Osteoporosis International

, Volume 16, Issue 7, pp 799–804 | Cite as

A meta-analysis of milk intake and fracture risk: low utility for case finding

  • John A. Kanis
  • Helena Johansson
  • Anders Oden
  • Chris De Laet
  • Olof Johnell
  • John A. Eisman
  • Eugene McCloskey
  • Dan Mellstrom
  • Huibert Pols
  • Jonathan Reeve
  • Alan Silman
  • Alan Tenenhouse
Original Article

Abstract

A low intake of calcium is widely considered to be a risk factor for future fracture. The aim of this study was to quantify this risk on an international basis and to explore the effect of age, gender and bone mineral density (BMD) on this risk. We studied 39,563 men and women (69% female) from six prospectively studied cohorts comprising EVOS/EPOS, CaMos, DOES, the Rotterdam study, the Sheffield study and a cohort from Gothenburg. Cohorts were followed for 152,000 person-years. The effect of calcium intake as judged by the intake of milk on the risk of any fracture, any osteoporotic fracture and hip fracture alone was examined using a Poisson model for each sex from each cohort. Covariates examined were age and BMD. The results of the different studies were merged by using the weighted β-coefficients. A low intake of calcium (less than 1 glass of milk daily) was not associated with a significantly increased risk of any fracture, osteoporotic fracture or hip fracture. There was no difference in risk ratio between men and women. When both sexes were combined there was a small but non-significant increase in the risk of osteoporotic and of hip fracture. There was also a small increase in the risk of an osteoporotic fracture with age which was significant at the age of 80 years (RR=1.15; 95% CI=1.02–1.30) and above. The association was no longer significant after adjustment for BMD. No significant relationship was observed by age for low milk intake and hip fracture risk. We conclude that a self-reported low intake of milk is not associated with any marked increase in fracture risk and that the use of this risk indicator is of little or no value in case-finding strategies.

Keywords

Calcium intake Hip fracture Meta-analysis Milk Osteoporotic fracture 

Notes

Acknowledgement

We are grateful to the International Osteoporosis Foundation, the International Society for Clinical Densitometry, the National Osteoporosis Foundation, and the European Community (EU FP 3/5). We acknowledge the Alliance for Better Bone Health, Lunar, Hologic, IGEA, Lilly, Novartis, Pfizer, Roche and Wyeth for their unrestricted support of this work.

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2004

Authors and Affiliations

  • John A. Kanis
    • 1
  • Helena Johansson
    • 2
  • Anders Oden
    • 2
  • Chris De Laet
    • 3
  • Olof Johnell
    • 4
  • John A. Eisman
    • 5
  • Eugene McCloskey
    • 6
  • Dan Mellstrom
    • 7
  • Huibert Pols
    • 8
  • Jonathan Reeve
    • 9
  • Alan Silman
    • 10
  • Alan Tenenhouse
    • 11
  1. 1.WHO Collaborating Centre for Metabolic Bone DiseasesUniversity of Sheffield Medical SchoolSheffield UK
  2. 2.GothenburgSweden
  3. 3.Scientific Institute of Public HealthBrusselsBelgium
  4. 4.Department of OrthopaedicsMalmo General HospitalMalmoSweden
  5. 5.Bone and Mineral Research Program, Garvan Institute of Medical ResearchSt Vincent’s Hospital & University of NSWSydneyAustralia
  6. 6.Osteoporosis Centre, University of SheffieldNorthern General HospitalSheffieldUK
  7. 7.Department of Geriatric MedicineGoteborg UniversityGothenburgSweden
  8. 8.Department of Internal MedicineErasmus UniversityRotterdamThe Netherlands
  9. 9.Strangeways Research LaboratoryCambridgeUK
  10. 10.ARC Epidemiology UnitUniversity of ManchesterManchesterUK
  11. 11.Division of Bone MetabolismThe Montreal General HospitalMontrealCanada

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