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Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women.

Abstract

BACKGROUND

Short trials of calcium supplementation show that it reduces loss of bone density in postmenopausal women; longer observational studies do not generally find a lower risk of hip fracture with higher-calcium diets. Fewer studies have focused on vitamin D in preventing postmenopausal osteoporosis or fractures.

OBJECTIVE

We assessed relations between postmenopausal hip fracture risk and calcium, vitamin D, and milk consumption.

DESIGN

In an 18-y prospective analysis in 72 337 postmenopausal women, dietary intake and nutritional supplement use were assessed at baseline in 1980 and updated several times during follow-up. We identified 603 incident hip fractures resulting from low or moderate trauma. Relative risks (RRs) from proportional hazards models were controlled for other dietary and nondietary factors.

RESULTS

Women consuming > or = 12.5 microg vitamin D/d from food plus supplements had a 37% lower risk of hip fracture (RR = 0.63; 95% CI: 0.42, 0.94) than did women consuming < 3.5 microg/d. Total calcium intake was not associated with hip fracture risk (RR = 0.96; 95% CI: 0.68, 1.34 for > or = 1200 compared with < 600 mg/d). Milk consumption was also not associated with a lower risk of hip fracture (P for trend = 0.21).

CONCLUSIONS

An adequate vitamin D intake is associated with a lower risk of osteoporotic hip fractures in postmenopausal women. Neither milk nor a high-calcium diet appears to reduce risk. Because women commonly consume less than the recommended intake of vitamin D, supplement use or dark fish consumption may be prudent.

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  • Authors+Show Affiliations

    ,

    Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA. diane.feskanich@channing.harvard.edu

    ,

    Source

    MeSH

    Animals
    Bone Density
    Calcium, Dietary
    Cohort Studies
    Diet
    Dietary Supplements
    Female
    Hip Fractures
    Humans
    Longitudinal Studies
    Middle Aged
    Milk
    Osteoporosis, Postmenopausal
    Postmenopause
    Proportional Hazards Models
    Prospective Studies
    Risk Factors
    Surveys and Questionnaires
    Vitamin D

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    12540414

    Citation

    Feskanich, Diane, et al. "Calcium, Vitamin D, Milk Consumption, and Hip Fractures: a Prospective Study Among Postmenopausal Women." The American Journal of Clinical Nutrition, vol. 77, no. 2, 2003, pp. 504-11.
    Feskanich D, Willett WC, Colditz GA. Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women. Am J Clin Nutr. 2003;77(2):504-11.
    Feskanich, D., Willett, W. C., & Colditz, G. A. (2003). Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women. The American Journal of Clinical Nutrition, 77(2), pp. 504-11.
    Feskanich D, Willett WC, Colditz GA. Calcium, Vitamin D, Milk Consumption, and Hip Fractures: a Prospective Study Among Postmenopausal Women. Am J Clin Nutr. 2003;77(2):504-11. PubMed PMID: 12540414.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women. AU - Feskanich,Diane, AU - Willett,Walter C, AU - Colditz,Graham A, PY - 2003/1/24/pubmed PY - 2003/2/25/medline PY - 2003/1/24/entrez SP - 504 EP - 11 JF - The American journal of clinical nutrition JO - Am. J. Clin. Nutr. VL - 77 IS - 2 N2 - BACKGROUND: Short trials of calcium supplementation show that it reduces loss of bone density in postmenopausal women; longer observational studies do not generally find a lower risk of hip fracture with higher-calcium diets. Fewer studies have focused on vitamin D in preventing postmenopausal osteoporosis or fractures. OBJECTIVE: We assessed relations between postmenopausal hip fracture risk and calcium, vitamin D, and milk consumption. DESIGN: In an 18-y prospective analysis in 72 337 postmenopausal women, dietary intake and nutritional supplement use were assessed at baseline in 1980 and updated several times during follow-up. We identified 603 incident hip fractures resulting from low or moderate trauma. Relative risks (RRs) from proportional hazards models were controlled for other dietary and nondietary factors. RESULTS: Women consuming > or = 12.5 microg vitamin D/d from food plus supplements had a 37% lower risk of hip fracture (RR = 0.63; 95% CI: 0.42, 0.94) than did women consuming < 3.5 microg/d. Total calcium intake was not associated with hip fracture risk (RR = 0.96; 95% CI: 0.68, 1.34 for > or = 1200 compared with < 600 mg/d). Milk consumption was also not associated with a lower risk of hip fracture (P for trend = 0.21). CONCLUSIONS: An adequate vitamin D intake is associated with a lower risk of osteoporotic hip fractures in postmenopausal women. Neither milk nor a high-calcium diet appears to reduce risk. Because women commonly consume less than the recommended intake of vitamin D, supplement use or dark fish consumption may be prudent. SN - 0002-9165 UR - https://www.unboundmedicine.com/medline/citation/12540414/full_citation L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/77.2.504 DB - PRIME DP - Unbound Medicine ER -