Top

Osteoporosis International

Published in:

01-02-2018 | Original Article

Milk and other dairy foods and risk of hip fracture in men and women

Authors: D. Feskanich, H. E. Meyer, T. T. Fung, H. A. Bischoff-Ferrari, W. C. Willett

Published in: Osteoporosis International | Issue 2/2018

Abstract

Summary

The role of dairy foods for hip fracture prevention remains controversial. In this study, among US men and women, a glass of milk per day was associated with an 8% lower risk of hip fracture. This contrasts with a reported increased risk with higher milk intake in Swedish women.

Introduction

The purpose of this study was to examine whether higher milk and dairy food consumption are associated with risk of hip fracture in older adults following a report of an increased risk for milk in Swedish women.

Methods

In two US cohorts, 80,600 postmenopausal women and 43,306 men over 50 years of age were followed for up to 32 years. Cox proportional hazards models were used to calculate the relative risks (RR) of hip fracture per daily serving of milk (240 mL) and other dairy foods that were assessed every 4 years, controlling for other dietary intakes, BMI, height, smoking, activity, medications, and disease diagnoses.

Results

Two thousand one hundred thirty-eight incident hip fractures were identified in women and 694 in men. Each serving of milk per day was associated with a significant 8% lower risk of hip fracture in men and women combined (RR = 0.92, 95% confidence interval (CI) 0.87 to 0.97). A suggestive inverse association was found for cheese in women only (RR = 0.91, CI 0.81 to 1.02). Yogurt consumption was low and not associated with risk. Total dairy food intake, of which milk contributed about half, was associated with a significant 6% lower risk of hip fracture per daily serving in men and women (RR = 0.94, CI 0.90 to 0.98). Calcium, vitamin D, and protein from non-dairy sources did not modify the association between milk and hip fracture, nor was it explained by contributions of these nutrients from milk.

Conclusions

In this group of older US adults, higher milk consumption was associated with a lower risk of hip fracture.

Available only for authorised users

Haentjens P, Magaziner J, Colón-Emeric CS, Vanderschueren D, Milisen K, Velkeniers B, Boonen S (2010) Meta-analysis: excess mortality after hip fracture among older women and men. Ann Intern Med 152(6):380–390CrossRef

Wright NC, Looker AC, Saag KG, Curtis JR, Delzell ES, Randall S, Dawson-Hughes B (2014) The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. J Bone Miner Res 29(11):2520–2526CrossRef

U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015–2020 Dietary Guidelines for Americans, 8^th Edition. December 2015. Available at http://health.gov/dietaryguidelines/2015/guidelines/

Kanis JA, Johansson H, Oden A, De Laet C, Johnell O, Eisman JA, Mc Closkey E, Mellstrom D, Pols H, Reeve J, Silman A, Tenenhouse AA (2005) Meta-analysis of milk intake and fracture risk: low utility for case finding. Osteoporos Int 16:799–804CrossRef

Bischoff-Ferrari HA, Dawson-Hughes B, Baron JA, Kanis JA, Orav EJ, Staehelin HB, Kiel DP, Burckhardt P, Henschkowski J, Spiegelman D, Li R, Wong JB, Feskanich D, Willett WC (2011) Milk intake and risk of hip fracture in men and women; a meta-analysis of prospective cohort studies. J Bone Miner Res 26(4):833–839CrossRef

Sahni S, Mangano KM, Tucker KL, Kiel DP, Casey VA, Hannan MT (2014) Protective association of milk intake on the risk of hip fracture: results from the Framingham original cohort. J Bone Miner Res 29(8):1756–1762CrossRef

Michaëlsson K, Wolk A, Langenskiöld S, Basu S, Eva Lemming W, Melhus H, Byberg L Milk intake and risk of mortality and fractures in women and men: cohort studies. BMJ 2014;Oct 28 349:g6015

Owusu W, Willett WC, Feskanich D, Ascherio A, Spiegelman D, Colditz GA (1997) Calcium intake and the incidence of forearm and hip fractures among men. J Nutr 127(9):1782–1787CrossRef

Feskanich D, Willett WC, Stampfer MJ, Colditz GA (1997) Milk, dietary calcium, and bone fractures in women: a 12-year prospective study. Am J Public Health 87(6):992–997CrossRef

10.

Feskanich D, Willett WC, Colditz GA (2003) Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women. Am J Clin Nutr 77(2):504CrossRef

11.

