Journal List > J Nutr Health > v.49(3) > 1081438

J Nutr Health. 2016 Jun;49(3):165-178. Korean.
Published online June 30, 2016.  https://doi.org/10.4163/jnh.2016.49.3.165
© 2016 The Korean Nutrition Society
Sex- and age group-specific associations between intakes of dairy foods and pulses and bone health in Koreans aged 50 years and older: Based on 2008~2011 Korea National Health and Nutrition Examination Survey
Hyun-Bi Seo and Young-Sun Choi
Department of Food and Nutrition, Daegu University, Gyeongbuk 38453, Korea.

To whom correspondence should be addressed. tel: +82-53-850-6833 Email: yschoi@daegu.ac.kr
Received March 16, 2016; Revised May 16, 2016; Accepted May 19, 2016.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Purpose

This study was performed to examine associations of intakes of milk and dairy products, pulses, and soy foods with bone health in Koreans aged 50 yr and older.

Methods

A total of 3,201 men and 3,581 women aged 50 yr and older who participated in the 2008~2011 Korea National Health and Nutrition Examination Survey were grouped by sex and age groups of 50~64 yr and 65 yr and older. Subjects within each sex and age group were divided into three bone health groups: normal, osteopenia, and osteoporosis groups based on bone mineral density. Intakes of nutrients and foods derived from 24-hour recall data were compared among three bone health groups. Associations between intake frequencies of foods, including milk, yogurt, tofu, or soy milk, and osteoporosis risk were evaluated based on confounding risk factor-adjusted logistic regression.

Results

Calcium intake was in the order of normal, osteopenia, and osteoporosis in men (p < 0.01) and women (p < 0.05) aged 50~64 yr as well as in men aged 65 yr and older (p < 0.001). In women aged 50~64 yr, intake of milk and dairy products was lower in the osteoporosis group (p < 0.01) as compared with the osteopenia group. Intake of pulses or tofu was not significantly different among bone health groups. Odds ratio (OR) for milk intake frequency (≥ 2 times/week) compared to intake frequency less than 1 time/month was 0.45 (95% CI 0.24~0.85, p for trend = 0.022) in men aged 65 yr and older. The OR for yogurt intake frequency (1 time/month~1 time/week) was 0.47 (95% CI 0.30~0.73, p for trend = 0.019) in women aged 50~64 yr. Intake frequency of tofu or soy milk was not associated with reduced risk of osteoporosis in all groups.

Conclusion

Dairy food intake was significantly associated with bone health, and its effect was sex- and age group-specific, whereas soy food intake was not. Dietary intervention to prevent osteoporosis would be effective for women aged 50~64 yr old and for men aged 65 yr and older.

Keywords: dairy; milk; soy foods; bone health; osteoporosis

Tables


Table 1
Age and anthropometric measurements of subjects depending on bone health status
Click for larger image


Table 2
Nutrient intakes of subjects depending on bone health status
Click for larger image


Table 3
Intakes of milk and dairy products and pulses of subjects depending on bone health status (g/day)
Click for larger image


Table 4
Correlation coefficients between calcium intake and dairy foods and pulses intake
Click for larger image


Table 5
Odds ratios (ORs) for osteoporosis of subjects depending on quartile level of calcium intake
Click for larger image


Table 6
Odds ratios (ORs) for osteoporosis of subjects depending on milk intake frequency
Click for larger image


Table 7
Odds ratios (ORs) for osteoporosis of subjects depending on yogurt intake frequency
Click for larger image


Table 8
Odds ratios (OR) for osteoporosis of subjects depending on tofu intake frequency
Click for larger image


Table 9
Odds ratios (ORs) for osteoporosis of subjects depending on soy milk intake frequency
Click for larger image


Table 10
Serum 25-hydroxy vitamin D levels in subjects depending on bone health status
Click for larger image

Notes

This research was supported by the Daegu University Research Grant, 2013.

