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Milk intake and bone mineral acquisition in adolescent girls: randomised, controlled intervention trial

BMJ 1997; 315 doi: (Published 15 November 1997) Cite this as: BMJ 1997;315:1255
  1. Joanna Cadogan, research studenta,
  2. Richard Eastell, professorb,
  3. Nicola Jones, research officerc,
  4. Margo E Barker (m.e.barker{at}, lecturera
  1. a Centre for Human Nutrition, University of Sheffield, Northern General Hospital, Sheffield S5 7AU
  2. b Department of Human Metabolism and Clinical Biochemistry, University of Sheffield, Northern General Hospital
  3. c Department of Public Health Medicine, University of Sheffield Medical School, Sheffield S10 2RX
  1. Correspondence to: Dr Barker
  • Accepted 7 July 1997


Objectives: To investigate the effect of milk supplementation on total body bone mineral acquisition in adolescent girls.

Design: 18 month, open randomised intervention trial.

Subjects: 82 white girls aged 12.2 (SD 0.3) years, recruited from four secondary schools in Sheffield.

Intervention: 568 ml (one pint) of whole or reduced fat milk per day for 18 months.

Main outcome measures: Total body bone mineral content and bone mineral density measured by dual energy x ray absorptiometry. Outcome measures to evaluate mechanism included biochemical markers of bone turnover (osteocalcin, bone alkaline phosphatase, deoxypyridinoline, N-telopeptide of type I collagen), and hormones important to skeletal growth (parathyroid hormone, oestradiol, insulin-like growth factor I).

Results: 80 subjects completed the trial. Daily milk intake at baseline averaged 150 ml in both groups. The intervention group consumed, on average, an additional 300 ml a day throughout the trial. Compared with the control group, the intervention group had greater increases of bone mineral density (9.6% v 8.5 %, P=0.017; repeated measures analysis of variance) and bone mineral content (27.0% v 24.1 %, P=0.009). No significant differences in increments in height, weight, lean body mass, and fat mass were observed between the groups. Bone turnover was not affected by milk supplementation. Serum concentrations of insulin-like growth factor I increased in the milk group compared with the control group (35% v 25 %, P=0.02).

Conclusion: Increased milk consumption significantly enhances bone mineral acquisition in adolescent girls and could favourably modify attainment of peak bone mass.

Key messages

  • Osteoporosis is a major public health problem; 40% of women will sustain an osteoporotic fracture

  • Maximising peak bone mass at skeletal maturity may be one of the most important protective measures against fracture in later life

  • Adolescence is a critical time for bone mineral acquisition An increase in milk consumption among adolescent girls resulted in significant gains in bone mineral over an 18 month period

  • This simple intervention indicates that increased milk consumption may be associated with higher peak bone mass


    • Accepted 7 July 1997
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