In a recent cohort study 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. Participants included 5,187 men and women aged ≥65 years from the Cardiovascular Health Study (CHS). Researchers found:

• 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) with spline models suggesting a U‐shaped association.
• In post hoc analyses, both the lowest (HR 1.31) and highest (HR 1.53) quartiles of niacin intake were associated with an increased risk of incident hip fracture vs quartiles 2 and 3.
• There was a trend for a significant inverse association of dietary niacin intake with hip bone mineral density (BMD), but no significant association with total body BMD or any body composition measures.