The observational study conducted by the Women’s Health Initiative involved 93,676 women ages 50 to 79 at 40 U.S. clinical centers. Recruitment for the study took place between 1993 and 1998. Researchers analyzed nutrient and food intake from questionnaires. Participants were scored for adherence to the Mediterranean dietary pattern — one that places an emphasis on consumption of fruits, vegetables, fish, nuts, legumes, whole grains and monounsaturated fat while avoiding red meat — and three others.
The three plans outside of the Mediterranean diet were derived from U.S. Dietary Guidelines and the Dietary Approaches to Stop Hypertension (DASH). These plans were associated with a reduction in hip fracture risk, but they did not attain statistical significance.
After making adjustments for result confounders like age and chronic morbidities, women who scored in the top quintile for Mediterranean diet adherence had a lower risk for hip fractures, with a hazard ratio of 0.80 and an absolute risk reduction 0.29 percent. Adherence to the other diet patterns produced hazard ratios of 0.87, 0.89 and 0.94 respectively.
Bernhard Haring, MD, a clinical fellow in the Department of Internal Medicine at the University of Würzburg, Germany, and one of the study’s authors, told Medscape, “The average woman should follow a healthy lifestyle, which includes adopting a healthy dietary pattern, [such as] a Mediterranean dietary pattern, and being physically active. To this point, unfortunately, the U.S. as well as other healthcare systems largely ignore nutrition and lifestyle measures in favor of pharmacology.”
Dr. Haring did express some concern about the study’s results regarding the lack of information collected on the physical activity of the participants, which could have rendered the favorable conclusions surrounding the Mediterranean diet nonsignificant.
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