University of Maryland, College Park, MD, USA.
Ascenian Consulting, Rochester, NY, USA.
J Nutr Sci. 2023 Sep 11;12:e96. doi: 10.1017/jns.2023.63. eCollection 2023.
Previous studies on the relationship between dairy consumption and hip fracture risk have reported inconsistent findings. Therefore, we aimed to conduct an algorithmically driven non-linear dose-response meta-analysis of studies assessing dairy intake and risk of developing incident hip fracture. Meta-analysis from PubMed and Google Scholar searches for articles of prospective studies of dairy intake and risk of hip fracture, supplemented by additional detailed data provided by authors. Meta-regression derived dose-response relative risks, with comprehensive algorithm-driven dose assessment across the entire dairy consumption spectrum for non-linear associations. Review of studies published in English from 1946 through December 2021. A search yielded 13 studies, with 486 950 adults and 15 320 fractures. Non-linear dose models were found to be empirically superior to a linear explanation for the effects of milk. Milk consumption was associated with incrementally higher risk of hip fractures up to an intake of 400 g/d, with a 7 % higher risk of hip fracture per 200 g/d of milk (RR 1⋅07, 95 % CI 1⋅05, 1⋅10; < 0⋅0001), peaking with 15 % higher risk (RR 1⋅15, 95 % CI 1⋅09, 1⋅21, < 0⋅0001) at 400 g/d versus 0 g/d. Although there is a dose-risk attenuation above 400 g/d, milk consumption nevertheless continued to exhibit elevated risk of hip fracture, compared to zero intake, up to 750 g/d. Meanwhile, the analysis of five cohort studies of yoghurt intake per 250 g/d found a linear inverse association with fracture risk (RR 0⋅85, 95 % CI 0⋅82, 0⋅89), as did the five studies of cheese intake per 43 g/d (~1 serving/day) (RR 0⋅81, 95 % CI 0⋅72, 0⋅92); these studies did not control for socioeconomic status. However, no apparent association between total dairy intake and hip fracture (RR per 250 g/d of total dairy = 0⋅97, 95 % CI 0⋅93, 1⋅004; = 0⋅079). There were both non-linear effects and overall elevated risk of hip fracture associated with greater milk intake, while lower risks of hip fracture were reported for higher yoghurt and cheese intakes.
先前关于乳制品摄入与髋部骨折风险之间关系的研究结果并不一致。因此，我们旨在通过对评估乳制品摄入量与髋部骨折发病风险的前瞻性研究进行算法驱动的非线性剂量反应荟萃分析，来解决这一问题。通过对 PubMed 和 Google Scholar 中有关乳制品摄入与髋部骨折风险的文章进行搜索，并结合作者提供的额外详细数据，进行荟萃分析。通过对整个乳制品摄入范围内的综合算法驱动剂量评估，得出剂量反应相对风险的元回归，并得出非线性关联。该研究回顾了 1946 年至 2021 年 12 月期间以英文发表的研究。检索到 13 项研究，涉及 486950 名成年人和 15320 例骨折。研究结果表明，与线性解释相比，非线性剂量模型更能解释牛奶的作用。摄入牛奶与髋部骨折风险呈递增关系，每天摄入 400 克牛奶，髋部骨折风险增加 7%（RR 1.07，95%CI 1.05，1.10；<0.0001），摄入 400 克牛奶与 0 克牛奶相比，髋部骨折风险增加 15%（RR 1.15，95%CI 1.09，1.21，<0.0001）。尽管每天摄入 400 克以上牛奶时，剂量与风险之间的关联会减弱，但与零摄入相比，摄入 750 克/天以内的牛奶仍会增加髋部骨折的风险。同时，对 5 项关于酸奶摄入量（每天 250 克）的队列研究的分析显示，与骨折风险呈线性负相关（RR 0.85，95%CI 0.82，0.89），对奶酪摄入量（每天 43 克/份，约 1 份/天）的 5 项研究也发现了类似的线性负相关（RR 0.81，95%CI 0.72，0.92）；这些研究没有控制社会经济地位。然而，总体上，全脂乳制品摄入量与髋部骨折之间没有明显的关联（RR 每天 250 克全脂乳制品=0.97，95%CI 0.93，1.004；=0.079）。摄入更多牛奶与髋部骨折的风险呈非线性相关，且总体风险增加，而摄入更多酸奶和奶酪与髋部骨折的风险降低。
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