Voluntary and Involuntary Weight Change and Risk of Osteoporotic Hip Fracture in Men and Women of Utah

Change in body weight is an important determinant of risk of osteoporotic hip fracture in aging adults. Weight loss has been associated with an increased risk of hip fracture and weight gain has been associated with a decreased risk of hip fracture . . Weight gain cannot be recommended as appropriate prevention against hip fracture, however, because it is associated with such adverse health outcomes as cardiovascular disease and diabetes, and weight loss is commonly recommended in the treatment of these types of diseases. Clarification of how weight loss is related to risk of hip fracture is needed to resolve this issue. An extensive review of published literature was completed to assess the relationships between hip fracture and body weight, weight change, and involuntary and voluntary weight loss. Change in body weight and weight lll loss that was either intentional or unintentional were then assessed for their effects on risk of hip fracture in a population-based case-control study of risk factors for osteoporotic hip fracture in aging Utah residents. Analyses of risk of hip fracture by quintile of weight change since age 18 and according to weight loss intention were performed through logistic regression modeling. Weight loss after age 18 was associated with an increased risk of hip fracture in men and women, and above average weight gain after age 18 was protective against hip fracture in women. Involuntary weight loss of more than 20 pounds was associated with an increased risk of hip fracture in men and women aged 50 to 69 years, but was not related to risk of hip fracture in participants aged 70 to 89. Voluntary weight loss of more than 20 pounds did not significantly increase risk of hip fracture in either age group. It was concluded that involuntary weight loss may be an important predictor of risk of hip fracture in aging adults and that voluntary weight loss may be safely recommended to aging adults without increasing their risk of hip fractur