@article {8104,
	title = {The Association of Aromatic Amino Acids with Incident Hip Fracture, aBMD, and Body Composition from the Cardiovascular Health Study.},
	journal = {Calcif Tissue Int},
	volume = {105},
	year = {2019},
	month = {2019 Aug},
	pages = {161-172},
	abstract = {<p>In 5187 persons~from the Cardiovascular Health Study,~there was no significant association of dietary intakes of aromatic amino acids (AAA) with areal BMD of the hip~or body composition. However, those who had the lowest dietary intakes of AAA were at increased risk for incident hip fractures. Prior studies of the association of protein intake with osteoporosis are conflicting and have not directly examined the relationship of aromatic amino acids (AAA) with fractures, areal bone mineral density (aBMD), and body composition. We sought to determine the relationship of dietary intakes of AAA with osteoporosis parameters in elderly men and women. 5187 men and women aged >= 65~years from the Cardiovascular Health Study (CHS) with dietary intakes of AAA (tryptophan, phenylalanine, tyrosine) estimated by food frequency questionnaire (FFQ) were included. We examined the relationship between a one-time estimate of daily dietary AAA intake with risk of incident hip fractures over a median of 13.2~years of fracture follow-up. A subset (n = 1336) who had dual energy X-ray absorptiometry (DXA) performed were included in a cross-sectional analysis of the association of dietary AAA intake with aBMD of the total hip and measurements of body composition. In multivariable models adjusted for demographic and clinical variables, medication use, and diet, higher dietary AAA intake was not significantly associated with incident hip fractures. All hazard ratios (HR) were less than one (tryptophan, HR 0.14, 95\% CI 0.01 to 1.89; phenylalanine, HR 0.60, 95\% CI 0.23 to 1.55; tyrosine, HR 0.59, 95\% CI 0.27 to 1.32), but confidence intervals were wide and included no difference. However, in post hoc analyses, the lowest quartile of intake for each AAA was associated with an increased risk for hip fracture compared to higher quartiles (p <= 0.047 for all). Dietary AAA intakes were not significantly associated with total hip aBMD or any measurements of body composition. Overall, there was no significant association of dietary AAA intake with hip fractures, aBMD of the hip, or body composition. However, there may be a subset of elderly individuals with low dietary intakes of AAA who are at increased for hip fractures.</p>},
	issn = {1432-0827},
	doi = {10.1007/s00223-019-00562-9},
	author = {Le, Brian and B{\r u}zkov{\'a}, Petra and Robbins, John A and Fink, Howard A and Raiford, Mattie and Isales, Carlos M and Shikany, James M and Coughlin, Steven S and Carbone, Laura D}
}
@article {7967,
	title = {Association of Dietary Niacin Intake With Incident Hip Fracture, BMD, and Body Composition: The Cardiovascular Health Study.},
	journal = {J Bone Miner Res},
	year = {2019},
	month = {2019 Jan 19},
	abstract = {<p>Interest in niacin has increased in the setting of reports suggesting that niacin plays a role in diseases of aging. No study to date has examined the association of dietary niacin intake with multiple skeletal health parameters including bone mineral density (BMD), hip fractures, and body composition, and none have included both African American and white men and women. Participants included 5187 men and women >=65 years from the Cardiovascular Health Study (CHS). Mean daily dietary niacin intake was 32.6 mg, with quartiles 1 through 4 defined as 3.6 to 21.8 mg/day, 21.9 to 30.2 mg/day, 30.3 to 40.9 mg/day, and 41.0 to 102.4 mg/day, respectively. Risk of incident hip fracture per 10 mg increment of daily dietary niacin intake was estimated using proportional hazards models. During a median follow-up of 13 years, 725 participants had an incident hip fracture. In models adjusted for demographic and clinical characteristics and diet, dietary niacin intake was significantly associated with an increased risk of hip fractures (hazard ratio [HR] 1.12; 95\% CI, 1.01 to 1.24) with spline models suggesting a U-shaped association. In post hoc analyses, both the lowest (HR 1.31; 95\% CI, 1.04 to 1.66) and highest (HR 1.53; 95\% CI, 1.20 to 1.95) quartiles of niacin intake were associated with an increased risk of incident hip fracture versus quartiles 2 and 3. There was a trend for a significant inverse association of dietary niacin intake with hip BMD (p = 0.06), but no significant association with total body BMD or any body composition measures. In this cohort of elderly, community-dwelling African American and white men and women, both high and low dietary niacin intakes were associated with a significantly increased risk of subsequent hip fracture, suggesting a possible U-shaped association. By comparison, dietary niacin may have an inverse linear association with hip BMD. {\textcopyright} 2018 American Society for Bone and Mineral Research.</p>},
	issn = {1523-4681},
	doi = {10.1002/jbmr.3639},
	author = {Carbone, Laura D and B{\r u}zkov{\'a}, Petra and Fink, Howard A and Raiford, Mattie and Le, Brian and Isales, Carlos M and Shikany, James M and Coughlin, Steven S and Robbins, John A}
}
