Wen-Ling Liao


This is a two year of follow up study of Adventist Health Study-2 (AHS-2). We assessed the association between physical activity, nutrient intake and risk of hip fracture among peri- and post menopausal Caucasian women using unconditional logistic regression models. All subjects completed a lifestyle questionnaire which including information of physical activity and frequency and portion size of food intake at enrollment into the study (2002-2007). The “Bi-Annual Hospitalization History” questionnaire which included a question about hip fractures due to minor trauma/falls was sent to subjects approximately two years after enrollment, with a response rat of 82.84%. In this cohort, a total of 151 new cases of hip fracture occurred among 25,398 peri- and post- menopausal women aged 45 or older during the 55, 313 person years of follow-up period giving an incidence rate of 273 per 100,000 person-years and 282 per 100,000 person years after direct age-adjustment (using the US 2000 female white population). There was a dose response inverse relationship between level of regular walking, running and jogging and hip fracture with 64% reduction of risk for those who reported walking more than 5 miles per week compared to those with less than 2.5 miles per week or no regular exercise. The risk of hip fracture was inversely associated with dairy food intake [OR = 0.86 (95% Cl: 0.39, 1.90) and OR = 0.70 (95% Cl: 0.35, 1.41), respectively, for intake of 2-/wk and 7+times/wk vs./wk]. Similarly, those in the highest tertile of dairy source protein (10.47+ g/day), experienced a clear lowering in hip fracture risk compared to those in the lowest tertile (< 4.31 g/day) of dairy source protein (OR=0.39 (95% Cl: 0.16, 0.98). Dairy protein showed an independent protective effect on hip fracture after adjusting for total protein and dietary calcium. In summary, our findings suggest that a regular walking program of at least 5 miles per week and dairy protein consumption lower the risk the hip fracture in this study population.


School of Public Health

First Advisor

Synnove Knutsen

Second Advisor

W. Lawrence Beeson

Third Advisor

Donna Gregory Thorpe

Degree Name

Doctor of Public Health (DrPH)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Hip Fractures -- diagnosis; Hip Fractures -- epidemiology; Osteoporosis, Postmenopausal -- physiopathology; Bone Density; Body Mass Index; Nutritional Support; Dietary Proteins -- administration & dosage; Health Behavior; Physical Fitness; Vegetarianism -- Religious aspects -- Seventh-day Adventists; Nutrition -- Religious aspects -- Seventh-day Adventists; Caucasian Race; Prospective Studies.



Digital Format


Digital Publisher

Loma Linda University Libraries

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This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website


Loma Linda University. Del E. Webb Memorial Library. University Archives