Dairy improved bones of senior women – if they also had enough vitamin D – Jan 2019

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.

J Nutr. 2019 Jan 1;149(1):139-148. doi: 10.1093/jn/nxy234.

Mangano KM1, Noel SE1, Sahni S2, Tucker KL1.
1 Department of Biomedical and Nutritional Sciences, University of Massachusetts-Lowell, Lowell, MA.
2 Institute for Aging Research, Hebrew SeniorLife, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

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.

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