American Journal of Epidemiology Advance Access originally published online on November 23, 2005
American Journal of Epidemiology 2006 163(1):9-17; doi:10.1093/aje/kwj005
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Original Contribution |
Antioxidant Intake and Risk of Osteoporotic Hip Fracture in Utah: An Effect Modified by Smoking Status
1 Department of Nutrition and Food Sciences, Utah State University, Logan, UT
2 Center for Epidemiologic Studies, Utah State University, Logan, UT
3 Department of Mathematics and Statistics, Utah State University, Logan, UT
4 Current affiliation: Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR
Reprint requests to Dr. Ronald G. Munger, Center for Epidemiologic Studies, UMC 4450, Utah State University, Logan, UT 84322-4450 (e-mail: rmunger{at}cc.usu.edu).
The role of antioxidant intake in osteoporotic hip fracture risk is uncertain and may be modified by smoking. In the Utah Study of Nutrition and Bone Health, a statewide, population-based case-control study, the authors investigated whether antioxidant intake was associated with risk of osteoporotic hip fracture and whether this association was modified by smoking status. The analyses included data on 1,215 male and female cases aged 
50 years who incurred a hip fracture during 1997–2001 and 1,349 age- and sex-matched controls. Diet was assessed by food frequency questionnaire. Among ever smokers, participants in the highest quintile of vitamin E intake (vs. the lowest) had a lower risk of hip fracture after adjustment for confounders (odds ratio = 0.29, 95% confidence interval (CI): 0.16, 0.52; p-trend < 0.0001). The corresponding odds ratio for ß-carotene intake was 0.39 (95% CI: 0.23, 0.68; p-trend = 0.0004), and for selenium intake it was 0.27 (95% CI: 0.12, 0.58; p-trend = 0.0003). Vitamin C intake did not have a significant graded association with hip fracture risk among ever smokers. Similar findings were obtained when an overall antioxidant intake score was used (odds ratio = 0.19, 95% CI: 0.10, 0.37; p-trend < 0.0001). No similar associations were found in never smokers. Antioxidant intake was associated with reduced risk of osteoporotic hip fracture in these elderly subjects, and the effect was strongly modified by smoking status.
aged; antioxidants; diet; dietary supplements; hip fractures; nutrition; osteoporosis; smoking
Abbreviations: CI, confidence interval; FFQ, food frequency questionnaire; MMSE, Mini-Mental State Examination
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