Abstract
OBJECTIVES: This study examined whether higher intakes of milk and other calcium-rich foods during adult years can reduce the risk of osteoporotic fractures. METHODS: This was a 12-year prospective study among 77761 women, aged 34 through 59 years in 1980, who had never used calcium supplements. Dietary intake was assessed with a food-frequency questionnaire in 1980, 1984, and 1986. Fractures of the proximal femur (n = 133) and distal radius (n = 1046) from low or moderate trauma were self-reported on biennial questionnaires. RESULTS: We found no evidence that higher intakes of milk or calcium from food sources reduce fracture incidence. Women who drank two or more glasses of milk per day had relative risks of 1.45 for hip fracture (95% confidence interval [CI] = 0.87, 2.43) and 1.05 for forearm fracture (95% CI = 0.88, 1.25) when compared with women consuming one glass or less per week. Likewise, higher intakes of total dietary calcium or calcium from dairy foods were not associated with decreased risk of hip or forearm fracture. CONCLUSIONS: These data do not support the hypothesis that higher consumption of milk or other food sources of calcium by adult women protects against hip or forearm fractures.
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Selected References
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- Abelow B. J., Holford T. R., Insogna K. L. Cross-cultural association between dietary animal protein and hip fracture: a hypothesis. Calcif Tissue Int. 1992 Jan;50(1):14–18. doi: 10.1007/BF00297291. [DOI] [PubMed] [Google Scholar]
- Baran D., Sorensen A., Grimes J., Lew R., Karellas A., Johnson B., Roche J. Dietary modification with dairy products for preventing vertebral bone loss in premenopausal women: a three-year prospective study. J Clin Endocrinol Metab. 1990 Jan;70(1):264–270. doi: 10.1210/jcem-70-1-264. [DOI] [PubMed] [Google Scholar]
- Barrett-Connor E., Chang J. C., Edelstein S. L. Coffee-associated osteoporosis offset by daily milk consumption. The Rancho Bernardo Study. JAMA. 1994 Jan 26;271(4):280–283. doi: 10.1001/jama.1994.03510280042030. [DOI] [PubMed] [Google Scholar]
- Chapuy M. C., Arlot M. E., Duboeuf F., Brun J., Crouzet B., Arnaud S., Delmas P. D., Meunier P. J. Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med. 1992 Dec 3;327(23):1637–1642. doi: 10.1056/NEJM199212033272305. [DOI] [PubMed] [Google Scholar]
- Colditz G. A., Martin P., Stampfer M. J., Willett W. C., Sampson L., Rosner B., Hennekens C. H., Speizer F. E. Validation of questionnaire information on risk factors and disease outcomes in a prospective cohort study of women. Am J Epidemiol. 1986 May;123(5):894–900. doi: 10.1093/oxfordjournals.aje.a114319. [DOI] [PubMed] [Google Scholar]
- Cumming R. G. Calcium intake and bone mass: a quantitative review of the evidence. Calcif Tissue Int. 1990 Oct;47(4):194–201. doi: 10.1007/BF02555919. [DOI] [PubMed] [Google Scholar]
- Cummings S. R., Black D. M., Nevitt M. C., Browner W. S., Cauley J. A., Genant H. K., Mascioli S. R., Scott J. C., Seeley D. G., Steiger P. Appendicular bone density and age predict hip fracture in women. The Study of Osteoporotic Fractures Research Group. JAMA. 1990 Feb 2;263(5):665–668. [PubMed] [Google Scholar]
- Cummings S. R., Nevitt M. C., Browner W. S., Stone K., Fox K. M., Ensrud K. E., Cauley J., Black D., Vogt T. M. Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group. N Engl J Med. 1995 Mar 23;332(12):767–773. doi: 10.1056/NEJM199503233321202. [DOI] [PubMed] [Google Scholar]
- Curhan G. C., Willett W. C., Rimm E. B., Stampfer M. J. A prospective study of dietary calcium and other nutrients and the risk of symptomatic kidney stones. N Engl J Med. 1993 Mar 25;328(12):833–838. doi: 10.1056/NEJM199303253281203. [DOI] [PubMed] [Google Scholar]
