Sahni Shivani, Mangano Kelsey M, Kiel Douglas P, Tucker Katherine L, Hannan Marian T
Institute for Aging Research, Hebrew SeniorLife, Boston, MA;
Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; and.
J Nutr. 2017 Apr;147(4):645-652. doi: 10.3945/jn.116.240390. Epub 2017 Mar 1.
Previous studies showed beneficial effects of specific dairy foods on bone health in middle-aged adults. We examined the association of milk, yogurt, cheese, cream, fluid dairy (milk + yogurt), and milk + yogurt + cheese intakes with bone mineral density (BMD) and 4-y percentage of change in BMD [▵%BMD; femoral neck, trochanter, and lumbar spine (LS)]. We further assessed whether these associations were modified by vitamin D supplement use in this cohort of older adults. Food-frequency questionnaire responses, baseline BMD (hip and spine, = 862 in 1988-1989), and follow-up BMD ( = 628 in 1992-1993) were measured in the Framingham study, a prospective cohort study of older Caucasian men and women aged 67-93 y. Outcomes included baseline BMD and ▵%BMD. Dairy-food intakes (servings per week) were converted to energy-adjusted residuals, and linear regression was used, adjusting for covariates. These associations were further examined by vitamin D supplement use. The mean age of the participants was 75 y. In the full sample, dairy-food items were not associated with BMD ( = 0.11-0.99) or with ▵%BMD ( = 0.29-0.96). Among vitamin D supplement users, but not among nonusers, higher milk, fluid dairy, and milk + yogurt + cheese intakes were associated with higher LS BMD ( = 0.011-0.009). Among vitamin D supplement users, but not among nonusers, higher milk + yogurt + cheese intakes were protective against trochanter BMD loss ( = 0.009). In this population of older adults, higher intakes of milk, fluid dairy, and milk + yogurt + cheese were associated with higher LS BMD, and a higher intake of milk + yogurt + cheese was protective against trochanter BMD loss among vitamin D supplement users but not among nonusers. These findings underscore that the benefits of dairy intake on the skeleton may be dependent on vitamin D intake.
以往研究表明，特定乳制品对中年成年人的骨骼健康有益。我们研究了牛奶、酸奶、奶酪、奶油、液态乳制品（牛奶 + 酸奶）以及牛奶 + 酸奶 + 奶酪的摄入量与骨矿物质密度（BMD）以及BMD的4年变化百分比[Δ%BMD；股骨颈、大转子和腰椎（LS）]之间的关联。我们进一步评估了在这个老年人群队列中，这些关联是否会因维生素D补充剂的使用而改变。在弗雷明汉姆研究中测量了食物频率问卷回答、基线BMD（髋部和脊柱，1988 - 1989年时n = 862）以及随访BMD（1992 - 1993年时n = 628），该研究是一项针对67 - 93岁老年白人男性和女性的前瞻性队列研究。结局指标包括基线BMD和Δ%BMD。将乳制品摄入量（每周份数）转换为能量调整残差，并使用线性回归，对协变量进行调整。通过维生素D补充剂的使用进一步研究这些关联。参与者的平均年龄为75岁。在整个样本中，乳制品与BMD（P = 0.11 - 0.99）或Δ%BMD（P = 0.29 - 0.96）均无关联。在维生素D补充剂使用者中，但非使用者中并非如此，较高的牛奶、液态乳制品以及牛奶 + 酸奶 + 奶酪摄入量与较高的腰椎BMD相关（P = 0.011 - 0.009）。在维生素D补充剂使用者中，但非使用者中并非如此，较高的牛奶 + 酸奶 + 奶酪摄入量可预防大转子BMD丢失（P = 0.009）。在这个老年人群中，较高的牛奶、液态乳制品以及牛奶 + 酸奶 + 奶酪摄入量与较高的腰椎BMD相关，并且较高的牛奶 + 酸奶 + 奶酪摄入量在维生素D补充剂使用者中可预防大转子BMD丢失，但在非使用者中并非如此。这些发现强调，乳制品摄入对骨骼的益处可能取决于维生素D的摄入。
