Fruit and vegetable consumption and injurious falls among adults aged ≥ 50 years from low- and middle-income countries

OBJECTIVE: Inadequate fruit and vegetable consumption may increase risk for falls. However, to date, only one study has examined this association in a sample restricted to females, while the mediators of this association are largely unknown. Therefore, we aimed to examine the association between fruit and vegetable consumption and injurious falls, and to identify potential mediators in a sample including both males and females.

METHODS: Cross-sectional, nationally representative data from the World Health Organization (WHO) Study on global AGEing and adult health (SAGE) were analyzed. Fruit/vegetable consumption was divided into two groups: ≥2 servings of fruits and ≥3 servings of vegetables per day (adequate consumption) or else (inadequate consumption). Fall-related injury referred to those that occurred in the past 12 months. Multivariable logistic regression and mediation analysis were conducted.

RESULTS: Data on 34,129 individuals aged ≥ 50 years were analyzed (mean age 62.4 years; 52.1% females). Overall, inadequate fruit/vegetable intake was associated with a significant 1.41 (95%CI = 1.05-1.90) times higher odds for injurious falls. This association was only significant among females (OR = 1.96; 95%CI = 1.32-2.85). Mediation analysis showed that affect (mediated percentage 8.8%), cognition (7.2%), and sleep/energy (7.5%) were significant mediators, but vision, grip strength, and gait speed were not.

CONCLUSIONS: Inadequate fruit and vegetable consumption was associated with higher odds for injurious falls among adults aged ≥ 50 years (especially females), and this association was partly mediated by cognition, affect, and sleep/energy. Future longitudinal studies are necessary to provide more insight into the underlying mechanisms, and to assess whether increasing fruit/vegetable consumption may reduce risk for falls.