Get Moving to Prevent Hip Fractures

Source: Tufts University
January 17, 2003 (Reviewed: January 21, 2005)

Fractured bones are a significant concern for women, postmenopausal women in particular. Declining estrogen levels put them at greater risk. Fortunately, it appears that moderate types of exercise - such as walking - can reduce the risk of hip fracture in postmenopausal women, including those who do not take hormone replacement therapy (HRT). That is the finding of a study recently published in the Journal of the American Medical Association.

The relationship between exercise and hip fracture

Researchers from Harvard Medical School and Harvard School of Public Health studied 61,200 postmenopausal women aged 40 to 77 who were enrolled in the Nurses' Health Study. At the beginning of the study the women did not have any major diseases, including heart disease, cancer, stroke, and osteoporosis.

Upon enrolling, the women filled out questionnaires that provided detailed information about their medical histories and their lifestyles, including diet and exercise. They filled out follow-up questionnaires every 2 years and were followed for a total of 12 years.

During this period, the researchers documented the number of hip fractures that occurred (excluding those that were the result of severe trauma, such as a skiing accident or falling from a ladder). They also documented the types of exercise the women participated in, as well as the duration and intensity of the activities. Walking was, by far, the most common activity among study participants.

Exercise made a difference

Over the 12-year period, there were 415 hip fractures. After considering other factors that could have influenced hip fracture risk, including age, weight, use of HRT, smoking, and diet, the researchers found that women who were moderately active (equivalent to at least 3 hours/week of walking at an average pace) had a 33% lower risk of hip fracture compared with women who exercised less than 1 hour per week. Those who exercised more than 3 hours a week cut their risk even further.

They also found that women who made changes in their exercise habits over the 12 years experienced parallel changes in their hip fracture risk. For example, of the women who reported a high activity level (4 hours/week or more) in 1980, the risk of hip fracture was doubled among those who decreased their activity to less than 1 hour/week by 1986.

How activity protects

Physical activity may reduce hip fracture risk in several ways. It can improve muscle strength and balance, which can reduce the risk for falling. It can also work directly at the site of the bone to increase bone density, which can lower the risk for fracture.

It's important to note that approximately 98% of the women in this study were white, so the results cannot necessarily be applied to non-white women, nor can they be applied to men.

Charting your own path to healthy hips

As the authors of this study point out, any type of weight-bearing exercise can help protect against hip fracture risk. While other types of exercise may produce more dramatic effects on bone, the fact that walking was effective in this study is encouraging, because it is often the easiest and most convenient form of exercise for many women.

Whatever type of activity you choose, aim to make it a regular part of your daily life, and complement it with other healthful behaviors, including eating right and not smoking. And be sure to see your doctor before beginning any new exercise regimen.

Source

• Walking and leisure-time activity and risk of hip fracture in postmenopausal women. D. Feskanich, W. Willett, G. Colditz, JAMA, 2002, vol. 288, pp. 2300--2306

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