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Does inadequate diet during childhood explain the higher high fracture rates in the Southern United States?
Osteoporosis International, 07/01/09

Paulozzi LJ – Findings suggest that inadequate nutrition during skeletal formation early in life might explain the higher incidence of hip fracture among older adults in the Southern states of US.

Methods

Study was led by speculation that state of residence early in life is a better predictor of the risk of hip fracture after age 65 than state of current residence
Geography of rickets mortality in the US before 1950 was compared with the geography of hip fracture rates among older adults during 1986–1993
Vital statistics data for the US white population for 1942–1948 allowed calculation of the ratio of deaths from rickets to live births for each geographic division of US
These ratios were correlated with previously published, standardized hip fracture rates among whites 65–89 yrs old during 1986–1993 by census division

Results

During 1942–1948, the rickets mortality ratio among whites was 3.11 in the South, 1.91 in the Northeast, 1.75 in the Midwest, and 1.04 in the West
The correlation of mortality with risk of hip fracture was 0.71 for both sexes combined and 0.86 for women

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