Introduction
This study aimed to determine if beneficial effects of individualized feedback of
fracture risk on osteoporosis preventive behaviors and bone mineral density observed
in a 2-year trial were sustained long-term.
Methods
This was a 10-year follow-up of a 2-year RCT in 470 premenopausal women aged 25–44
years, who were randomized to one of two educational interventions (the Osteoporosis
Prevention and Self-Management Course [OPSMC] or an osteoporosis information leaflet)
and received tailored feedback of their relative risk of fracture in later life (high
versus normal risk groups). Bone mineral density of lumbar spine and femoral neck
were measured by dual-energy X-ray absorptiometry. Physical activity, dietary calcium
intake, calcium and vitamin D supplements, and smoking status were measured by questionnaires.
Results
From 2 to 12 years, the high-risk group had a smaller decrease in femoral neck bone
mineral density (β=0.023, 95% CI=0.005, 0.041 g/cm2) but similar lumbar spine bone mineral density change as the normal-risk group. They
were more likely to use calcium (relative risk=1.66, 95% CI=1.22, 2.24) and vitamin
D supplements (1.99, 95% CI=1.27, 3.11). The OPSMC had no effects on bone mineral
density change. Both high-risk (versus normal-risk) and the OPSMC groups (versus leaflet)
had a more favorable pattern of smoking behavior change (relative risk=1.85, 95% CI=0.70,
4.89 and relative risk=2.27, 95% CI=0.86, 6.01 for smoking cessation; relative risk=0.33,
95% CI=0.13, 0.80 and relative risk=0.28, 95% CI=0.10, 0.79 for commenced or persistent
smoking).
Conclusions
Feedback of high fracture risk to younger women was associated with long-term improvements
in osteoporosis preventive behaviors and attenuated femoral neck bone mineral density
loss. Therefore, this could be considered as a strategy to prevent osteoporosis.
Trial registration
Australian New Zealand Clinical Trials Registry (ANZCTR) NCT00273260.
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Article Info
Publication History
Published online: December 12, 2017
Identification
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© 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
