Association Between Dietary Calcium Intake, Dairy Product Consumption and Body Composition Indices in Healthy Postmenopausal Women: A Cross‐Sectional Analysis
Authors: Ong Angel M. , Weiler Hope A. , Wall Michelle , Daskalopoulou Stella S. , Goltzman David , Morin Suzanne N. 
Published: November 2023

Evidence on the inverse association between dietary calcium (dCa) and body composition has been inconsistent. The objective of this study was to examine the association between dCa intake, dairy product consumption and body composition indices (BCI) in healthy postmenopausal women. Baseline data of 91 women participating in a randomized controlled trial (RCT) that aims to evaluate the effect of dCa as compared to supplemental Ca intake on vascular health (ClinicalTrial.Gov NCT0173140) were analyzed. All were ≥50 y, non‐users of Ca or vitamin D supplements at baseline, with a BMI >19 and <35 kg/m2. A validated 51‐item semi‐quantitative food frequency questionnaire was administered to assess usual dCa, dietary vitamin D and dairy product intakes over the preceding month. Body mass index (BMI) was calculated from measured height and weight. Body fat mass (FM), percent body fat (%BF), and fat‐free mass (FFM) were measured by bioelectrical impedance analysis using a body composition analyzer in “standard mode” (Tanita TBF‐310). FM index (FMI) and FFM index (FFMI) were calculated. Physical activity level (PAL) was assessed using the International Physical Activity Questionnaire. Intakes were categorized into two groups as below or above the observed median. Differences in means of BCI between groups of dCa (<850 or ≥850 mg/d), total dairy products (<1.5 or ≥1.5 servings/d), milk (<0.5 or ≥0.5 serving/d), yogurt (<0.5 or ≥0.5 serving/d), and cheese (<0.5 or ≥0.5 serving/d) consumption were analyzed using a one‐way analysis of covariance after adjustment for age, dietary vitamin D intake and PAL. Participants were 60±6 y with a mean BMI of 25.5±3.9 kg/m2 and a median PAL of 2487 MET‐mins/week (interquartile range [IQR] 1535–4753). Median dCa intake was 846 mg/d (IQR 605–1072). Daily median servings of total dairy products, milk, yogurt and cheese were 1.59 (IQR 0.97–2.48), 0.5 (IQR 0.07–0.93), 0.43 (IQR 0.12–0.74), and 0.51 (IQR 0.29–0.84), respectively. There were no differences in BCI between groups of dCa intake or total dairy product consumption (Table 1). No differences were found between groups of milk or yogurt consumption and BCI (Table 2). However, there was a lower mean %BF (33.0% vs 35.8%, p=0.03) and FM (21.8% vs 25.0%, p=0.045) in cheese intake ≥0.5 serving/d compared to the group with <0.5 serving/d of cheese intake. Although dCa and total dairy product intakes were not associated with body composition, our results suggest that cheese intake may be inversely associated with adiposity in healthy postmenopausal women. Our ongoing RCT with a larger sample will enable a better evaluation of the association between dCa and BCI as compared to dairy and supplemental Ca in this population.Support or Funding InformationThis work was supported by funding from the Canadian Institutes of Health Research and the Dairy Farmers of Canada. The funding agencies did not have a role in design, implementation, analysis or interpretation.
Adjusted means (95% confidence interval) of body composition indices between dietary calcium intake groups and groups of dairy consumption‡

Dietary calcium
Dairy

<850 mg/d (n=48)
≥850 mg/d (n=43)
p‐value
<1.5 servings/d (n=43)
≥1.5 servings/d (n=48)
p‐value

BMI (kg/m2)
25.8 (24.6, 27.0)
25.2 (23.9, 26.5)
0.52
26.2 (25.0, 27.4)
25.0 (23.8, 26.1)
0.17

%BF
34.9 (32.9, 36.8)
33.9 (31.8, 35.9)
0.53
35 (33.0, 36.9)
33.9 (32.0, 35.7)
0.43

FM (kg)
24.1 (21.8, 26.4)
22.6 (20.1, 25.0)
0.41
24.5 (22.2, 26.8)
22.4 (20.2, 24.6)
0.22

FFM (kg)
42.6 (41.7, 43.6)
43 (41.9, 44.0)
0.67
43 (42.0, 44.0)
42.6 (41.7, 43.6)
0.60

FMI
9.3 (8.4, 10.2)
8.7 (7.8, 9.7)
0.43
9.5 (8.6, 10.4)
8.6 (7.8, 9.5)
0.20

FFMI
16.6 (16.1, 17.0)
16.5 (16.0, 16.9)
0.81
16.7 (16.3, 17.2)
16.3 (15.9, 16.7)
0.18

BMI, body mass index; %BF, percent body fat; FM, body fat mass; FFM, fat‐free mass; FMI, fat mass index; FFMI, fat‐free mass index.
Analysis of covariance adjusted for age, dietary vitamin D intake and physical activity level.

Adjusted means (95% confidence interval) of body composition indices between groups of milk, yogurt and cheese consumption‡

Milk
Yogurt
Cheese

<0.5 servings/day (n=45)
≥0.5 servings/day (n=46)
<0.5 servings/day (n=49)
≥0.5 servings/day (n=42)
<0.5 servings/day (n=45)
≥0.5 servings/day (n=46)

BMI (kg/m2)
25.4 (24.2, 26.6)
25.7 (24.5, 26.9)
25.7 (24.6, 26.8)
25.4 (24.2, 26.6)
25.9 (24.7, 27.0)
25.2 (24.1, 26.4)

%BF
33.1 (31.2, 35.0)
35.7 (33.8, 37.5)
34.6 (32.8, 36.4)
34.2 (32.2, 36.1)
35.8 (34.1, 37.6)
33.0 (31.2, 34.7)*

FM (kg)
22.3 (20.0, 24.6)
24.4 (22.2, 26.7)
23.5 (21.4, 25.7)
23.2 (20.9, 25.5)
25.0 (22.8, 27.1)
21.8 (19.7, 24.0)**

FFM (kg)
42.9 (41.9, 43.9)
42.7 (41.7, 43.7)
42.4 (41.5, 43.3)
43.3 (42.3, 44.3)
43.2 (42.3, 44.2)
42.4 (41.4, 43.3)

FFMI
16.7 (16.3, 17.2)
16.3 (15.9, 16.7)
16.6 (16.2, 17.0)
16.5 (16.0, 16.9)
16.4 (16.0, 16.8)
16.6 (16.1, 17.0)

FMI
8.7 (7.8, 9.6)
9.3 (8.5, 10.2)
9.1 (8.3, 10.0)
8.9 (8.0, 9.8)
9.5 (8.6, 10.3)
8.6 (7.7, 9.4)

BMI, body mass index; %BF, percent body fat; FM, body fat mass; FFM, fat‐free mass; FMI, fat mass index; FFMI, fat‐free mass index.
Analysis of covariance adjusted for age, dietary vitamin D intake and physical activity level.
Adjusted mean significantly different from <0.5 cheese servings/d (p=0.03).
Adjusted mean significantly different from <0.5 cheese servings/d (p=0.045).