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Milk intake and risk of mortality and fractures in women and men: cohort studies

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g6015 (Published 28 October 2014) Cite this as: BMJ 2014;349:g6015

Rapid Response:

We read with interest your article regarding milk intake and associations with various morbidities. The results were unexpected and raise concern regarding potential implications towards a decrease in milk intake that may not be appropriate. Previously published meta-analysis analyzing milk intake and fractures, cardiovascular disease, and mortality showed no apparent patterns towards increase in fractures or mortality. [1,2,3]

There are several confounders missing from the study that may bias results in these cohorts. Food intake, specifically red meat consumption, vegetable intake and alcohol consumption may have added valuable information. Family history, gravity and parity, and genetic variability also need to be considered. In addition, it is unpredictable whether the model relating negative effects of D-galactose seen in the animal model described can be translated to the human metabolism and cannot be concluded as such.

The published negative results of milk intake above 3 glasses per day yield potential harms including development of other vitamin deficiencies due to the 22 other essential nutrients that milk contains. [4] As an observational study, results published have limits of applicability not only to other ethnic populations but may be so biased as to be inapplicable to the presented cohorts; data need to be interpreted with significant caution and should not change dietary practice at this time.

1 Bischoff-Ferrari HA, Dawson-Hughes B, baron JA, Kanis JA, Orav EJ, Staehelin HB et al. Milk intake and risk of hip fracture in men and women: a meta-analysis of prospective cohort studies. J Bone Miner Res 2011;26:833-839.

2 Kanis JA, Johansson H, Oden A, De Laet C, Johnell O, Eisman JA, et al. A meta-analysis of milk intake and fracture risk: low utility for case finding. Osteoporos Int 2005;16:799-804.

3 Soedamah-Muthu SS, Ding EL, Al-Delaimy WK, Hu FB, Engberink MF, Willett WC, et al. Milk and dairy consumption and incidence of cardiobascular diseases and all-cause mortality: dose-response meta-analysis of prospective cohort studies. Am J Clin Nutri. 2011;93:158-171.

4 Heaney RP. Dairy and bone health. J Am Coll Nutr 2009;28:82S-90S.

Competing interests: No competing interests

01 December 2014
Margaret Dziadosz
Fellow; Maternal Fetal Medicine
Laxmi Baxi, MD
New York University Langone Medical Center
149 E 33rd St