Milk and other dairy foods and risk of hip fracture in men and women



The role of dairy foods for hip fracture prevention remains controversial. In this study, among US men and women, a glass of milk per day was associated with an 8% lower risk of hip fracture. This contrasts with a reported increased risk with higher milk intake in Swedish women.


The purpose of this study was to examine whether higher milk and dairy food consumption are associated with risk of hip fracture in older adults following a report of an increased risk for milk in Swedish women.


In two US cohorts, 80,600 postmenopausal women and 43,306 men over 50 years of age were followed for up to 32 years. Cox proportional hazards models were used to calculate the relative risks (RR) of hip fracture per daily serving of milk (240 mL) and other dairy foods that were assessed every 4 years, controlling for other dietary intakes, BMI, height, smoking, activity, medications, and disease diagnoses.


Two thousand one hundred thirty-eight incident hip fractures were identified in women and 694 in men. Each serving of milk per day was associated with a significant 8% lower risk of hip fracture in men and women combined (RR = 0.92, 95% confidence interval (CI) 0.87 to 0.97). A suggestive inverse association was found for cheese in women only (RR = 0.91, CI 0.81 to 1.02). Yogurt consumption was low and not associated with risk. Total dairy food intake, of which milk contributed about half, was associated with a significant 6% lower risk of hip fracture per daily serving in men and women (RR = 0.94, CI 0.90 to 0.98). Calcium, vitamin D, and protein from non-dairy sources did not modify the association between milk and hip fracture, nor was it explained by contributions of these nutrients from milk.


In this group of older US adults, higher milk consumption was associated with a lower risk of hip fracture.

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  1. 1.

    Haentjens P, Magaziner J, Colón-Emeric CS, Vanderschueren D, Milisen K, Velkeniers B, Boonen S (2010) Meta-analysis: excess mortality after hip fracture among older women and men. Ann Intern Med 152(6):380–390

    Article  Google Scholar 

  2. 2.

    Wright NC, Looker AC, Saag KG, Curtis JR, Delzell ES, Randall S, Dawson-Hughes B (2014) The recent prevalence of osteoporosis and low bone mass in the United States based on bone mineral density at the femoral neck or lumbar spine. J Bone Miner Res 29(11):2520–2526

    Article  Google Scholar 

  3. 3.

    U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015–2020 Dietary Guidelines for Americans, 8th Edition. December 2015. Available at

  4. 4.

    Kanis JA, Johansson H, Oden A, De Laet C, Johnell O, Eisman JA, Mc Closkey E, Mellstrom D, Pols H, Reeve J, Silman A, Tenenhouse AA (2005) Meta-analysis of milk intake and fracture risk: low utility for case finding. Osteoporos Int 16:799–804

    Article  Google Scholar 

  5. 5.

    Bischoff-Ferrari HA, Dawson-Hughes B, Baron JA, Kanis JA, Orav EJ, Staehelin HB, Kiel DP, Burckhardt P, Henschkowski J, Spiegelman D, Li R, Wong JB, Feskanich D, Willett WC (2011) Milk intake and risk of hip fracture in men and women; a meta-analysis of prospective cohort studies. J Bone Miner Res 26(4):833–839

    CAS  Article  Google Scholar 

  6. 6.

    Sahni S, Mangano KM, Tucker KL, Kiel DP, Casey VA, Hannan MT (2014) Protective association of milk intake on the risk of hip fracture: results from the Framingham original cohort. J Bone Miner Res 29(8):1756–1762

    CAS  Article  Google Scholar 

  7. 7.

    Michaëlsson K, Wolk A, Langenskiöld S, Basu S, Eva Lemming W, Melhus H, Byberg L Milk intake and risk of mortality and fractures in women and men: cohort studies. BMJ 2014;Oct 28 349:g6015

  8. 8.

    Owusu W, Willett WC, Feskanich D, Ascherio A, Spiegelman D, Colditz GA (1997) Calcium intake and the incidence of forearm and hip fractures among men. J Nutr 127(9):1782–1787

    CAS  Article  Google Scholar 

  9. 9.

    Feskanich D, Willett WC, Stampfer MJ, Colditz GA (1997) Milk, dietary calcium, and bone fractures in women: a 12-year prospective study. Am J Public Health 87(6):992–997

    CAS  Article  Google Scholar 

  10. 10.

    Feskanich D, Willett WC, Colditz GA (2003) Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women. Am J Clin Nutr 77(2):504

    CAS  Article  Google Scholar 

  11. 11.

