Issue: November 2010
November 01, 2010
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Trend of rising hip fracture rates in East attributed to ‘Westernization’

Issue: November 2010
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ASBMR Annual Meeting

TORONTO — A Westernized lifestyle may be responsible for the increasing rates of hip fractures in countries in the Eastern part of the world, a researcher said here at the American Society of Bone and Mineral Research Annual Meeting.

“Hip fracture rates seem to be falling in the West and rising in some parts of Asia,” said Steven Cummings, MD, professor of epidemiology and medicine at the University of San Francisco and California Pacific Medical Center Research Institute. “The rates of hip fractures in the West and in the East are starting to converge, accompanied by the homogenization of cultural economies around the world.”

In the early ’90s, China had about one-eighth the rate of hip fracture rates compared with white people in the United States, according to Cummings. However, since the mid-’90s, hip fracture rates have been declining in Western countries, including the United States, United Kingdom, Canada and Denmark, mainly due to increases in bone density, he said.

Cummings said increasing Westernization and lifestyle changes are prompting increasing rates of hip fractures in the East.

Using China as one example, “Beijing has rapidly urbanized,” including an increase in the number of cars and Western-style apartments. Traditional lifestyle in China has been to squat in apartments, but the growing presence of sofas and chairs in apartments has made squatting less common, Cummings said.

“By squatting, you may be decreasing the risk for falling, and it may even improve bone mineral density,” he told the audience. “Increasing urbanization is decreasing squatting.”

In an interview with Endocrine Today, Cummings said the daily lifestyle of those in the East has become more sedentary.

“There are changes in the patterns of physical activity in the ordinary things that people do every day,” he said, using examples of driving instead of walking and sitting rather than squatting.

However, he said increases in BMD in Western countries “can only be attributed in a small part to pharmacologic therapy.”

“We are not sure why BMDs seem to be improving [in the West], as was found in the Study of Osteoporotic Fractures,” for which Cummings is a researcher, he said. “It may be due to increases in weight, increasing use of calcium and vitamin D, or things that we have not been able to discern. We are seeing this same trend in men.” – by Louise Gagnon

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