References
1. Lee J, Jang S. A study on reference values and prevalence of osteoporosis in Korea: the Korea National Health and Nutrition Examination Survey 2008-2011. J Korean Official Stat 2013;18(2):42–65.
2. Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium. Dietary reference intakes for calcium and vitamin D. Washington (D.C.): National Academies Press; 2011.
3. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2013: Korea National Health and Nutrition Examination Survey (KNHANES VI-1). Cheongju: Korea Centers for Disease Control and Prevention; 2014.
4. Weinsier RL, Krumdieck CL. Dairy foods and bone health: examination of the evidence. Am J Clin Nutr 2000;72(3):681–689.
5. Michaëlsson K, Wolk A, Langenskiöld S, Basu S, Warensjö Lemming E, Melhus H, Byberg L. Milk intake and risk of mortality and fractures in women and men: cohort studies. BMJ 2014;349:g6015.
6. Heaney RP. Dairy and bone health. J Am Coll Nutr 2009;28 Suppl 1:82S–90S.
7. Ma DF, Qin LQ, Wang PY, Katoh R. Soy isoflavone intake increases bone mineral density in the spine of menopausal women: meta-analysis of randomized controlled trials. Clin Nutr 2008;27(1):57–64.
8. Liu J, Ho SC, Su YX, Chen WQ, Zhang CX, Chen YM. Effect of long-term intervention of soy isoflavones on bone mineral density in women: a meta-analysis of randomized controlled trials. Bone 2009;44(5):948–953.
9. Korea Health Industry Development Institute. National food & nutrition statistics 2011: based on 2011 Korea National Health and Nutrition Examination Survey. Cheongwon: Korea Health Industry Development Institute; 2013.
10. Mun SO, Kim J, Yang YJ. Factors associated with bone mineral density in Korean postmenopausal women aged 50 years and above: using 2008-2010 Korean National Health and Nutrition Examination Survey. Korean J Community Nutr 2013;18(2):177–186.
11. Go G, Tserendejid Z, Lim Y, Jung S, Min Y, Park H. The association of dietary quality and food group intake patterns with bone health status among Korean postmenopausal women: a study using the 2010 Korean National Health and Nutrition Examination Survey Data. Nutr Res Pract 2014;8(6):662–669.
12. Shin CS, Choi HJ, Kim MJ, Kim JT, Yu SH, Koo BK, Cho HY, Cho SW, Kim SW, Park YJ, Jang HC, Kim SY, Cho NH. Prevalence and risk factors of osteoporosis in Korea: a communitybased cohort study with lumbar spine and hip bone mineral density. Bone 2010;47(2):378–387.
13. Kim YR, Lee TY, Lee JH. Age-related bone mineral density, accumulated bone loss rate at multiple skeletal sites in Korean men. J Korea Acad Ind Coop Soc 2014;15(6):3781–3788.
14. Kweon S, Kim Y, Jang MJ, Kim Y, Kim K, Choi S, Chun C, Khang YH, Oh K. Data resource profile: the Korea National Health and Nutrition Examination Survey (KNHANES). Int J Epidemiol 2014;43(1):69–77.
15. Hannan MT, Felson DT, Dawson-Hughes B, Tucker KL, Cupples LA, Wilson PW, Kiel DP. Risk factors for longitudinal bone loss in elderly men and women: the Framingham Osteoporosis Study. J Bone Miner Res 2000;15(4):710–720.
16. Choi HJ, Lee DJ. Age-related change of spinal bone mineral density and accumulated bone loss rate in women. J Korean Soc Menopause 2003;9(2):171–176.
17. Lee S, Jang S, Jung D, Lee J. Reconsideration of the mechanical loading hypothesis: is obesity protective against osteoporosis? J Korean Official Stat 2014;19(2):1–29.
18. Bendavid EJ, Shan J, Barrett-Connor E. Factors associated with bone mineral density in middle-aged men. J Bone Miner Res 1996;11(8):1185–1190.
19. Reid IR. Fat and bone. Arch Biochem Biophys 2010;503(1):20–27.
20. Kim JH, Choi HJ, Kim MJ, Shin CS, Cho NH. Fat mass is negatively associated with bone mineral content in Koreans. Osteoporos Int 2012;23(7):2009–2016.