    Stampfer MJ, Willett WC, Speizer FE, Dyserrt DC, Lipnick R, Rosner B, Hennekens CH (1984) Test of the National Death Index. Am J Epidemiol 119(5):837–839

    CAS  Article  Google Scholar 

  12. 12.

    Rich-Edwards JW, Corsano KA, Stampfer MJ (1994) Test of the National Death Index and Equifax Nationwide Death Search. Am J Epidemiol 140(11):10016–10019

    Article  Google Scholar 

  13. 13.

    Colditz GA, Martin P, Stampfer MJ, Willett WC, Sampson L, Rosner B, Hennekens CH, Speizer FE (1986) Validation of questionnaire information on risk factors and disease outcomes in a prospective cohort study of women. Am J Epidemiol 123(5):894–900

    CAS  Article  Google Scholar 

  14. 14.

    Feskanich D, Rimm EB, Giovannucci EL, Colditz GA, Stampfer MJ, Litin LB, Willett WC (1993) Reproducibility and validity of food intake measurements from a semiquantitative food frequency questionnaire. J Am Diet Assoc 93(7):790–796

    CAS  Article  Google Scholar 

  15. 15.

    Salvini S, Hunter DJ, Sampson L, Stampfer MJ, Colditz GA, Rosner B, Willett WC (1989) Food-based validation of a dietary questionnaire: the effects of week-to-week variation in food consumption. Int J Epidemiol 18(4):858–867

    CAS  Article  Google Scholar 

  16. 16.

    Ainsworth BE, Haskell WL, Leon AS, Jacobs DR, Montoye HJ, Sallis JF, Paffenbarger RS (1993) Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sports Exerc 25(1):71–80

    CAS  Article  Google Scholar 

  17. 17.

    Durrleman S, Simon R (1989) Flexible regression models with cubic splines. Stat Med 8:551–561

    CAS  Article  Google Scholar 

  18. 18.

    DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7(3):177–188

    CAS  Article  Google Scholar 

  19. 19.

    Feskanich D, Bischoff-Ferrari HA, Frazier AL, Willett WC (2014) Milk consumption during teenage years and risk of hip fracture in older adults. JAMA Pediatr 168(1):54–60

    Article  Google Scholar 

  20. 20.

    Michaelsson K, Melhus H, Bellocco R, Wolk A (2003) Dietary calcium and vitamin D intake in relation to osteoporotic fracture risk. Bone 32(6):694–703

    CAS  Article  Google Scholar 

  21. 21.

    Cui X, Zuo P, Zhang Q, Li X, Hu Y, Long J, Packer L, Liu J (2006) Chronic systemic D-galactose exposure induces memory loss, neurodegeneration, and oxidative damage in mice: protective effects of R-alpha-lipoic acid. J Neurosci Res 83(8):1584–1590

    CAS  Article  Google Scholar 

  22. 22.

    Hardy R, Cooper MS (2009) Bone loss in inflammatory disorders. J Endocrinol 201(3):309–320

    CAS  Article  Google Scholar 

  23. 23.

    Berglundh S, Malmgren L, Luthman H, McGuigan F, Akesson K (2015) C-reactive protein, bone loss, fracture, and mortality in elderly women: a longitudinal study in the OPRA cohort. Osteoporos Int 26(2):727–735

    CAS  Article  Google Scholar 

  24. 24.

    Roubenoff R (2007) Physical activity, inflammation and muscle loss. Nutr Rev 65(12 suppl 3):S208–S212

    Article  Google Scholar 

  25. 25.

    Abrahamson A. Galactose in dairy products. Available at

  26. 26.

    Ogden, CL, Carroll MD, Fryar CD, Flegal KM (2015) Prevalence of obesity among adults and youth: United States, 2011–2014. NCHS data brief, no. 219. Hyattsville, MD: National Center for Health Statistics

  27. 27.

    Molarius A, Lindén-Boström M, Granström F, Jan Karlsson J (2016) Obesity continues to increase in the majority of the population in mid-Sweden—a 12-year follow-up. Eur J Pub Health 26(4):622–627

    Article  Google Scholar 

  28. 28.

    Kanis JA, Johnell O, De Laet C, Jonsson B, Oden A, Ogelsby AK (2002) International variations in hip fracture probabilities: implications for risk assessment. J Bone Miner Res 17(7):1237

    Article  Google Scholar 

  29. 29.

    Bischoff-Ferrari HA, Willett WC, Wong JB, Stuck AE, Staehelin HB, Orav EJ, Thoma A, Kiel DP, Henschkowski J (2009) Prevention of nonvertebral fractures with oral vitamin D and dose dependency: a meta-analysis of randomized controlled trials. Arch Intern Med 169(6):551

    CAS  Article  Google Scholar 

  30. 30.

