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Dairy consumption and bone health

Purdue University Department of Foods and Nutrition 1264 Stone Hall West Lafayette, IN 47907-1264

Dear Sir:

In a recent review article that examined the evidence of a link between dairy foods and bone health, Weinsier and Krumdieck (1) conclude that "the body of scientific evidence appears inadequate to support a recommendation for daily intake of dairy foods to promote bone health in the general US population." They base their conclusions on a division of studies into those that showed a favorable effect of dairy food intake on bone health and those that did not. They prioritized studies according to the strength of the evidence. Category A studies (the strongest) were randomized controlled trials or longitudinal cohorts with 3000 participants who were followed for >5 y. However, these 2 types of studies are not equivalent. Observational studies can accurately assess the outcome measures of bone mineral density or fracture, but their ability to assess dietary intakes is weak. Large size does not overcome that weakness; it merely adds a spurious sense of accuracy. The number of epidemiologic studies that did not show a significant relation is not surprising considering the weak ability to determine the independent variable.

Observational studies of the effect of folate on neural tube defects showed a pattern nearly identical to that found for calcium. It was the randomized controlled trials that confirmed the importance of increasing folate intake during the reproductive years.

If only randomized controlled trials were assigned to category A, then studies showing a favorable relation between dairy food intake and bone health would number 5 and span age groups ranging from 11 y through menopause. Studies showing an unfavorable effect of dairy food intake on bone health would have no category A studies.

Thus, using the same evidence as that used by the authors, we conclude that adequate dairy consumption is supportive of good bone health. One of us recently reviewed this same literature and came to just that conclusion (2).

REFERENCES

1. Weinsier RL, Krumdieck CL. Dairy foods and bone health: examination of the evidence. Am J Clin Nutr 2000;72:681–9.[Abstract/Free Full Text]
2. Heaney RP. Calcium, dairy, products and osteoporosis. J Am Coll Nutr 2000;19:83S–99S.[Abstract/Free Full Text]

This article has been cited by other articles:

				L. D McCabe, B. R Martin, G. P McCabe, C. C Johnston, C. M Weaver, and M. Peacock Dairy intakes affect bone density in the elderly Am. J. Clinical Nutrition, October 1, 2004; 80(4): 1066 - 1074. [Abstract] [Full Text] [PDF]

This Article Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Weaver, C. M Articles by Heaney, R. P Search for Related Content PubMed PubMed Citation Articles by Weaver, C. M Articles by Heaney, R. P Agricola Articles by Weaver, C. M Articles by Heaney, R. P