Impact of whole dairy matrix on musculoskeletal health and aging–current knowledge and research gaps

Abstract

Dairy products are included in dietary guidelines worldwide, as milk, yoghurt, and cheese are good sources of calcium and protein, vital nutrients for bones and muscle mass maintenance. Bone growth and mineralization occur during infancy and childhood, peak bone mass being attained after early adulthood. A low peak bone mass has consequences later in life, including increased risk of osteoporosis and fractures. Currently, more than 200 million people worldwide suffer from osteoporosis, with approximately 9 million fractures yearly. This poses a tremendous economic burden on health care. Between 5% and 10% of the elderly suffer from sarcopenia, the loss of muscle mass and strength, further increasing the risk of fractures due to falls. Evidence from interventional and observational studies support that fermented dairy products in particular exert beneficial effects on bone growth and mineralization, attenuation of bone loss, and reduce fracture risk. The effect cannot be explained by single nutrients in dairy, which suggests that a combined or matrix effect may be responsible similar to the matrix effects of foods on cardiometabolic health. Recently, several plant-based beverages and products have become available and marketed as substitutes for dairy products, even though their nutrient content differs substantially from dairy. Some of these products have been fortified, in efforts to mimic the nutritional profile of milk, but it is unknown whether the additives have the same bioavailability and beneficial effect as dairy. We conclude that the dairy matrix exerts an effect on bone and muscle health that is more than the sum of its nutrients, and we suggest that whole foods, not only single nutrients, need to be assessed in future observational and intervention studies of health outcomes. Furthermore, the importance of the matrix effect on health outcomes argues in favor of making future dietary guidelines food based. Keywords Bone. Cheese. Fermented dairy products. Milk. Muscle Abbreviations BMD Bone mineral density BMC Bone mineral content Ca Calcium Ca:P Calcium-to-phosphorus ratio CHD Coronary heart disease The original version of this article was revised due to a retrospective Open Access order.

The Associations between Dairy Product Consumption and Biomarkers of Inflammation, Adipocytokines, and Oxidative Stress in Children: A Cross-Sectional Study

“…Although the mechanistic pathways by which milk might alleviate inflammation is not completely understood, milk contains nutrients such as calcium, vitamin D, bio active peptides, and linoleic acid, which possess anti-inflammatory properties and act in distinct pathways to mitigate inflammation [ 34 , 35 , 36 ]. However, recent evidence indicates that the impact of dairy on health outcomes cannot be attributed to a single element present in dairy, and the overall nutrient composition or so-called the matrix effect needs to be considered [ 37 ]. Nevertheless, we did not find an association between milk intakes and other inflammatory markers i.e., hs-CRP, IL-6, or adiponectin in children.…”

The Role of Milk Components, Pro-, Pre-, and Synbiotic Foods in Calcium Absorption and Bone Health Maintenance

“…The main components of dairy that have been shown to affect the human health are protein (from whey, casein, fragments), fat [saturated/unsaturated, short chain fatty acids (SCFA)], minerals (calcium, magnesium, phosphate), sodium, and sugars (lactose, galactose, glucose) as well as the components of the milk fat globule membrane (MFGM) (i.e., the biological membrane surrounding the lipid droplets in milk) ( 4 ). The final dairy product nutritional value tends to be determined by the milk-based source (age, mammalian-type, feed and lactation stage), processing/preparation type (storage condition, temperature and heat duration) as well as the fermentation and cultures used and any additives ( 5 ). Table 1 shows a list of controlled trials using dairy products to mitigate bone loss and support bone health in adults.…”

Milk Consumption for the Prevention of Fragility Fractures

“…The potential bias by the corporate funding of trials or even speaker fees or travel grants should not be neglected [ 141 , 142 , 143 ]. Of 22 review articles (in English, found in PubMed by the search term “review AND (milk OR dairy) AND (osteoporosis OR fracture)” and limited to those papers with milk, dairy, or other dairy products in the titles published in 2016–2020) published in the past years, 13 papers [ 144 , 145 , 146 , 147 , 148 , 149 , 150 , 151 , 152 , 153 , 154 , 155 , 156 ] were written by at least one author with links to the dairy industry or dairy associations, whereas the authors of nine papers [ 4 , 9 , 10 , 157 , 158 , 159 , 160 , 161 , 162 ] did not report any such conflicts of interest. Although not explored, the proportion of opinion papers, comments, and letters to the editors with conflicts of interest is likely to be higher.…”