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. 2023 Jan;34(1):111-118.
doi: 10.1007/s00198-022-06522-8. Epub 2022 Nov 11.

Risk of major osteoporotic fractures among ultra-orthodox Jews

Merav Jacobson Bensky  1 , Limor Adler  2   3 , Tamar Banon  2 , Linoy Gabay  2 , Yishai Mintzker  2   4
Affiliations

Risk of major osteoporotic fractures among ultra-orthodox Jews

Merav Jacobson Bensky et al. Osteoporos Int. 2023 Jan.

Erratum in

Abstract

The Ultra-Orthodox Jewish population has behaviors that can influence the risk for osteoporotic fractures. We investigated whether this population is more prone to osteoporotic fractures than non-Orthodox Jewish. We did not find a significant difference in osteoporotic fracture rates between the two populations despite major differences in exposure to potential risk factors.

Introduction: The Ultra-Orthodox Jewish population is a conservative population with unique cultural behaviors such as modest clothing and specific dietary restrictions, which can influence bone density and risk for osteoporotic fractures. The aim of this study is to investigate whether the Ultra-Orthodox Jewish population is more prone to osteoporotic fractures than the non-Orthodox Jewish population.

Methods: This retrospective cohort study utilized computerized records from Maccabi Health Service. Study population included patients 65 years and older without a history of osteoporotic fracture, who reside in regions of Ultra-Orthodox and non-Orthodox Jews. The primary outcome was the adjusted risk to osteoporotic fracture during 9 years of follow-up. Cox regression included patient characteristics and risk factors for osteoporosis.

Results: A total of 115,134 patients were included in this study: 5397 patients residing in Ultra-Orthodox regions (51.0% female) and 109,737 patients residing in non-Orthodox regions (52.6% female). A total of 16,352 (14.2%) patients had an osteoporotic fracture during the study period. There was no significant difference in fracture rate between Ultra-Orthodox and non-Orthodox (14.3% vs. 14.2%, p = 0.827). Among Ultra-Orthodox and non-Orthodox females and males, there were no significant differences in fracture rates (19.1% vs. 19.1% p = 0.982 and 9.3% vs. 8.8% p = 0.311, respectively). The adjusted hazard risk for the Ultra-Orthodox Jews was 1.026, 95% CI: 0.95-1.11, p = 0.512.

Conclusion: We did not find a significant difference in the rate of osteoporotic fractures between Ultra-Orthodox and non-Orthodox populations despite major differences in exposure to potential risk factors. Results suggest that the perception of risk factors relevant for the religious communities should be re-evaluated.

Keywords: Cohort study; Community health; Cultural difference; Osteoporosis; Osteoporotic fracture; Sun exposure.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Flow chart of patients included in the cohort
Fig. 2
Fig. 2
Kaplan-Meyer curve of male patients only: survival without a fracture in Ultra-Orthodox and control groups
See this image and copyright information in PMC

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