Determinants of incident vertebral fracture in men and women: results from the European Prospective Osteoporosis Study (EPOS)

The aim of this analysis was to determine the influence of lifestyle, anthropometric and reproductive factors on the subsequent risk of incident vertebral fracture in men and women aged 50-79 years. Subjects were recruited from population registers from 28 centers across Europe. At baseline, they completed an interviewer-administered questionnaire and had lateral thoraco-lumbar spine radiographs performed. Repeat spinal radiographs were performed a mean of 3.8 years later. Incident vertebral fractures were defined morphometrically and also qualitatively by an experienced radiologist. Poisson regression was used to determine the influence of the baseline risk factor variables on the occurrence of incident vertebral fracture. A total of 3173 men (mean age 63.1 years) and 3402 women (mean age 62.2 years) contributed data to the analysis. In total there were 193 incident morphometric and 224 qualitative fractures. In women, an age at menarche 16 years or older was associated with an increased risk of vertebral fracture (RR=1.80; 95%CI 1.24, 2.63), whilst use of hormonal replacement was protective (RR=0.58; 95%CI 0.34, 0.99). None of the lifestyle factors studied including smoking, alcohol intake, physical activity or milk consumption showed any consistent associations with incident vertebral fracture. In men and women, increasing body weight and body mass index were associated with a reduced risk of vertebral fracture though, apart from body mass index in men, the confidence intervals embraced unity. For most variables the strengths of the associations observed were similar using the qualitative and morphometric approaches to fracture definition. In conclusion our data suggest that modification of other lifestyle risk factors is unlikely to have a major impact on the population occurrence of vertebral fractures. The important biological mechanisms underlying vertebral fracture risk need to be explored using new investigational strategies

Modern and ancient amalgamated sandy meander‐belt deposits: recognition and controls on development

Amalgamated sandy meander belts and their deposits are common in modern continental and marine‐connected basins yet comprise a minor constituent of the reported fluvial rock record. This suggests that either amalgamated meander‐belts are uncommon in the rock record or that the recognition criteria are lacking to identify sandy meandering river deposits. To address this apparent discrepancy, the authors document the range and occurrence of amalgamated sandy meander belts (ASMB) from modern basins and the stratigraphic record. ASMB are widely distributed throughout both present and rock record sedimentary basins occurring in foreland, extensional, cratonic, strike‐slip and passive margin basins. They occur in all climatic settings ranging from tundra to hot deserts. Three specific occurrences of ASMB are recognised in modern basins: in the proximal to medial parts of distributive fluvial systems (DFS), as laterally‐confined belts that mainly form axial fluvial systems; and as valley‐confined meander belts that may infill bedrock, alluvial or coastal plain valleys. From the limited amount of rock record examples of ASMB that are available, it is clear that they occur in similar settings to those observed in modern basins, the recognition of which provides a framework for the further prediction and identification of ASMB in the rock record. The lack of recognition of ASMB in the rock record is considered to be due to an absence of characteristics that allow clear distinction between sandy meandering and braided fluvial deposits. Characteristics considered common to both include: multi‐storey, laterally extensive (sheet‐like) amalgamated channel belts, dominance of downstream accreting bedforms, no fining upwards grain‐size profile and little or no fine‐grained sediment and/or soil preservation. In contrast, features considered characteristic of meandering rivers such as inclined heterolithic stratification, high palaeocurrent dispersion, single storey channels and fining upwards grain‐size profiles are absent. The authors suggest that no single criterion can be used to definitively identify sandy meander belt deposits in the rock record and that a combination of systematic variations in accretion direction, palaeocurrent dispersal patterns and recognition of storey scale accretion surfaces is necessary to identify clearly this fluvial style. The common occurrence and distribution of sandy meander belts in modern sedimentary basins together with their limited recognition in the rock record suggests that their true stratigraphic distribution has yet to be determined. This has important implications for palaeogeographic reconstructions, understanding the impact of plant colonisation on fluvial planform style and predicting sandstone body dimensions and internal heterogeneity distribution within hydrocarbon reservoirs and aquifers