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Vegetable and fruit intake and injurious falls risk in older women: a prospective cohort study

  • Marc Sim (a1) (a2), Lauren C. Blekkenhorst (a1) (a2), Joshua R. Lewis (a1) (a2) (a3), Catherine P. Bondonno (a1) (a2), Amanda Devine (a1), Kun Zhu (a4) (a5), Richard J. Woodman (a6), Richard L. Prince (a4) (a5) and Jonathan M. Hodgson (a1) (a2)...
Abstract

The role of vegetable and fruit intake in reducing falls risk in elderly populations is uncertain. This study examined the associations of vegetable and fruit intake with falls-related hospitalisations in a prospective cohort study of elderly women (n 1429, ≥70 years), including effects on muscular function, which represented a potential causal pathway. Muscular function, measured using grip strength and timed-up-and-go (TUG), and vegetable and fruit intake, quantified using a validated FFQ, were assessed at baseline (1998). Incident falls-related hospitalisation over 14·5-year follow-up was captured by the Hospital Morbidity Data Collection, linked via the Western Australian Data Linkage System. Falls-related hospitalisation occurred in 568 (39·7 %) of women. In multivariable-adjusted models, falls-related hospitalisations were lower in participants consuming more vegetables (hazard ratio (HR) per 75 g serve: 0·90 (95 % CI 0·82, 0·99)), but not fruit intake (per 150 g serve: 1·03 (95 % CI 0·93, 1·14)). Only total cruciferous vegetable intake was inversely associated with falls-related hospitalisation (HR: per 20 g serve: 0·90 (95 % CI 0·83, 0·97)). Higher total vegetable intake was associated with lower odds for poor grip strength (OR: 0·87 (95 % CI 0·77, 0·97)) and slow TUG (OR: 0·88 (95 % CI 0·78, 0·99)). Including grip strength and TUG in the multivariable-adjusted model attenuated the association between total vegetable intake and falls-related hospitalisations. In conclusion, elderly women with higher total and cruciferous vegetable intake had lower injurious falls risk, which may be explained in a large part by better physical function. Falls reduction may be considered an additional benefit of higher vegetable intake in older women.

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Corresponding author
*Corresponding author: M. Sim, email marc.sim@ecu.edu.au
References
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1. Masud, T & Morris, RO (2001) Epidemiology of falls. Age Ageing 30, 37.
2. Gale, CR, Cooper, C & Aihie Sayer, A (2016) Prevalence and risk factors for falls in older men and women: The English Longitudinal Study of Ageing. Age Ageing 45, 789794.
3. Johansson, J, Nordström, A & Nordström, P (2016) Greater fall risk in elderly women than in men is associated with increased gait variability during multitasking. J Am Med Dir Assoc 17, 535540.
4. Ambrose, AF, Paul, G & Hausdorff, JM (2013) Risk factors for falls among older adults: a review of the literature. Maturitas 75, 5161.
5. Deandrea, S, Lucenteforte, E, Bravi, F, et al. (2010) Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology 21, 658668.
6. Payette, H, Coulombe, C, Boutier, V, et al. (2000) Nutrition risk factors for institutionalization in a free-living functionally dependent elderly population. J Clin Epidemiol 53, 579587.
7. van Berleere, M & Dauchet, L (2017) Fruits, Vegetables and Health: Evidence from Meta-analyses of Prospective Epidemiological Studies, Vegetarian and Plant-based Diets in Health and Disease Prevention. New York: Elsevier Inc.
8. Kim, J, Lee, Y, Kye, S, et al. (2014) Association of vegetables and fruits consumption with sarcopenia in older adults: the Fourth Korea National Health and Nutrition Examination Survey. Age Ageing 44, 96102.
9. Semba, RD, Blaum, C, Guralnik, JM, et al. (2003) Carotenoid and vitamin E status are associated with indicators of sarcopenia among older women living in the community. Aging Clin Exp Red 15, 482487.
10. Robinson, SM, Jameson, KA, Batelaan, SF, et al. (2008) Diet and its relationship with grip strength in community‐dwelling older men and women: the Hertfordshire cohort study. J Am Geriatr Soc 56, 8490.