Stampfer MJ, Willett WC, Speizer FE, Dyserrt DC, Lipnick R, Rosner B, Hennekens CH (1984) Test of the National Death Index. Am J Epidemiol 119(5):837–839CrossRef

12.

Rich-Edwards JW, Corsano KA, Stampfer MJ (1994) Test of the National Death Index and Equifax Nationwide Death Search. Am J Epidemiol 140(11):10016–10019CrossRef

13.

Colditz GA, Martin P, Stampfer MJ, Willett WC, Sampson L, Rosner B, Hennekens CH, Speizer FE (1986) Validation of questionnaire information on risk factors and disease outcomes in a prospective cohort study of women. Am J Epidemiol 123(5):894–900CrossRef

14.

Feskanich D, Rimm EB, Giovannucci EL, Colditz GA, Stampfer MJ, Litin LB, Willett WC (1993) Reproducibility and validity of food intake measurements from a semiquantitative food frequency questionnaire. J Am Diet Assoc 93(7):790–796CrossRef

15.

Salvini S, Hunter DJ, Sampson L, Stampfer MJ, Colditz GA, Rosner B, Willett WC (1989) Food-based validation of a dietary questionnaire: the effects of week-to-week variation in food consumption. Int J Epidemiol 18(4):858–867CrossRef

16.

Ainsworth BE, Haskell WL, Leon AS, Jacobs DR, Montoye HJ, Sallis JF, Paffenbarger RS (1993) Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sports Exerc 25(1):71–80CrossRef

17.

Durrleman S, Simon R (1989) Flexible regression models with cubic splines. Stat Med 8:551–561CrossRef

18.

DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7(3):177–188CrossRef

19.

Feskanich D, Bischoff-Ferrari HA, Frazier AL, Willett WC (2014) Milk consumption during teenage years and risk of hip fracture in older adults. JAMA Pediatr 168(1):54–60CrossRef

20.

Michaelsson K, Melhus H, Bellocco R, Wolk A (2003) Dietary calcium and vitamin D intake in relation to osteoporotic fracture risk. Bone 32(6):694–703CrossRef

21.

Cui X, Zuo P, Zhang Q, Li X, Hu Y, Long J, Packer L, Liu J (2006) Chronic systemic D-galactose exposure induces memory loss, neurodegeneration, and oxidative damage in mice: protective effects of R-alpha-lipoic acid. J Neurosci Res 83(8):1584–1590CrossRef

22.

Hardy R, Cooper MS (2009) Bone loss in inflammatory disorders. J Endocrinol 201(3):309–320CrossRef

23.

Berglundh S, Malmgren L, Luthman H, McGuigan F, Akesson K (2015) C-reactive protein, bone loss, fracture, and mortality in elderly women: a longitudinal study in the OPRA cohort. Osteoporos Int 26(2):727–735CrossRef

24.

Roubenoff R (2007) Physical activity, inflammation and muscle loss. Nutr Rev 65(12 suppl 3):S208–S212CrossRef

25.

Abrahamson A. Galactose in dairy products. Available at http://stud.epsilon.slu.se/7718/1/abrahamson_a_150317.pdf

26.

Ogden, CL, Carroll MD, Fryar CD, Flegal KM (2015) Prevalence of obesity among adults and youth: United States, 2011–2014. NCHS data brief, no. 219. Hyattsville, MD: National Center for Health Statistics

27.

Molarius A, Lindén-Boström M, Granström F, Jan Karlsson J (2016) Obesity continues to increase in the majority of the population in mid-Sweden—a 12-year follow-up. Eur J Pub Health 26(4):622–627CrossRef

28.

Kanis JA, Johnell O, De Laet C, Jonsson B, Oden A, Ogelsby AK (2002) International variations in hip fracture probabilities: implications for risk assessment. J Bone Miner Res 17(7):1237CrossRef

29.

Bischoff-Ferrari HA, Willett WC, Wong JB, Stuck AE, Staehelin HB, Orav EJ, Thoma A, Kiel DP, Henschkowski J (2009) Prevention of nonvertebral fractures with oral vitamin D and dose dependency: a meta-analysis of randomized controlled trials. Arch Intern Med 169(6):551CrossRef

30.

