Open Access Highly Accessed Research article

Dietary patterns associated with fall-related fracture in elderly Japanese: a population based prospective study

Yasutake Monma1, Kaijun Niu2, Koh Iwasaki3*, Naoki Tomita4, Naoki Nakaya5, Atsushi Hozawa5, Shinichi Kuriyama5, Shin Takayama3, Takashi Seki3, Takashi Takeda3, Nobuo Yaegashi13, Satoru Ebihara6, Hiroyuki Arai4, Ryoichi Nagatomi2 and Ichiro Tsuji5

Author Affiliations

1 Graduate Medical Education Center, Tohoku University Hospital, Sendai, Japan

2 Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine

3 Center for Asian Traditional Medicine, Tohoku University Graduate School of Medicine

4 Department of Geriatrics & Gerontology Division of Brain Science, Institute of Development Aging and Cancer, Tohoku University

5 Department of Public Health and Forensic Medicine, Tohoku University Graduate School of Medicine

6 Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine

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BMC Geriatrics 2010, 10:31  doi:10.1186/1471-2318-10-31

Published: 1 June 2010



Diet is considered an important factor for bone health, but is composed of a wide variety of foods containing complex combinations of nutrients. Therefore we investigated the relationship between dietary patterns and fall-related fractures in the elderly.


We designed a population-based prospective survey of 1178 elderly people in Japan in 2002. Dietary intake was assessed with a 75-item food frequency questionnaire (FFQ), from which dietary patterns were created by factor analysis from 27 food groups. The frequency of fall-related fracture was investigated based on insurance claim records from 2002 until 2006. The relationship between the incidence of fall-related fracture and modifiable factors, including dietary patterns, were examined. The Cox proportional hazards regression model was used to examine the relationships between dietary patterns and incidence of fall-related fracture with adjustment for age, gender, Body Mass Index (BMI) and energy intake.


Among 877 participants who agreed to a 4 year follow-up, 28 suffered from a fall-related fracture. Three dietary patterns were identified: mainly vegetable, mainly meat and mainly traditional Japanese. The moderately confirmed (see statistical methods) groups with a Meat pattern showed a reduced risk of fall-related fracture (Hazard ratio = 0.36, 95% CI = 0.13 - 0.94) after adjustment for age, gender, BMI and energy intake. The Vegetable pattern showed a significant risk increase (Hazard ratio = 2.67, 95% CI = 1.03 - 6.90) after adjustment for age, gender and BMI. The Traditional Japanese pattern had no relationship to the risk of fall-related fracture.


The results of this study have the potential to reduce fall-related fracture risk in elderly Japanese. The results should be interpreted in light of the overall low meat intake of the Japanese population.