Leisure Physical Activity and the Risk of Fracture in Men
Karl Michaëlsson1,2*, Helena Olofsson1, Karin Jensevik2, Sune Larsson1, Hans Mallmin1, Lars Berglund2, Bengt Vessby3, Håkan Melhus4
1 Section of Orthopaedics, Department of Surgical Sciences, University Hospital, Uppsala, Sweden, 2 Uppsala Clinical Research Center, University Hospital, Uppsala, Sweden, 3 Section of Geriatrics, Department of Public Health, University Hospital, Uppsala, Sweden, 4 Section of Clinical Pharmacology, Department of Medical Sciences, University Hospital, Uppsala, Sweden

Background

Data from previous studies are inconsistent, and it is therefore uncertain whether, to what extent, and at what level leisure physical activity influences the risk of osteoporotic fractures in men.

Methods and Findings

A cohort of 2,205 men, 49–51 y of age, was enrolled in a longitudinal, population-based study. Leisure physical activity and other lifestyle habits were established at baseline and at ages 60, 70, 77, and 82 y. During 35 y of follow-up, 482 men had at least one fracture. Cox's proportional hazards regression was used to determine hazard ratios (HRs) of fracture associated with time-dependent physical activity habits and covariates. Men with a sedentary lifestyle (HR 2.56, 95% confidence interval 1.55–4.24) or men who walked or bicycled only for pleasure (HR 1.61, 95% confidence interval 1.10–2.36) had an increased adjusted risk of hip fracture compared with men who participated in regular sports activities for at least 3 h/wk. At the end of follow-up, 8.4% of the men with a high physical activity, 13.3% of the men with a medium physical activity, and 20.5% of the men with a low physical activity had suffered a hip fracture. According to the estimation of population-attributable risk, one third of all hip fractures could be prevented by participation in regular sports activities. High activity also conferred a reduced overall fracture risk.

Conclusions

Our data indicate that regular sports activities can reduce the risk of fractures in older men.

Funding: Financial support for this study was provided by the Swedish Research Council (K2006-73x-13511-07-3). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests: The authors have declared that no competing interests exist.

Academic Editor: Stuart Ralston, University of Edinburgh, United Kingdom

Citation: Michaëlsson K, Olofsson H, Jensevik K, Larsson S, Mallmin H, et al. (2007) Leisure Physical Activity and the Risk of Fracture in Men. PLoS Med 4(6): e199 doi:10.1371/journal.pmed.0040199

Received: November 2, 2006; Accepted: April 20, 2007; Published: June 19, 2007

Copyright: © 2007 Michaëlsson et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abbreviations: CI, confidence interval; HR, hazard ratio, ULSAM, Uppsala Longitudinal Study of Adult Men; VO2max, maximal oxygen uptake