Dairy Based Desserts are Negatively Associated with Bone Mineral Density among Puerto Rican Adults
Authors: Mangano Kelsey M , Noel Sabrina E , Bigornia Sherman J , Tucker Katherine L 
Published: November 2023

Background

Dairy foods have been shown to be protective for bone health, as these foods are a rich source of many nutrients known to be beneficial to bone. The majority of research on dairy and bone health has been conducted in Caucasian populations. It is important to study these associations in Latino populations as they are at high risk for developing osteoporosis. Further, their dietary patterns differ from other ethnic populations.

Objective

To examine the association of total dairy and dairy food groups with bone mineral density (BMD) among older Puerto Rican adults from the Boston Puerto Rican Osteoporosis Study, an ancillary study to the Boston Puerto Rican Health Study (BPRHS).

Methods

Diet was assessed at baseline of the BPRHS by a food frequency questionnaire, adapted and validated for use in this population. BMD (g/cm2) was measured by whole body dual energy x‐ray absorptiometry at the hip and lumbar spine, L2–L4 approximately 2y after baseline. Participants were excluded if their t‐scores were greater than −4.0, and/or their total energy intake was >4,800 kcal/d or <600 kcal/d. Therefore, our total sample with bone, diet and covariate measures was 883 for models of the hip and 864 for the lumbar spine. Dairy intake was categorized into four groups: total dairy, fluid dairy (milk and yogurt), cheese, and dairy dessert (combined intake of the following: pudding, ice cream, cheesecake, custard/flan, cream). To account for total energy, all dairy groups were calculated as percentage of total energy intake. Tertiles of each dairy group were created, where tertile 3 (T3) represents the highest intake, and tertile 1 (T1) represents the lowest intake. Generalized linear regression compared adjusted least‐squares mean BMD across tertiles of dairy food groups.

Results

Average age was 60±7y (range: 46–79); average BMI 32±7 kg/m2; and 73% of the sample were women. The median percent energy intake from each dairy group, by tertile was: total dairy, T1 6.0%, T2 11.6%, T3 18.6%; fluid dairy, T1 2.0%, T2 5.9%, T3 11.7%; cheese, T1 0.7%, T2 2.7%, T3 6.0%; dairy dessert, T1 0.1%, T2 0.9%, T3 3.3%. Total dairy intake was not associated with BMD at any site after adjustment for covariates (p‐trend range: 0.43–0.64). In dairy food group analyses, BMD at the hip and spine did not differ across tertiles of fluid dairy intake (p‐trend range: 0.24–0.66) or cheese intake (p‐trend range: 0.16–0.35). A significant, negative association was observed between high intakes of dairy dessert with BMD at the femoral neck (T2vsT1, p=0.02; T3vsT1, p=0.02); total femur (T2vsT1, p=0.02; T3vsT1, p=0.04) and lumbar spine (T3vsT1, p=0.04) (Figure).

Conclusions

Total dairy intake is not associated with BMD in older Puerto Rican adults, despite their relatively high percentage contribution to total energy. However, higher intake of dairy desserts is negatively associated with BMD. Further investigation will explore why dairy desserts contribute to lower BMD in this population.

Support or Funding Information

P01 AG023394P50 HL105185R01 AG027087