Milk and Health

Willett, Walter C.; Ludwig, David S.

doi:10.1056/nejmra1903547

Cited by 137 publications

(110 citation statements)

References 103 publications

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“…Not all of the available information supports the idea of a high intake of dairy products being beneficial for bone [20]. In the US, data from the NHANES III population-based survey, including a cohort of nearly 10,000 women and men, showed no correlation between calcium intake and BMD at the hip site, and the correlation was more applicable for subjects with higher levels of 25(OH)D [21].…”

Section: Calcium Vitamin D and Dairy Productsmentioning

confidence: 99%

Nutrients and Dietary Patterns Related to Osteoporosis

2020

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Osteoporosis is a common chronic disease characterized by a decrease in bone mineral density, impaired bone strength, and an increased risk of fragility fractures. Fragility fractures are associated with significant morbidity, mortality and disability and are a major public health problem worldwide. The influence of nutritional factors on the development and progression of this disease can be significant and is not yet well established. Calcium intake and vitamin D status are considered to be essential for bone metabolism homeostasis. However, some recent studies have questioned the usefulness of calcium and vitamin D supplements in decreasing the risk of fractures. The adequate intake of protein, vegetables and other nutrients is also of interest, and recommendations have been established by expert consensus and clinical practice guidelines. It is important to understand the influence of nutrients not only in isolation but also in the context of a dietary pattern, which is a complex mixture of nutrients. In this review, we evaluate the available scientific evidence for the effects of the main dietary patterns on bone health. Although some dietary patterns seem to have beneficial effects, more studies are needed to fully elucidate the true influence of diet on bone fragility.

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Section: Calcium Vitamin D and Dairy Productsmentioning

confidence: 99%

Nutrients and Dietary Patterns Related to Osteoporosis

2020

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“…The phrase "milk gives you strong bones" has been used in promotional campaigns both in Sweden and in the US. In contrast, ecological studies show that countries with the highest calcium and total milk product intakes have the highest fracture rates [4]. Different milk products are frequently considered as one entity in cohort studies.…”

Section: Introductionmentioning

confidence: 99%

Milk Consumption for the Prevention of Fragility Fractures

Byberg

Lemming

2020

Nutrients

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Results indicating that a high milk intake is associated with both higher and lower risks of fragility fractures, or that indicate no association, can all be presented in the same meta-analysis, depending on how it is performed. In this narrative review, we discuss the available studies examining milk intake in relation to fragility fractures, highlight potential problems with meta-analyses of such studies, and discuss potential mechanisms and biases underlying the different results. We conclude that studies examining milk and dairy intakes in relation to fragility fracture risk need to study the different milk products separately. Meta-analyses should consider the doses in the individual studies. Additional studies in populations with a large range of intake of fermented milk are warranted.

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“…In contrast, in a large Japanese cohort study, high consumption was related to somewhat lower mortality rates, but the comparison was made between consumption of, on average, half a serving per day (100 mL) and never drinking milk [6]. Hence, there may be a U-or J-shaped pattern of mortality with non-fermented milk consumption and presenting such a pattern as a hazard ratio per unit change is not advisable, an approach commonly used in meta-analysis [1]. If the hazard ratio per unit change is based on a specific milk type by fat content while retaining other non-fermented milk consumption in the analysis, the result will be a severely biased calculation as displayed in the last column of Table 2.…”

Section: Discussionmentioning

confidence: 99%

“…For the ultimate clinically important outcome, time to death, long lasting interventional studies are not feasible. Cohort studies have provided mixed results, with some presenting lower, some null, and some higher rates of all-cause mortality with higher milk consumption [1]. Moreover, it is presently unclear whether only high consumption of whole milk is related to mortality or also low-fat milk consumption [2,3].…”

Section: Introductionmentioning

confidence: 99%

Mixing of Apples and Oranges in Milk Research: A Cohort Analysis of Non-Fermented Milk Intake and All-Cause Mortality

Michaëlsson

Byberg

2020

Nutrients

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Mortality in relation to type of milk intake is unclear. We present mortality rates by intake of non-fermented milk fat content type and examine the degree of bias when other fat content types of non-fermented milk are kept in the reference category. For this purpose, we used a longitudinal cohort consisting of 61,433 women who had been administered food frequency questionnaires in 1987–1990 and in 1997, and analyzed time to death. Non-fermented milk consumption was divided into low ≤0.5%, medium 1.5%, or high fat 3%. For each specific type of milk, the first analysis (A) is restricted to those who consumed less than one serving per day of the other milk subtypes. In the second analysis (B), everyone is retained, i.e., leading to a reference category “contaminated” with other milk consumers. During follow-up, 22,391 women died. Highest (≥3 glasses/day) vs. lowest consumption category of milk (<1 glass/day) with 0.5% fat content was associated with a multivariable hazard ratio (HR) of 1.71 (95%CI 1.57–1.86) in analysis A, whereas the same comparison with a “contaminated” reference category in analysis B provided a HR of 1.34 (95%CI 1.24–1.45), p-value for homogeneity <0.0001. The corresponding HRs for 1.5% fat milk were: 1.82 (95%CI 1.63–2.04) and 1.38 (95%CI 1.25–1.51), and for 3% fat milk 1.95 (95%CI 1.77–2.15) and 1.40 (95%CI 1.29–1.52). HR for ≥3 glasses/day of total milk was 1.95 (95%CI 1.84–2.06). We observe a higher mortality in women with high milk consumption, irrespective of milk fat content. A “contaminated” reference group substantially attenuates the actual estimates.

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Milk and Health

Cited by 137 publications

References 103 publications

Nutrients and Dietary Patterns Related to Osteoporosis

Nutrients and Dietary Patterns Related to Osteoporosis

Milk Consumption for the Prevention of Fragility Fractures

Mixing of Apples and Oranges in Milk Research: A Cohort Analysis of Non-Fermented Milk Intake and All-Cause Mortality

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