Protective effect of total and supplemental vitamin C intake on the risk of hip fracture—a 17-year follow-up from the Framingham Osteoporosis Study

• Published in: Osteoporosis international 2009-11, Vol.20 (11), p.1853-1861
• Main Authors: Sahni, S, Hannan, M. T, Gagnon, D, Blumberg, J, Cupples, L. A, Kiel, D. P, Tucker, K. L
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Ascorbic Acid - administration & dosage; Biological and medical sciences; Bone Density - drug effects; Confounding Factors (Epidemiology); Diet - statistics & numerical data; Dietary Supplements; Diseases of the osteoarticular system; Endocrinology; Epidemiologic Methods; Female; Fractures; Hip Fractures - epidemiology; Hip Fractures - etiology; Hip Fractures - prevention & control; Humans; Injuries of the limb. Injuries of the spine; Male; Massachusetts - epidemiology; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Older people; Original Article; Orthopedics; Osteoporosis - complications; Osteoporosis - epidemiology; Osteoporosis - prevention & control; Osteoporosis. Osteomalacia. Paget disease; Osteoporotic Fractures - epidemiology; Osteoporotic Fractures - etiology; Osteoporotic Fractures - prevention & control; Potassium, Dietary - administration & dosage; Rheumatology; Risk factors; Traumas. Diseases due to physical agents; Vitamin C
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-009-0897-y

Summary Vitamin C may play a role in bone health. In the Framingham Study, subjects with higher total or supplemental vitamin C intake had fewer hip fractures and non-vertebral fractures as compared to subjects with lower intakes. Therefore, vitamin C may have a protective effect on bone health in older adults. Introduction Dietary antioxidants such as vitamin C may play a role in bone health. We evaluated associations of vitamin C intake (total, dietary, and supplemental) with incident hip fracture and non-vertebral osteoporotic fracture, over a 15- to 17-year follow-up, in the Framingham Osteoporosis Study. Methods Three hundred and sixty-six men and 592 women (mean age 75 ± 5 years) completed a food frequency questionnaire (FFQ) in 1988-1989 and were followed for non-vertebral fracture until 2003 and hip fracture until 2005. Tertiles of vitamin C intake were created from estimates obtained using the Willett FFQ, after adjusting for total energy (residual method). Hazard ratios were estimated using Cox-proportional hazards regression, adjusting for covariates. Results Over follow-up 100 hip fractures occurred. Subjects in the highest tertile of total vitamin C intake had significantly fewer hip fractures (P trend = 0.04) and non-vertebral fractures (P trend = 0.05) compared to subjects in the lowest tertile of intake. Subjects in the highest category of supplemental vitamin C intake had significantly fewer hip fractures (P trend = 0.02) and non-vertebral fractures (P trend = 0.07) compared to non-supplement users. Dietary vitamin C intake was not associated with fracture risk (all P > 0.22). Conclusion These results suggest a possible protective effect of vitamin C on bone health in older adults.