21. Chung JE, Hwang SJ, Kim MJ, Song JY, Cho HH, Kwon DJ, Lew YO, Lim YT, Kim EJ, Kim JH, Kim JH, Kim MR. Relationship between body composition and bone mineral density in pre- and post-menopausal women. J Korean Soc Menopause 2010;16(1):29–38.
22. Tucker KL, Hannan MT, Chen H, Cupples LA, Wilson PW, Kiel DP. Potassium, magnesium, and fruit and vegetable intakes are associated with greater bone mineral density in elderly men and women. Am J Clin Nutr 1999;69(4):727–736.
23. Lim HJ. A study on the calcium and sodium intakes and urinary calcium excretion of adults in Busan. Korean J Community Nutr 2011;16(2):215–226.
24. Lim YS, Lee SW, Tserendejid Z, Jeong SY, Go G, Park HR. Prevalence of osteoporosis according to nutrient and food group intake levels in Korean postmenopausal women: using the 2010 Korea National Health and Nutrition Examination Survey Data. Nutr Res Pract 2015;9(5):539–546.
25. Kim KH, Lee K, Ko YJ, Kim SJ, Oh SI, Durrance DY, Yoo D, Park SM. Prevalence, awareness, and treatment of osteoporosis among Korean women: the Fourth Korea National Health and Nutrition Examination Survey. Bone 2012;50(5):1039–1047.
26. Hong H, Kim EK, Lee JS. Effects of calcium intake, milk and dairy product intake, and blood vitamin D level on osteoporosis risk in Korean adults: analysis of the 2008 and 2009 Korea National Health and Nutrition Examination Survey. Nutr Res Pract 2013;7(5):409–417.
27. Kanis JA, Johansson H, Oden A, De Laet C, Johnell O, Eisman JA, Mc Closkey E, Mellstrom D, Pols H, Reeve J, Silman A, Tenenhouse A. A meta-analysis of milk intake and fracture risk: low utility for case finding. Osteoporos Int 2005;16(7):799–804.
28. Sahni S, Tucker KL, Kiel DP, Quach L, Casey VA, Hannan MT. Milk and yogurt consumption are linked with higher bone mineral density but not with hip fracture: the Framingham Offspring Study. Arch Osteoporos 2013;8:119.
29. Kim YR, Nam HS, Lee TY. Soy protein consumption and bone mineral density in early postmenopausal Korean women. J Korea Acad Ind Coop Soc 2012;13(10):4711–4716.
30. Somekawa Y, Chiguchi M, Ishibashi T, Aso T. Soy intake related to menopausal symptoms, serum lipids, and bone mineral density in postmenopausal Japanese women. Obstet Gynecol 2001;97(1):109–115.
31. Kim JI, Kang MJ. Recent consumption and physiological status of vitamin D in Korean population. Food Ind Nutr 2012;17(2):7–10.
32. Nakamura K, Saito T, Oyama M, Oshiki R, Kobayashi R, Nishiwaki T, Nashimoto M, Tsuchiya Y. Vitamin D sufficiency is associated with low incidence of limb and vertebral fractures in community-dwelling elderly Japanese women: the Muramatsu Study. Osteoporos Int 2011;22(1):97–103.
33. Woo J, Lau E, Swaminathan R, Pang CP, MacDonald D. Biochemical predictors for osteoporotic fractures in elderly Chinese--a longitudinal study. Gerontology 1990;36(1):55–58.
34. Scragg R, Camargo CA Jr. Frequency of leisure-time physical activity and serum 25-hydroxyvitamin D levels in the US population: results from the Third National Health and Nutrition Examination Survey. Am J Epidemiol 2008;168(6):577–586.
35. Yoon JS, Song MK. Vitamin D intake, outdoor activity time and serum 25-OH vitamin D concentrations of Korean postmenopausal women by season and by age. Korean J Community Nutr 2015;20(2):120–128.
36. McCabe LD, Martin BR, McCabe GP, Johnston CC, Weaver CM, Peacock M. Dairy intakes affect bone density in the elderly. Am J Clin Nutr 2004;80(4):1066–1074.
37. Yoon SS. Review: Distribution, lactose malabsorption, and alleviation strategies of lactose intolerance. J Korean Dairy Technol Sci Assoc 2009;27(2):55–62.