Decreased Smoking, Drinking Associated with Reduced Hip Fractures

In a new study, researchers have found that there is an association between reduced incidence of hip fractures and decreases in smoking and heavy drinking. These findings were shared in a study detailing the data from 40-year long Framingham Heart Study, in JAMA Internal Medicine.

Hip fractures are a serious public health issue. These fractures can limit your movement, reduce your independence, and even increase morbidity and mortality rates.

Along with being a financial burden, fractures can be a huge threat to heart and brain health as it increases the risk of blood clots after being immobile for long periods. Nearly 50 percent of the people who have a hip fracture are not able to regain the ability to live independently.

According to estimates, 1 in 3 women and 1 in 12 men will sustain a hip fracture in their lifetime. Also, 86% of hip fractures occur in individuals aged 65 years and older, according to Centers for Disease Control and Prevention.

Source: American Bone Health

However, these hip fracture rates in the United States have been declining over the past few decades. Experts have previously believed that this has been primarily due to improved treatments for bone health.

But it may be just one of the factors at play here according to the new National Institutes of Health funded study. The results from this new study indicate that modifiable lifestyle factors may be beneficial to bone health as well.

A team from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), led by Dr. Timothy Bhattacharyya, wanted to see why the hip fractures rate are declining in a long-term study cohort. This cohort was for the Framingham Heart Study launched in 1948 to determine factors that contribute to cardiovascular disease.

Source: Kindly Care

Though many of the original participants have passed away, the study continues to examine another two generations of residents in and near Framingham, Massachusetts.

The NIAMS team took data of 4,918 men and 5,634 women who participated in the Framingham Study. All the subjects under study were followed for a first hip fracture, for 40 years, between 1970 and 2010.

The study saw that the rate of hip fractures, after taking age out of the equation, decreased by 4.4% each year across the study period. The decrease could be observed in both men and women.

What was interesting in this finding was the fact that in this particular group the rate of smoking decreased from 38% in the 1970s to 15% in the period from 2006 to 2010. During the same period, heavy drinking decreased from 7% to 4.5%. but other factors that could affect rates of hip fractures like being underweight and going through early menopause, did not change over the study period.

According to the NIAMS team, this points to the need for interventions that can help people change these modifiable lifestyle factors such as smoking and drinking, in addition to considering osteoporosis treatments in individuals at risk of hip fractures.

However, that may be a difficult task, as the potential pool for hip fractures is quite large due to these risk factors. According to the latest Behavioral Risk Factor Surveillance System (BRFSS) survey, more than half of the US adult population drank alcohol in the past 30 days, in the year 2018. And nearly 16% of the adult population reported binge drinking, and 7% reported heavy drinking.

Source: CDC

National Institute of Alcohol Abuse and Alcoholism (NIAAA) defines heavy alcohol use as more than 4 drinks on any day for men or more than 3 drinks for women.

On the other hand, nearly 14 of every 100 U.S. adults aged 18 years or older (13.7%) smoked cigarettes, in the year 2018. This means an estimated 34.2 million adults in the United States currently smoke cigarettes. Heavy smoker is any smoker who reports consuming 20 cigarettes or more per day, according to CDC.

Source: Statista

One thing to not here in this study is that all individuals in this cohort were white. So, it is difficult to deduce if same is true for people of different ethnicities and races.

Another limitation of the study was that all individuals in the study had lower rates of obesity than the national average. The study also did not include measurements of bone mineral density, because when the study was started the technology for this measurement was not available in 1970s.

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