Department of Endocrinology and Metabolism, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou, 215006, China.
Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, No. 199 Ren'ai Road, Suzhou, 215123, China.
Osteoporos Int. 2020 Aug;31(8):1411-1425. doi: 10.1007/s00198-020-05383-3. Epub 2020 May 7.
In the present meta-analysis, reductions in the risk of hip fracture with milk consumption were only observed among American adults, but not among Scandinavian adults, possibly because milk products are more commonly fortified with vitamin D in the former population than in Scandinavian countries. The reduction in the risk of hip fracture was also observed with yogurt consumption, which is often associated with healthy lifestyles and dietary patterns that contribute to improved bone health.
Although dairy products contain bone-beneficial nutrients, the association between dairy consumption and the risk of hip fracture remains equivocal. Fueling this uncertainty, the elevated risk of hip fracture in association with milk consumption was observed in a cohort of Swedish women. A systematic review and meta-analysis of prospective cohort studies was performed to critically evaluate the association, or lack thereof, between dairy consumption (milk, yogurt, and cheese) and the risk of hip fracture.
A random effects model was used to generate the summary relative risks (RRs) with their 95% confidence intervals (CIs) for the associations of interest.
In the meta-analysis of the highest versus lowest category of consumption, higher consumption of yogurt (RR 0.78, 95% CI 0.68, 0.90), but not milk (RR 0.86, 95% CI 0.73, 1.02) or cheese (RR 0.85, 95% CI 0.66, 1.08), was associated with a lower risk of hip fracture. For milk, the reduced risk of fracture with higher milk consumption was observed in the USA (RR 0.75, 95% CI 0.65, 0.87), but not in Scandinavian countries (RR 1.00, 95% CI 0.85, 1.17). These findings were further supported by the fact that American studies (RR 0.93, 95% CI 0.88, 0.98; per 1 glass/day), but not Scandinavian studies (RR 1.01, 95% CI 0.95, 1.07; per 1 glass/day), demonstrated a linear association between milk consumption and the risk of hip fracture.
The cumulative evidence from prospective cohort studies reassuringly suggests that the risk of hip fracture may not be elevated among people who consume milk, yogurt, and cheese, and that a greater consumption of milk or yogurt may even be associated with a lower risk of hip fracture depending on the factors that may differ across the population of interest.
在本次荟萃分析中，只有美国成年人中观察到牛奶消费降低髋部骨折风险，而斯堪的纳维亚成年人中则没有，这可能是因为前者的牛奶产品比斯堪的纳维亚国家更常添加维生素 D。酸奶消费也观察到髋部骨折风险降低，这与健康的生活方式和饮食模式有关，有助于改善骨骼健康。
尽管乳制品含有对骨骼有益的营养成分，但乳制品消费与髋部骨折风险之间的关联仍存在争议。造成这种不确定性的原因是，在瑞典女性的队列研究中观察到与牛奶消费相关的髋部骨折风险增加。对前瞻性队列研究进行了系统评价和荟萃分析，以严格评估乳制品消费（牛奶、酸奶和奶酪）与髋部骨折风险之间的关联，或缺乏关联。
使用随机效应模型生成相关风险比（RR）及其 95%置信区间（CI），以评估感兴趣的关联。
在最高与最低消费类别的荟萃分析中，较高的酸奶消费（RR0.78，95%CI0.68，0.90），但不是牛奶（RR0.86，95%CI0.73，1.02）或奶酪（RR0.85，95%CI0.66，1.08）与髋部骨折风险降低相关。对于牛奶，在美国（RR0.75，95%CI0.65，0.87），但不是在斯堪的纳维亚国家（RR1.00，95%CI0.85，1.17），较高的牛奶消费与骨折风险降低相关。这些发现进一步得到了以下事实的支持：美国的研究（RR0.93，95%CI0.88，0.98；每 1 杯/天），而不是斯堪的纳维亚的研究（RR1.01，95%CI0.95，1.07；每 1 杯/天），表明牛奶消费与髋部骨折风险之间存在线性关联。
来自前瞻性队列研究的累积证据令人放心地表明，在摄入牛奶、酸奶和奶酪的人群中，髋部骨折的风险可能不会升高，而且摄入更多的牛奶或酸奶甚至可能与髋部骨折风险降低相关，具体取决于不同人群中可能存在差异的因素。