    Bischoff-Ferrari HA, Willett WC, Orav EJ, Lips P, Meunier PJ, Lyons RA, Flicker L, Wark J, Jackson RD, Cauley JA, Meyer HE, Pfeifer M, Sanders KM, Stähelin HB, Theiler R, Dawson-Hughes BA (2012) Pooled analysis of vitamin D dose requirements for fracture prevention. N Engl J Med 367(1):40–49

    CAS  Article  Google Scholar 

  31. 31.

    Das UN (2001) Is obesity an inflammatory condition? Nutrition 17(11–12):953–966

    CAS  Article  Google Scholar 

  32. 32.

    Baker-LePain JC, Nakamurab MC, Lane NE (2011) Effects of inflammation on bone: an update. Curr Opin Rheumatol 23(4):389–395

    Article  Google Scholar 

  33. 33.

    Rolland T, Boutroy S, Vilayphiou N, Blaizot S, Chapurlat R, Szulc P (2012) Poor trabecular microarchitecture at the distal radius in older men with increased concentration of high-sensitivity C-reactive protein—the STRAMBO study. Calcif Tissue Int 90(6):496–506

    CAS  Article  Google Scholar 

  34. 34.

    De Laet C, Kanis JA, Odén A, Johanson H, Johnell O, Delmas P, Eisman JA, Kroger H, Fujiwara S, Garnero P, McCloskey EV, Mellstrom D, Melton LJ 3rd, Meunier PJ, Pols HAP, Reeve J, Silman A, Tenenhouse A (2005) Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 16(11):1330–1338

    Article  Google Scholar 

  35. 35.

    Armstrong ME, Spencer EA, Cairns BJ, Banks E, Pirie K, Green J, Wright FL, Reeves GK, Beral V (2011 Jun) Body mass index and physical activity in relation to the incidence of hip fracture in postmenopausal women. J Bone Miner Res 26(6):1330–1338

    Article  Google Scholar 

  36. 36.

    Nielson CM, Marshall LM, Adams AL, LeBlanc ES, Cawthon PM, Ensrud K, Stefanick ML, Barrett-Connor E, Orwoll ES (2011) BMI and fracture risk in older men: the osteoporotic fractures in men study (MrOS). J Bone Miner Res 26(3):496–502

    Article  Google Scholar 

  37. 37.

    Meyer HE, Willett WC, Flint AJ, Feskanich D (2016) Abdominal obesity and hip fracture: results from the Nurses’ Health Study and the Health Professionals Follow-up Study. Osteoporos Int 27(6):2127–2136

    CAS  Article  Google Scholar 

  38. 38.

    Sharples AP, Hughes DC, Deane CS, Saini A, Selman C, Stewart CE (2015) Longevity and skeletal muscle mass: the role of IGF signalling, the sirtuins, dietary restriction and protein intake. Aging Cell 14(4):511–523

    CAS  Article  Google Scholar 

  39. 39.

    Fekete ÁA, Givens DI, Lovegrove JA (2016) Can milk proteins be a useful tool in the management of cardiometabolic health? An updated review of human intervention trials. Proc Nutr Soc 75(3):328–341

    Article  Google Scholar 

  40. 40.

    Barba G, Russo P (2006) Dairy foods, dietary calcium and obesity: a short review of the evidence. Nutr Metab Cardiovasc Dis 16(6):445–451

    Article  Google Scholar 

  41. 41.

    Abargouei AS, Janghorbani M, Salehi-Marzijarani M, Esmaillzadeh A (2012) Effect of dairy consumption on weight and body composition in adults: a systematic review and meta-analysis of randomized controlled clinical trials. Int J Obes 36(12):1485–1493

    CAS  Article  Google Scholar 

  42. 42.

    Booth AO, Huggins CE, Wattanapenpaiboon N, Nowson CA (2015) Effect of increasing dietary calcium through supplements and dairy food on body weight and body composition: a meta-analysis of randomized controlled trials. Brit J Nutr 114(7):1013–1025

    CAS  Article  Google Scholar 

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This study is funded by US National Institutes of Health grants CA186107, CA167552, and AG030521.

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Correspondence to D. Feskanich.

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Feskanich, D., Meyer, H.E., Fung, T.T. et al. Milk and other dairy foods and risk of hip fracture in men and women. Osteoporos Int 29, 385–396 (2018).

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  • Cohort
  • Dairy
  • Hip fracture
  • Men
  • Milk
  • Women