Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
Crit Rev Food Sci Nutr. 2020;60(10):1722-1737. doi: 10.1080/10408398.2019.1590800. Epub 2019 Mar 26.
Although some studies have reported the beneficial effects of milk and dairy product consumption on osteoporosis and risk of fracture, the findings are conflicting. We summarized earlier data on the association between milk and dairy intake and risk of osteoporosis and hip fracture through a meta-analysis. A systematic literature search of relevant reports published in PubMed, ISI (Web of Science), EMBASE, SCOPUS, and Google Scholar until August 2018 was conducted. Total dairy intake was protectively associated with reduced risk of osteoporosis based on cross-sectional and case-control studies (0.63; 95% CI: 0.55-0.73). Milk consumption was not associated with the risk of osteoporosis (overall RR = 0.79; 95% CI: 0.57-1.08). In non-linear dose-response meta-analysis, increase intake of dairy (at the level of 0 to 250 grams per day) was associated with a reduced risk of osteoporosis ( = 0.005). Meta-regression of included studies revealed an inverse linear association between dairy and milk intake and risk of osteoporosis; such that every additional 200-gram intake of dairy and milk was associated with a 22% and 37% reduced risk of osteoporosis, respectively. In terms of hip fracture, milk consumption was associated with a 25% reduced risk of hip fracture only in cross-sectional and case-control studies (overall RR = 0.75; 95%CI: 0.57-0.99). In linear meta-regression, every additional 200-gram milk intake per day was associated with a 9% greater risk of hip fracture in cohort studies. Despite an inverse association between milk and dairy intake and risk of osteoporosis and hip fracture in cross-sectional and case-control studies, no such association was seen in cohort studies. Given the advantages of the cohort over case-control studies, we concluded that a greater intake of milk and dairy products was not associated with a lower risk of osteoporosis and hip fracture.
虽然一些研究报告了牛奶和乳制品消费对骨质疏松症和骨折风险的有益影响，但结果存在矛盾。我们通过荟萃分析总结了先前关于牛奶和乳制品摄入与骨质疏松症和髋部骨折风险之间关系的研究数据。对 2018 年 8 月之前在 PubMed、ISI（Web of Science）、EMBASE、SCOPUS 和 Google Scholar 上发表的相关报告进行了系统的文献检索。基于横断面和病例对照研究，总乳制品摄入量与骨质疏松症风险降低呈保护相关（0.63；95%CI：0.55-0.73）。牛奶消费与骨质疏松症风险无关（总 RR = 0.79；95%CI：0.57-1.08）。在非线性剂量反应荟萃分析中，增加乳制品（0 至 250 克/天）的摄入量与骨质疏松症风险降低相关（ = 0.005）。纳入研究的荟萃回归分析显示，乳制品和牛奶摄入量与骨质疏松症风险之间存在负线性关联；即，每额外摄入 200-250 克乳制品和牛奶，骨质疏松症的风险分别降低 22%和 37%。就髋部骨折而言，只有在横断面和病例对照研究中，牛奶消费与髋部骨折风险降低 25%相关（总 RR = 0.75；95%CI：0.57-0.99）。在线性荟萃回归中，每天额外摄入 200 克牛奶与队列研究中髋部骨折风险增加 9%相关。尽管在横断面和病例对照研究中，牛奶和乳制品摄入与骨质疏松症和髋部骨折风险之间存在负相关，但在队列研究中未观察到这种相关性。鉴于队列研究优于病例对照研究，我们得出结论，摄入更多的牛奶和乳制品与降低骨质疏松症和髋部骨折风险无关。