Bischoff-Ferrari HA, Willett WC, Orav EJ, Lips P, Meunier PJ, Lyons RA, Flicker L, Wark J, Jackson RD, Cauley JA, Meyer HE, Pfeifer M, Sanders KM, Stähelin HB, Theiler R, Dawson-Hughes BA (2012) Pooled analysis of vitamin D dose requirements for fracture prevention. N Engl J Med 367(1):40–49CrossRef

31.

Das UN (2001) Is obesity an inflammatory condition? Nutrition 17(11–12):953–966CrossRef

32.

Baker-LePain JC, Nakamurab MC, Lane NE (2011) Effects of inflammation on bone: an update. Curr Opin Rheumatol 23(4):389–395CrossRef

33.

Rolland T, Boutroy S, Vilayphiou N, Blaizot S, Chapurlat R, Szulc P (2012) Poor trabecular microarchitecture at the distal radius in older men with increased concentration of high-sensitivity C-reactive protein—the STRAMBO study. Calcif Tissue Int 90(6):496–506CrossRef

34.

De Laet C, Kanis JA, Odén A, Johanson H, Johnell O, Delmas P, Eisman JA, Kroger H, Fujiwara S, Garnero P, McCloskey EV, Mellstrom D, Melton LJ 3rd, Meunier PJ, Pols HAP, Reeve J, Silman A, Tenenhouse A (2005) Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 16(11):1330–1338CrossRef

35.

Armstrong ME, Spencer EA, Cairns BJ, Banks E, Pirie K, Green J, Wright FL, Reeves GK, Beral V (2011 Jun) Body mass index and physical activity in relation to the incidence of hip fracture in postmenopausal women. J Bone Miner Res 26(6):1330–1338CrossRef

36.

Nielson CM, Marshall LM, Adams AL, LeBlanc ES, Cawthon PM, Ensrud K, Stefanick ML, Barrett-Connor E, Orwoll ES (2011) BMI and fracture risk in older men: the osteoporotic fractures in men study (MrOS). J Bone Miner Res 26(3):496–502CrossRef

37.

Meyer HE, Willett WC, Flint AJ, Feskanich D (2016) Abdominal obesity and hip fracture: results from the Nurses’ Health Study and the Health Professionals Follow-up Study. Osteoporos Int 27(6):2127–2136CrossRef

38.

Sharples AP, Hughes DC, Deane CS, Saini A, Selman C, Stewart CE (2015) Longevity and skeletal muscle mass: the role of IGF signalling, the sirtuins, dietary restriction and protein intake. Aging Cell 14(4):511–523CrossRef

39.

Fekete ÁA, Givens DI, Lovegrove JA (2016) Can milk proteins be a useful tool in the management of cardiometabolic health? An updated review of human intervention trials. Proc Nutr Soc 75(3):328–341CrossRef

40.

Barba G, Russo P (2006) Dairy foods, dietary calcium and obesity: a short review of the evidence. Nutr Metab Cardiovasc Dis 16(6):445–451CrossRef

41.

Abargouei AS, Janghorbani M, Salehi-Marzijarani M, Esmaillzadeh A (2012) Effect of dairy consumption on weight and body composition in adults: a systematic review and meta-analysis of randomized controlled clinical trials. Int J Obes 36(12):1485–1493CrossRef

42.

Booth AO, Huggins CE, Wattanapenpaiboon N, Nowson CA (2015) Effect of increasing dietary calcium through supplements and dairy food on body weight and body composition: a meta-analysis of randomized controlled trials. Brit J Nutr 114(7):1013–1025CrossRef

Title: Milk and other dairy foods and risk of hip fracture in men and women
Authors: D. Feskanich
H. E. Meyer
T. T. Fung
H. A. Bischoff-Ferrari
W. C. Willett
Publication date: 01-02-2018
Publisher: Springer London
Published in: Osteoporosis International / Issue 2/2018
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-017-4285-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Milk and other dairy foods and risk of hip fracture in men and women

Abstract

Summary

Introduction

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2018

Serum parathyroid hormone is associated with increased cortical porosity of the inner transitional zone at the proximal femur in postmenopausal women: the Tromsø Study

Teriparatide for treatment of patients with bisphosphonate-associated atypical fracture of the femur

Reviewers 2017

Geisinger high-risk osteoporosis clinic (HiROC): 2013–2015 FLS performance analysis

Two threshold levels of vitamin D and the prevalence of comorbidities in outpatients of a tertiary hospital

Osteoporosis and bone mineral density in patients with Wilson’s disease: a systematic review and meta-analysis