

Results After an average of 7.6 years of follow-up, 1025 new incident bone fractures were reported, including 34 hip and 159 wrist fractures (incidence rates; 71.6 and 334.7 per 105 woman-years, respectively). The risk of fracture increased with increasing age, body height and total fat intake, while it was significantly lower among obese and African American women. The relative risk among African Americans was 0.45 (95% CI : 0.32–0.63) compared with non-African Americans. Women taller than 170 cm had a 64% increase in risk of fractures, as compared with those under 155 cm. These associations were generally more pronounced when fractures were limited to those at the hip and wrist.

Conclusions The present study provides an indication for a potential role of dietary fat in the development of postmenopausal fractures and further evidence to support protective effects of obesity, short stature and African American ethnicity.

Keywords Obesity, height, diet, race, postmenopausal bone fracture, prospective study

Accepted 15 July 1999


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