Abstract
The relevance of dairy produce for the diminishment of osteoporotic risk is still a matter of scientific debate due to the outcome of a few single observational studies. This review will address the most robust point estimate on the role of dairy products, as reported in systematic reviews and meta-analyses on randomised controlled trials in the case of bone mineralisation or prospective studies in the case of fracture risk. Plain dairy products or those fortified with Ca and/or vitamin D improve total body bone mineral content (BMC) by 45-50 g over 1 year when the daily baseline Ca intake is lower than 750 mg in Caucasians and Chinese girls. In Caucasian and Chinese women, Ca from (fortified) dairy products increases bone mineral density (BMD) by 0·7-1·8 % over 2 years dependent on the site of measurement. Despite the results on BMC, there are currently no studies that have investigated the potential of dairy products to reduce fracture risk in children. In adult Caucasian women, daily intake of 200-250 ml of milk is associated with a reduction in fracture risk of 5 % or higher. In conclusion, the role of dairy products for BMC or BMD has been sufficiently established in Chinese and Caucasian girls and women. In Caucasian women, drinking milk also reduces fracture risk. More research on the role of dairy products within the context of bone health-promoting diets is needed in specific ethnicities, other than Chinese and Caucasians, and in men.
Highlights
Dairy products provide more bone-beneficial nutrients, such as protein, Ca, Mg, K, Zn and P per unit energy than any other typical food found in the adult diet[1], the relevance of dairy products for the prevention of osteoporotic fractures is still a matter of scientific debate as some large prospective studies have suggested that increased milk consumption during adolescence[2] or adult life[3] may be associated with a higher hip fracture risk in men[2] or women[3]
When other designs were included in the systematic review/meta-analyses, the discussion was restricted to randomised controlled trials (RCT) for bone mineral density (BMD)/bone mineral content (BMC) and prospective studies for fracture risk
Despite the results on BMC, there are currently no studies that have investigated the potential of dairy products to reduce fracture risk in children
Summary
Dairy products provide more bone-beneficial nutrients, such as protein, Ca, Mg, K, Zn and P per unit energy than any other typical food found in the adult diet[1], the relevance of dairy products for the prevention of osteoporotic fractures is still a matter of scientific debate as some large prospective studies have suggested that increased milk consumption during adolescence[2] or adult life[3] may be associated with a higher (future) hip fracture risk in men[2] or women[3]. There is broad consensus that high bone mineral density (BMD) will increase the likelihood of reduced osteoporosis and fracture risk in later life[7]. Maximising bone mineral mass during childhood and adolescence, and achieving the highest possible peak bone mass at the end of the skeleton’s maturation process, may contribute to fracture risk reduction during adolescence and possibly in the elderly. Computer simulations of the bone remodelling process predict that the onset of osteoporosis will be delayed by 13 years[8] and the fracture risk during adult life will be reduced by 50 %(9), if peak bone mass is 10 % higher than the mean and sustained over time. Rizzoli et al[8] described that more than 60 % of the variance of peak bone mass is genetically determined, and that the remainder may be amenable to (lifestyle) interventions such as adequate dietary intake of Ca, protein and vitamin D, as well as regular weight-bearing physical activity[8]
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