Can a simple diet change reduce your risk of falling? New research reveals that older adults—especially women—who eat fewer fruits and vegetables face a significantly higher chance of injurious falls.
Study: Fruit and vegetable consumption and injurious falls among adults aged ≥ 50 years from low- and middle-income countries. Image Credit: Hananeko_Studio / Shutterstock
In a recent study published in the journal Aging Clinical and Experimental Research, researchers investigated the link between fruit and vegetable consumption and the risk of injurious falls in adults aged 50 and older, analyzing data from a large, nationally representative sample.
They found that inadequate fruit and vegetable intake was associated with a higher risk of falls, particularly among females, with cognition, affect, and sleep/energy acting as modest partial mediators (<10% of the association each).
The study suggests that improving vegetable and fruit intake could potentially reduce fall risk, but further research is needed to confirm causality and explore underlying mechanisms.
Background
Falls are a major health concern for older adults, affecting one-third of community-dwelling seniors each year and often leading to serious injuries. They are the leading cause of injury-related deaths and disabilities, particularly in low- and middle-income countries (LMICs), where healthcare systems are often under-resourced.
Effective interventions to prevent falls are crucial, and identifying risk factors is key. While many factors contribute to falls, such as poor balance, cognitive decline, and vision impairment, inadequate vegetable and fruit consumption is a potential but underexplored risk factor. Poor nutrition may increase fall risk by affecting mental health, cognitive function, vision, sleep, and physical performance.
Previous research has linked vegetable intake to a lower risk of injurious fall-related hospitalizations in older women, but no studies have examined this relationship in both sexes or different populations. More research is needed to understand sex-specific differences and the potential role of vegetable and fruit consumption in fall prevention, particularly in LMICs.
About the Study
This study analyzed data from 34,129 adults over 50 across six LMICs (China, Ghana, India, Mexico, Russia, and South Africa) using the World Health Organization’s Study on Global Ageing and Adult Health survey, which was collected between 2007 and 2010.
Through face-to-face interviews, participants provided information on injurious fall-related injuries, vegetable and fruit intake, and other health factors. Adequate vegetable and fruit consumption was defined as at least two servings of fruit and three servings of vegetables daily.
Mediators such as mental health, cognition, vision, sleep, handgrip strength, and gait speed were assessed using standardized questions and physical tests. Notably, vision, grip strength, and gait speed did not significantly mediate the relationship. Control variables included sex, age, wealth, education, diabetes, physical activity, body mass index (BMI), alcohol use, and smoking.
The analysis used logistic regression to examine the link between vegetable and fruit intake and fall-related injuries, adjusting for potential confounders. Mediation analysis determined how much specific health factors contributed to this relationship.
Findings
Of the individuals included in the study, 13,175 were from China, 4,305 from Ghana, 6,560 from India, 2,313 from Mexico, 3,938 from Russia, and 3,838 from South Africa.
Approximately 67% of those included had inadequate vegetable and fruit intake, while 4.2% experienced injurious falls. Approximately 52% were female, and the included individuals were, on average, 62.4 years old.
Researchers found that inadequate vegetable and fruit intake was linked to higher odds of injurious falls, especially among females, in a sample of 34,129 individuals aged 50 and above.
Those with insufficient intake were likelier to have lower education, income, and poor health status, including cognitive and physical impairments. After adjusting for confounders, inadequate vegetable and fruit intake was correlated with a 1.41 higher odds of falls, with a stronger effect in females (1.96).
Mediation analysis indicated that the state of emotion, cognition, and sleep or energy modestly (7–8%) mediated this relationship, though the explained variation was slight. These findings emphasize the need for dietary improvements to reduce fall risks, particularly in women.
Conclusions
The study aligns with previous research suggesting that inadequate vegetable and fruit intake increases the risk of injurious falls, particularly in women. Mediation analysis highlights the modest role of effect, cognition, and sleep or energy as contributing factors.
These findings are significant for public health interventions targeting vegetable and fruit consumption, especially in LMICs where such dietary patterns are common and economic barriers to accessing nutritious foods persist. The study suggests that promoting vegetable and fruit intake may help reduce fall risks, complementing global initiatives like the WHO Global Action Plan for Non-Communicable Diseases and the United Nations Decade of Action on Nutrition.
The study’s strengths include its large, representative sample from multiple LMICs and the use of mediation analysis to understand underlying mechanisms. However, the cross-sectional design limits causal inference, and the reliance on self-reported data may introduce bias.
Future research should focus on longitudinal studies to confirm causal relationships and explore other mediators, such as micronutrient deficiencies or inflammation. Additionally, examining gender differences in more detail and investigating specific types of vegetables and fruits consumed could provide further insights. Interventions should address economic barriers to ensure wider accessibility to nutritious foods in LMICs.
Journal reference:
- Fruit and vegetable consumption and injurious falls among adults aged ≥ 50 years from low- and middle-income countries. Smith, L., Sánchez, G.F.L., Veronese, N., Tully, M.A., Pizzol, D., Butler, L., Rahmati, M., López-Gil, J.F., Barnett, Y., Jacob, L., Soysal, P., Castagna, A., Shin, J.I., Koyanagi, A. Aging Clinical and Experimental Research (2025). DOI: 10.1007/s40520-025-02966-0, https://link.springer.com/article/10.1007/s40520-025-02966-0