11. Neville, CE, Young, IS, Gilchrist, SECM, et al. (2013) Effect of increased fruit and vegetable consumption on physical function and muscle strength in older adults. Age 35, 24092422.
12. Myint, PK, Welch, AA, Bingham, SA, et al. (2007) Fruit and vegetable consumption and self-reported functional health in men and women in the European Prospective Investigation into Cancer–Norfolk (EPIC–Norfolk): a population-based cross-sectional study. Public Health Nutr 10, 3441.
13. Prince, RL, Devine, A, Dhaliwal, SS, et al. (2006) Effects of calcium supplementation on clinical fracture and bone structure: results of a 5-year, double-blind, placebo-controlled trial in elderly women. Arch Intern Med 166, 869875.
14. Bischoff-Ferrari, HA, Dawson-Hughes, B, Willett, WC, et al. (2004) Effect of vitamin D on falls: a meta-analysis. JAMA 291, 19992006.
15. Hodge, A, Patterson, AJ, Brown, WJ, et al. (2000) The anti Cancer Council of Victoria FFQ: relative validity of nutrient intakes compared with weighed food records in young to middle‐aged women in a study of iron supplementation. Aust N Z J Public Health 24, 576583.
16. Ireland, P, Jolley, D, Giles, G, et al. (1994) Development of the Melbourne FFQ: a food frequency questionnaire for use in an Australian prospective study involving an ethnically diverse cohort. Asia Pac J Clin Nutr 3, 1931.
17. Woods, RK, Stoney, RM, Ireland, PD, et al. (2002) A valid food frequency questionnaire for measuring dietary fish intake. Asia Pac J Clin Nutr 11, 5661.
18. Lewis, J, Milligan, G & Hunt, A (1995) Nuttab95 Nutrient Data Table for Use in Australia. Canberra: Australian Government Publishing Service.
19. National Health and Medical Research Council (2013) Australian Dietary Guidelines. Canberra: National Health and Medical Research Council.
20. Fulgoni, VL, Keast, DR & Drewnowski, A (2009) Development and validation of the nutrient-rich foods index: a tool to measure nutritional quality of foods. J Nutr 139, 15491554.
21. National Health and Medical Research Council (2006) Nutrient Reference Values for Australia and New Zealand. Canberra: National Health and Medical Research Council.
22. Blekkenhorst, LC, Bondonno, CP, Lewis, JR, et al. (2017) Association of dietary nitrate with atherosclerotic vascular disease mortality: a prospective cohort study of older adult women. Am J Clin Nutr 106, 207216.
23. Bruce, DG, Devine, A & Prince, RL (2002) Recreational physical activity levels in healthy older women: the importance of fear of falling. J Am Geriatr Soc 50, 8489.
24. Devine, A, Dhaliwal, SS, Dick, IM, et al. (2004) Physical activity and calcium consumption are important determinants of lower limb bone mass in older women. J Bone Miner Res 19, 16341639.
25. McArdle, WD, Katch, FI & Katch, VL (2010) Exercise Physiology: Nutrition, Energy, and Human Performance. Philadelphia, PA: Lippincott Williams & Wilkins.
26. Britt, H, Scahill, S & Miller, G (1997) ICPC PLUS© for community health? A feasibility study. Health Inf Manag J 27, 171175.
27. Australian Bureau of Statistics (1991) Socio-Economic Indexes for Areas. Canberra: Australian Bureau of Statistics.
28. Podsiadlo, D & Richardson, S (1991) The timed ‘Up & Go’: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39, 142148.
29. Duchowny, KA, Peterson, MD & Clarke, PJ (2017) Cut points for clinical muscle weakness among older Americans. Am J Prev Med 53, 6369.
30. Zhu, K, Devine, A, Lewis, JR, et al. (2011) Timed up and go test and bone mineral density measurement for fracture prediction. Arch Intern Med 171, 16551661.
31. Hodgson, JM, Prince, RL, Woodman, RJ, et al. (2016) Apple intake is inversely associated with all-cause and disease-specific mortality in elderly women. Br J Nutr 115, 860867.
