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

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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.

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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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Authors and Affiliations

  1. WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield , S10 2RX, UK

    John A. Kanis

  2. Gothenburg, Sweden

    Helena Johansson & Anders Oden

  3. Scientific Institute of Public Health, Brussels, Belgium

    Chris De Laet

  4. Department of Orthopaedics, Malmo General Hospital, S-214 01, Malmo, Sweden

    Olof Johnell

  5. Bone and Mineral Research Program, Garvan Institute of Medical Research, St Vincent’s Hospital & University of NSW, Sydney, Australia

    John A. Eisman

  6. Osteoporosis Centre, University of Sheffield, Northern General Hospital, Sheffield, UK

    Eugene McCloskey

  7. Department of Geriatric Medicine, Goteborg University, Gothenburg, Sweden

    Dan Mellstrom

  8. Department of Internal Medicine, Erasmus University, Rotterdam, The Netherlands

    Huibert Pols

  9. Strangeways Research Laboratory, Wort’s Causeway, Cambridge, UK

    Jonathan Reeve

  10. ARC Epidemiology Unit, University of Manchester, Manchester, UK

    Alan Silman

  11. Division of Bone Metabolism, The Montreal General Hospital, Montreal, Canada

    Alan Tenenhouse

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  1. John A. Kanis
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Kanis, J.A., Johansson, H., Oden, A. et al. A meta-analysis of milk intake and fracture risk: low utility for case finding. Osteoporos Int 16, 799–804 (2005). https://doi.org/10.1007/s00198-004-1755-6

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  • DOI: https://doi.org/10.1007/s00198-004-1755-6

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