Dietary Habits and Osteoporotic Fracture Risk: Retrospective Cohort Study Using Large-Scale Claims Data

Abstract Context Lifestyle habits, such as exercise, alcohol consumption, and smoking, are known to be closely associated with the risk of osteoporotic fracture. However, little is known regarding the association between osteoporotic fracture and dietary habits such as skipping breakfast and having a late dinner. Objective This study aimed to examine the association between lifestyle habits, including diet, and the risk of osteoporotic fracture. Methods Individuals aged 20 years or older were enrolled using the results of lifestyle questionnaires in health checkup data and the DeSC database, a Japanese claims database. Outcome was defined as the diagnosis of osteoporotic fracture (hip, distal forearm, vertebral, and humeral fractures). A Cox proportional-hazards model was used to calculate the association between osteoporotic fracture risk and lifestyle, adjusting for conventional risk factors. In the lifestyle questionnaires, those who answered “yes” to each question were compared to those who answered “no.” Results Altogether, 927 130 participants were included, with a median follow-up duration of 2.6 years. The adjusted hazard ratios (95% CI) for lifestyle factors of smoking, daily alcohol consumption, exercise habits, fast gait speed, enough sleep, skipping breakfast, and late dinner were 1.11 (1.06-1.17), 0.91 (0.88-0.95), 0.99 (0.97-1.02), 0.84 (0.82-0.86), 0.95 (0.93-0.98), 1.18 (1.12-1.23), and 1.08 (1.04-1.12), respectively. Conclusion Our study is the first to demonstrate that skipping breakfast and having a late dinner are independently associated with a higher risk of osteoporotic fracture, using a large health checkup cohort.