高乳制品摄入量与维生素 D 充足的成年人的骨密度较高有关：来自波士顿波多黎各骨质疏松症研究的结果。
Higher Dairy Intakes Are Associated with Higher Bone Mineral Density among Adults with Sufficient Vitamin D Status: Results from the Boston Puerto Rican Osteoporosis Study.
机构信息
Department of Biomedical and Nutritional Sciences, University of Massachusetts-Lowell, Lowell, MA.
Institute for Aging Research, Hebrew SeniorLife, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
出版信息
J Nutr. 2019 Jan 1;149(1):139-148. doi: 10.1093/jn/nxy234.
BACKGROUND
Dairy foods have been shown to improve bone mineral density (BMD) in non-Hispanic whites. Puerto Rican adults have a higher prevalence of osteoporosis and vitamin D deficiency than non-Hispanic whites. However, there is little understanding of lifestyle influences on bone in this population.
OBJECTIVE
The aim of this study was to examine associations of dairy intakes with BMD among adults from the Boston Puerto Rican Osteoporosis Study with and without adequate serum vitamin D status.
METHODS
A total of 904 participants in this cross-sectional analysis provided dietary intakes with a culturally tailored food-frequency questionnaire. Dairy food groups were calculated [total dairy, modified dairy (without cream or dairy desserts), fluid dairy (milk + yogurt), cheese, yogurt, and cream and desserts]. BMD (grams per centimeter squared) was measured using dual-energy X-ray absorptiometry. Vitamin D status was defined as sufficient (serum 25-hydroxyvitamin D [25(OH)D] ≥20 ng/mL) or insufficient (<20 ng/mL). General linear models were used to examine associations between dairy intake and BMD, stratified by vitamin D status.
RESULTS
Of the total sample, 73% were women, of whom 87% were postmenopausal. Mean ± SD age was 60.0 ± 7.6 y and mean ± SD body mass index (kg/m2) was 32.3 ± 6.6. Mean serum 25(OH)D (range: 4-48 ng/mL) was 14.3 ± 3.6 ng/mL in insufficient individuals and 26.0 ± 5.5 ng/mL in sufficient individuals. In the full sample, higher intakes of modified dairy foods (β = 0.0015, P = 0.02) and milk (β = 0.0018, P = 0.04) were associated with higher femoral neck (FN) BMD. Among those who were vitamin D sufficient, higher intakes of total dairy (P = 0.03-0.07), fluid dairy (P = 0.01-0.05), and milk (P = 0.02-0.09) were significantly related to higher FN and lumbar spine BMD, respectively. Among vitamin D-insufficient participants, dairy intakes were not associated with BMD (P-range = 0.11-0.94).
CONCLUSIONS
Dairy food intakes were associated with higher BMD among adults, particularly those with sufficient vitamin D status. Future studies should confirm findings longitudinally and assess culturally acceptable lifestyle interventions to improve bone health among Hispanic adults. This trial was registered at clinicaltrials.gov as NCT01231958.
背景
乳制品已被证明可提高非西班牙裔白种人的骨密度（BMD）。波多黎各成年人骨质疏松症和维生素 D 缺乏的患病率高于非西班牙裔白种人。然而，对于这一人群的骨骼，人们对生活方式的影响知之甚少。
目的
本研究旨在检查在波士顿波多黎各骨质疏松症研究中，有和没有足够血清维生素 D 状态的成年人中，乳制品摄入量与 BMD 的相关性。
方法
本横断面分析共纳入 904 名参与者，他们提供了文化适应的食物频率问卷中的饮食摄入量。乳制品食物组计算[总乳制品、改良乳制品（不含奶油或乳制品甜点）、液体乳制品（牛奶+酸奶）、奶酪、酸奶和奶油及甜点]。使用双能 X 射线吸收法测量 BMD（每平方厘米克数）。维生素 D 状态定义为充足（血清 25-羟维生素 D [25(OH)D]≥20ng/mL）或不足（<20ng/mL）。使用一般线性模型，按维生素 D 状态分层，检验乳制品摄入量与 BMD 之间的关系。
结果
在总样本中，73%为女性，其中 87%为绝经后女性。平均年龄±标准差为 60.0±7.6 岁，平均体重指数（kg/m2）为 32.3±6.6。血清 25(OH)D（范围：4-48ng/mL）在维生素 D 不足者中为 14.3±3.6ng/mL，在充足者中为 26.0±5.5ng/mL。在全样本中，较高的改良乳制品（β=0.0015，P=0.02）和牛奶（β=0.0018，P=0.04）摄入量与股骨颈（FN）BMD 较高有关。在维生素 D 充足的人群中，较高的总乳制品（P=0.03-0.07）、液体乳制品（P=0.01-0.05）和牛奶（P=0.02-0.09）摄入量分别与 FN 和腰椎 BMD 升高显著相关。在维生素 D 不足的参与者中，乳制品摄入量与 BMD 无关（P 值范围为 0.11-0.94）。
结论
乳制品摄入量与成年人的 BMD 较高有关，尤其是维生素 D 状态充足的成年人。未来的研究应从纵向角度证实这一发现，并评估可接受的文化生活方式干预措施，以改善西班牙裔成年人的骨骼健康。该试验在 clinicaltrials.gov 上注册为 NCT01231958。
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