Abstract
The relationship between osteoporosis and lactose intolerance is unclear. This study aims to evaluate the association between self-reported lactose intolerance and symptom severity caused by lactose malabsorption and bone mineral density (BMD). A total of 496 American hip arthroplasty patients took part in this study. Information on BMD and socio-demographic factors were retrospectively extracted from medical records. BMD of the lumbar spine (LS), femoral neck of the operative hip (FNOH), and femoral neck of the non-operative hip (FNH) were measured via dual-energy x-ray absorptiometry scans (DXA). Patients also completed a survey regarding dietary and lifestyle habits from the time of surgery. We found that 9.3% of participants reported lactose intolerance and 33.3%% suffered from either osteopenia or osteoporosis in at least one (location). The population that did not self-identify as lactose intolerant consumed significantly more dairy (p < 0.0001) and animal protein (p = 0.004) than those with intolerance. There was no significant difference in BMD between self-identified lactose intolerant individuals and non-lactose intolerant individuals. In a stepwise multiple regression analysis, body mass index (BMI) and age were the only common predictors of BMD for all locations (p < 0.05). However, yogurt intake was a significant predictor of BMD of FNOH in the multivariate analysis. This study suggests that lactose intolerance is not associated with bone mineral density. We also found that being vegan or vegetarian may increase the risk of low BMD.
Highlights
Osteoporosis is a skeletal disorder defined by bone mass degradation [1], creating irreversible changes in bone structure and increasing fracture vulnerability [2]
Individuals with lactose intolerance did not significantly differ from those without lactose intolerance regarding most of the variables assessed with the exception of vitamin D supplementation, consumption of food fortified with calcium, dairy, and protein
Individuals without lactose intolerance were more likely to take vitamin D supplements and consume food fortified with calcium at least once a week and report a higher intake of dairy consumption and animal protein
Summary
Osteoporosis is a skeletal disorder defined by bone mass degradation [1], creating irreversible changes in bone structure and increasing fracture vulnerability [2]. Osteoporosis is a silent disease [3]. That does not elicit symptoms before a fracture occurs [1]. Nearly 200 million people are affected by low bone mass, attributing to 8.9 million fractures each year [3]. By the year 2050, fracture rates are expected to increase by 240% in women and 310% in men [4]. 5964 disability-adjusted life years (DALYs) were lost in North America and Europe due to hip fractures [5], attributable to 0.21% of the total global burden of disease [6]. The financial and social burden posed by this condition impels a clear understanding of the risk factors involved in its development so that preventative measures may be implemented
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