32. Blekkenhorst, LC, Hodgson, JM, Lewis, JR, et al. (2017) Vegetable and fruit intake and fracture-related hospitalisations: a prospective study of older women. Nutrients 9, E511.
33. Deandrea, S, Bravi, F, Turati, F, et al. (2013) Risk factors for falls in older people in nursing homes and hospitals. A systematic review and meta-analysis. Arch Gerontol Geriatr 56, 407415.
34. Fried, LP, Tangen, CM, Walston, J, et al. (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56, M146M157.
35. Lauretani, F, Semba, RD, Bandinelli, S, et al. (2008) Low plasma carotenoids and skeletal muscle strength decline over 6 years. J Gerontol A Biol Sci Med Sci 63, 376383.
36. Rantanen, T, Guralnik, JM, Foley, D, et al. (1999) Midlife hand grip strength as a predictor of old age disability. JAMA 281, 558560.
37. Syddall, H, Cooper, C, Martin, F, et al. (2003) Is grip strength a useful single marker of frailty? Age Ageing 32, 650656.
38. Viccaro, LJ, Perera, S & Studenski, SA (2011) Is timed up and go better than gait speed in predicting health, function, and falls in older adults? J Am Geriatr Soc 59, 887892.
39. Perry, MC, Carville, SF, Smith, ICH, et al. (2007) Strength, power output and symmetry of leg muscles: effect of age and history of falling. Eur J Appl Physiol 100, 553561.
40. Houston, DK, Stevens, J, Cai, J, et al. (2005) Dairy, fruit, and vegetable intakes and functional limitations and disability in a biracial cohort: the Atherosclerosis Risk in Communities Study. Am J Clin Nutr 81, 515522.
41. Cesari, M, Pahor, M, Bartali, B, et al. (2004) Antioxidants and physical performance in elderly persons: the Invecchiare in Chianti (InCHIANTI) study. Am J Clin Nutr 79, 289294.
42. Bahadoran, Z, Tohidi, M, Nazeri, P, et al. (2012) Effect of broccoli sprouts on insulin resistance in type 2 diabetic patients: a randomized double-blind clinical trial. Int J Food Sci Nutr 63, 767771.
43. Lee, RH & Colon-Emeric, C (2014) Increased fracture risk among women with diabetes mellitus is mediated by increased falls propensity. J Am Geriatr Soc 62, S58.
44. Abdel-Aal, E-SM, Akhtar, H, Zaheer, K, et al. (2013) Dietary sources of lutein and zeaxanthin carotenoids and their role in eye health. Nutrients 5, 11691185.
45. Visser, M, Pahor, M, Taaffe, DR, et al. (2002) Relationship of interleukin-6 and tumor necrosis factor-α with muscle mass and muscle strength in elderly men and women: the Health ABC Study. J Gerontol A Biol Sci Med Sci 57, M326M332.
46. Schaap, LA, Pluijm, SMF, Deeg, DJH, et al. (2006) Inflammatory markers and loss of muscle mass (sarcopenia) and strength. Am J Med 119, 526.e9e17.
47. Shan, Y, Zhao, R, Geng, W, et al. (2010) Protective effect of sulforaphane on human vascular endothelial cells against lipopolysaccharide-induced inflammatory damage. Cardiovasc Toxicol 10, 139145.
48. Semba, RD, Lauretani, F & Ferrucci, L (2007) Carotenoids as protection against sarcopenia in older adults. Arch Biochem Biophys 458, 141145.
49. Arreola, R, Quintero-Fabián, S, López-Roa, RI, et al. (2015) Immunomodulation and anti-inflammatory effects of garlic compounds. J Immunol Res 2015, 401630.
50. Dawson-Hughes, B, Harris, SS & Ceglia, L (2008) Alkaline diets favor lean tissue mass in older adults. Am J Clin Nutr 87, 662665.
51. Australian Bureau of Statistics (2015) National Health Survey: First Results, 20142015. Canberra: Australian Bureau of Statistics.
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British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
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