- Dawson-Hughes B. Calcium supplementation and bone loss: a review of controlled clinical trials. Am J Clin Nutr. 1991 Jul;54(1 Suppl):274S–280S. doi: 10.1093/ajcn/54.1.274S. [DOI] [PubMed] [Google Scholar]
- Dawson-Hughes B., Dallal G. E., Krall E. A., Sadowski L., Sahyoun N., Tannenbaum S. A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women. N Engl J Med. 1990 Sep 27;323(13):878–883. doi: 10.1056/NEJM199009273231305. [DOI] [PubMed] [Google Scholar]
- Dawson-Hughes B., Jacques P., Shipp C. Dietary calcium intake and bone loss from the spine in healthy postmenopausal women. Am J Clin Nutr. 1987 Oct;46(4):685–687. doi: 10.1093/ajcn/46.4.685. [DOI] [PubMed] [Google Scholar]
- Elders P. J., Netelenbos J. C., Lips P., van Ginkel F. C., Khoe E., Leeuwenkamp O. R., Hackeng W. H., van der Stelt P. F. Calcium supplementation reduces vertebral bone loss in perimenopausal women: a controlled trial in 248 women between 46 and 55 years of age. J Clin Endocrinol Metab. 1991 Sep;73(3):533–540. doi: 10.1210/jcem-73-3-533. [DOI] [PubMed] [Google Scholar]
- Ettinger B., Genant H. K., Cann C. E. Postmenopausal bone loss is prevented by treatment with low-dosage estrogen with calcium. Ann Intern Med. 1987 Jan;106(1):40–45. doi: 10.7326/0003-4819-106-1-40. [DOI] [PubMed] [Google Scholar]
- Farmer M. E., White L. R., Brody J. A., Bailey K. R. Race and sex differences in hip fracture incidence. Am J Public Health. 1984 Dec;74(12):1374–1380. doi: 10.2105/ajph.74.12.1374. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fehily A. M., Coles R. J., Evans W. D., Elwood P. C. Factors affecting bone density in young adults. Am J Clin Nutr. 1992 Sep;56(3):579–586. doi: 10.1093/ajcn/56.3.579. [DOI] [PubMed] [Google Scholar]
- Feskanich D., Willett W. C., Stampfer M. J., Colditz G. A. Protein consumption and bone fractures in women. Am J Epidemiol. 1996 Mar 1;143(5):472–479. doi: 10.1093/oxfordjournals.aje.a008767. [DOI] [PubMed] [Google Scholar]
- Heaney R. P. Nutritional factors in bone health in elderly subjects: methodological and contextual problems. Am J Clin Nutr. 1989 Nov;50(5 Suppl):1182–1235. doi: 10.1093/ajcn/50.5.1182. [DOI] [PubMed] [Google Scholar]
- Heikinheimo R. J., Inkovaara J. A., Harju E. J., Haavisto M. V., Kaarela R. H., Kataja J. M., Kokko A. M., Kolho L. A., Rajala S. A. Annual injection of vitamin D and fractures of aged bones. Calcif Tissue Int. 1992 Aug;51(2):105–110. doi: 10.1007/BF00298497. [DOI] [PubMed] [Google Scholar]
- Holbrook T. L., Barrett-Connor E., Wingard D. L. Dietary calcium and risk of hip fracture: 14-year prospective population study. Lancet. 1988 Nov 5;2(8619):1046–1049. doi: 10.1016/s0140-6736(88)90065-7. [DOI] [PubMed] [Google Scholar]
- Hu J. F., Zhao X. H., Jia J. B., Parpia B., Campbell T. C. Dietary calcium and bone density among middle-aged and elderly women in China. Am J Clin Nutr. 1993 Aug;58(2):219–227. doi: 10.1093/ajcn/58.2.219. [DOI] [PubMed] [Google Scholar]
- Hu J. F., Zhao X. H., Parpia B., Campbell T. C. Dietary intakes and urinary excretion of calcium and acids: a cross-sectional study of women in China. Am J Clin Nutr. 1993 Sep;58(3):398–406. doi: 10.1093/ajcn/58.3.398. [DOI] [PubMed] [Google Scholar]
- Hui S. L., Slemenda C. W., Johnston C. C., Jr Baseline measurement of bone mass predicts fracture in white women. Ann Intern Med. 1989 Sep 1;111(5):355–361. doi: 10.7326/0003-4819-111-5-355. [DOI] [PubMed] [Google Scholar]
- Johnston C. C., Jr, Miller J. Z., Slemenda C. W., Reister T. K., Hui S., Christian J. C., Peacock M. Calcium supplementation and increases in bone mineral density in children. N Engl J Med. 1992 Jul 9;327(2):82–87. doi: 10.1056/NEJM199207093270204. [DOI] [PubMed] [Google Scholar]
- Looker A. C., Harris T. B., Madans J. H., Sempos C. T. Dietary calcium and hip fracture risk: the NHANES I Epidemiologic Follow-Up Study. Osteoporos Int. 1993 Jul;3(4):177–184. doi: 10.1007/BF01623673. [DOI] [PubMed] [Google Scholar]
- Matković V., Kostial K., Simonović I., Buzina R., Brodarec A., Nordin B. E. Bone status and fracture rates in two regions of Yugoslavia. Am J Clin Nutr. 1979 Mar;32(3):540–549. doi: 10.1093/ajcn/32.3.540. [DOI] [PubMed] [Google Scholar]
- Murphy S., Khaw K. T., May H., Compston J. E. Milk consumption and bone mineral density in middle aged and elderly women. BMJ. 1994 Apr 9;308(6934):939–941. doi: 10.1136/bmj.308.6934.939. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nelson M. E., Fisher E. C., Dilmanian F. A., Dallal G. E., Evans W. J. A 1-y walking program and increased dietary calcium in postmenopausal women: effects on bone. Am J Clin Nutr. 1991 May;53(5):1304–1311. doi: 10.1093/ajcn/53.5.1304. [DOI] [PubMed] [Google Scholar]
- Paganini-Hill A., Chao A., Ross R. K., Henderson B. E. Exercise and other factors in the prevention of hip fracture: the Leisure World study. Epidemiology. 1991 Jan;2(1):16–25. doi: 10.1097/00001648-199101000-00004. [DOI] [PubMed] [Google Scholar]
- Parfitt A. M. Trabecular bone architecture in the pathogenesis and prevention of fracture. Am J Med. 1987 Jan 26;82(1B):68–72. doi: 10.1016/0002-9343(87)90274-9. [DOI] [PubMed] [Google Scholar]
- Recker R. R., Heaney R. P. The effect of milk supplements on calcium metabolism, bone metabolism and calcium balance. Am J Clin Nutr. 1985 Feb;41(2):254–263. doi: 10.1093/ajcn/41.2.254. [DOI] [PubMed] [Google Scholar]
- Reid I. R., Ames R. W., Evans M. C., Gamble G. D., Sharpe S. J. Effect of calcium supplementation on bone loss in postmenopausal women. N Engl J Med. 1993 Feb 18;328(7):460–464. doi: 10.1056/NEJM199302183280702. [DOI] [PubMed] [Google Scholar]
- Riis B., Thomsen K., Christiansen C. Does calcium supplementation prevent postmenopausal bone loss? A double-blind, controlled clinical study. N Engl J Med. 1987 Jan 22;316(4):173–177. doi: 10.1056/NEJM198701223160401. [DOI] [PubMed] [Google Scholar]
- Salvini S., Hunter D. J., Sampson L., Stampfer M. J., Colditz G. A., Rosner B., Willett W. C. Food-based validation of a dietary questionnaire: the effects of week-to-week variation in food consumption. Int J Epidemiol. 1989 Dec;18(4):858–867. doi: 10.1093/ije/18.4.858. [DOI] [PubMed] [Google Scholar]
- Sandler R. B., Slemenda C. W., LaPorte R. E., Cauley J. A., Schramm M. M., Barresi M. L., Kriska A. M. Postmenopausal bone density and milk consumption in childhood and adolescence. Am J Clin Nutr. 1985 Aug;42(2):270–274. doi: 10.1093/ajcn/42.2.270. [DOI] [PubMed] [Google Scholar]
- Smith E. L., Gilligan C., Smith P. E., Sempos C. T. Calcium supplementation and bone loss in middle-aged women. Am J Clin Nutr. 1989 Oct;50(4):833–842. doi: 10.1093/ajcn/50.4.833. [DOI] [PubMed] [Google Scholar]
- Soroko S., Holbrook T. L., Edelstein S., Barrett-Connor E. Lifetime milk consumption and bone mineral density in older women. Am J Public Health. 1994 Aug;84(8):1319–1322. doi: 10.2105/ajph.84.8.1319. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stracke H., Renner E., Knie G., Leidig G., Minne H., Federlin K. Osteoporosis and bone metabolic parameters in dependence upon calcium intake through milk and milk products. Eur J Clin Nutr. 1993 Sep;47(9):617–622. [PubMed] [Google Scholar]
- Wickham C. A., Walsh K., Cooper C., Barker D. J., Margetts B. M., Morris J., Bruce S. A. Dietary calcium, physical activity, and risk of hip fracture: a prospective study. BMJ. 1989 Oct 7;299(6704):889–892. doi: 10.1136/bmj.299.6704.889. [DOI] [PMC free article] [PubMed] [Google Scholar]